S&C QCOR ASC 2567s
d QCOR:  Quality, Certification and Oversight Reports.
ASCs 2567s
Selection Criteria

Time Interval

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Provider Characteristics

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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
28C0001042 Innovative Surgical Solutions Llc Dba Columbus Surgery Center 3772 43rd Avenue, Suite B Columbus NE 7 (Kansas City) 12/15/2021 YI2M11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0181 ADMINISTRATION OF DRUGS Standard
28C0001042 Innovative Surgical Solutions Llc Dba Columbus Surgery Center 3772 43rd Avenue, Suite B Columbus NE 7 (Kansas City) 01/16/2019 49S221 Recertification
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0712 Fire Drills Standard
K0920 Electrical Equipment ? Power Cords and Extension Cords Standard
K0923 Electrical Equipment ? Ground-Fault Circuit-Interrupter Protection Standard
28C0001044 Outpatient Surgical Specialties Center Llc 11704 W Center Road, Suite 110 Omaha NE 7 (Kansas City) 01/12/2023 5E7E2-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
Q0266 DISCHARGE - ORDER Standard
28C0001044 Outpatient Surgical Specialties Center Llc 11704 W Center Road, Suite 110 Omaha NE 7 (Kansas City) 01/12/2023 5E7E2-L1 Recertification
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0321 Hazardous Areas - Enclosure Standard
K0341 Fire Alarm System - Installation Standard
K0345 Fire Alarm System - Testing and Maintenance Standard
K0374 Subdivision of Building Spaces ? Smoke Barrier Doors Standard
K0511 Utilities - Gas and Electric Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
28C0001044 Outpatient Surgical Specialties Center Llc 11704 W Center Road, Suite 110 Omaha NE 7 (Kansas City) 07/10/2019 GWEX21 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
K0223 Doors with Self-Closing Devices Standard
K0346 Fire Alarm System - Out of Service Standard
K0929 Gas Equipment ? Precautions for Handling Oxygen Standard
28C0001047 Kearney Eye Surgical Center Inc 411 W 39th Street, Suite 2 Kearney NE 7 (Kansas City) 07/27/2023 5FF0A-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0266 DISCHARGE - ORDER Standard
28C0001047 Kearney Eye Surgical Center Inc 411 W 39th Street, Suite 2 Kearney NE 7 (Kansas City) 07/27/2023 5FF0A-L1 Recertification
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0353 Sprinkler System - Maintenance and Testing Standard
K0761 Maintenance, Inspection & Testing - Doors Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
28C0001047 Kearney Eye Surgical Center Inc 411 W 39th Street, Suite 2 Kearney NE 7 (Kansas City) 12/04/2019 F6XG21 Recertification
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0345 Fire Alarm System - Testing and Maintenance Standard
K0353 Sprinkler System - Maintenance and Testing Standard
K0761 Maintenance, Inspection & Testing - Doors Standard
K0914 Electrical Systems - Maintenance and Testing Standard
28C0001050 Midwest Surgery Center Inc 10784 V Street Omaha NE 7 (Kansas City) 11/30/2022 5DF05-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0266 DISCHARGE - ORDER Standard
28C0001050 Midwest Surgery Center Inc 10784 V Street Omaha NE 7 (Kansas City) 11/28/2022 5DF05-L1 Recertification
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0131 Multiple Occupancies Standard
K0291 Emergency Lighting Standard
K0761 Maintenance, Inspection & Testing - Doors Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
K0923 Electrical Equipment ? Ground-Fault Circuit-Interrupter Protection Standard
K0933 Features of Fire Protection ? Fire Loss Prevention Standard