S&C QCOR ASC 2567s
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ASCs 2567s
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Time Interval

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Provider Characteristics

Use these filters if you want to limit the report to providers that have certain characteristics. To select more than one option, hold down the Ctrl (individual point-and-click) OR Shift keys (select through a range) while you click on the additional desired option(s).

Survey Type & Deficiency Tags

Use these filters if you want to limit the reports to providers on specific survey types, or to reports that were cited for specific ASC deficiency tags and tag types. To select more than one option, hold down the Ctrl (individual point-and-click) OR Shift keys (select through a range) while you click on the additional desired option(s).

CCN and Facility Name

Use these filters if you know the name (or partial name) of the facility you are searching for, or the CMS Certification Number (CCN) for the facility you are searching for.

Other Survey Characteristics

Select one of the options below to filter by surveys that cite deficiencies or by surveys that are deficiency-free. By default, only surveys that cite deficiencies are displayed. Selecting "All" displays all surveys.

CMS Certification Number Facility Name Address City State CMS Region Date of CMS Survey Survey Event ID Survey Type Statement of Deficiencies Report
▼ 28C0001035 Physicians Clinic Inc D/B/A Mpc Colonoscopy Center 9850 Nicholas Street, Suite 100 Omaha NE 7 (Kansas City) 12/07/2022 5E19D-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0062 ANESTHETIC - DISCHARGE Standard
▼ 28C0001035 Physicians Clinic Inc D/B/A Mpc Colonoscopy Center 9850 Nicholas Street, Suite 100 Omaha NE 7 (Kansas City) 12/06/2022 5E19D-L1 Recertification
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0291 Emergency Lighting Standard
K0293 Exit Signage Standard
K0321 Hazardous Areas - Enclosure Standard
K0341 Fire Alarm System - Installation Standard
K0353 Sprinkler System - Maintenance and Testing Standard
K0910 Gas and Vacuum Piped Systems - Modifications Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
K0919 Electrical Equipment - Other Standard
K0920 Electrical Equipment ? Power Cords and Extension Cords Standard
K0923 Electrical Equipment ? Ground-Fault Circuit-Interrupter Protection Standard
▼ 28C0001035 Physicians Clinic Inc D/B/A Mpc Colonoscopy Center 9850 Nicholas Street, Suite 100 Omaha NE 7 (Kansas City) 06/19/2019 118M21 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
K0321 Hazardous Areas - Enclosure Standard
▼ 28C0001035 Physicians Clinic Inc D/B/A Mpc Colonoscopy Center 9850 Nicholas Street, Suite 100 Omaha NE 7 (Kansas City) 06/14/2019 118M11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
Q0062 ANESTHETIC - DISCHARGE Standard
▼ 28C0001036 Oregon Trail Eye Surgery Center, Inc 329 West 40th Street Scottsbluff NE 7 (Kansas City) 06/08/2023 5F5A9-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0061 ANESTHETIC RISK AND EVALUATION Standard
Q0062 ANESTHETIC - DISCHARGE Standard
Q0162 FORM AND CONTENT OF RECORD Standard
▼ 28C0001036 Oregon Trail Eye Surgery Center, Inc 329 West 40th Street Scottsbluff NE 7 (Kansas City) 06/27/2019 4KIQ11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
Q0261 PATIENT ASSESSMENT AND ADMISSION Standard
▼ 28C0001037 Vance Thompson Vision Surgery Center Ne, Llc 4909 South 118th Street Omaha NE 7 (Kansas City) 02/29/2024 61D81-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0065 PHYSICIAN EVALUATION OF RISK Standard
▼ 28C0001037 Vance Thompson Vision Surgery Center Ne, Llc 4909 South 118th Street Omaha NE 7 (Kansas City) 02/27/2024 61D81-L1 Recertification
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0354 Sprinkler System - Out of Service Standard
K0712 Fire Drills Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
K0921 Electrical Equipment ? Testing and Maintenance Requirements Standard
▼ 28C0001037 Vance Thompson Vision Surgery Center Ne, Llc 4909 South 118th Street Omaha NE 7 (Kansas City) 07/29/2020 YQZ421 Recertification
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0200 Means of Egress Requirements - Other Standard
▼ 28C0001038 Advanced Surgery Center, Llc 111 S 10th Street Omaha NE 7 (Kansas City) 06/25/2025 66441-L1 Recertification
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard