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
▼ 28C0001050 Midwest Surgery Center Inc 10784 V Street Omaha NE 7 (Kansas City) 05/31/2019 PXHA11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
Q0109 EMERGENCY EQUIPMENT Standard
▼ 28C0001050 Midwest Surgery Center Inc 10784 V Street Omaha NE 7 (Kansas City) 05/30/2019 PXHA21 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
K0321 Hazardous Areas - Enclosure Standard
K0341 Fire Alarm System - Installation Standard
K0374 Subdivision of Building Spaces ? Smoke Barrier Doors Standard
K0920 Electrical Equipment ? Power Cords and Extension Cords Standard
K0933 Features of Fire Protection ? Fire Loss Prevention Standard
▼ 28C0001054 Southwest Lincoln Surgery Center, Llc Dba Southwest Lincoln Surgery Center 2222 S 16th Street, Suite 315 Lincoln NE 7 (Kansas City) 05/03/2023 5E7E7-L1 Recertification
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0291 Emergency Lighting Standard
K0321 Hazardous Areas - Enclosure Standard
K0914 Electrical Systems - Maintenance and Testing Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
K0933 Features of Fire Protection ? Fire Loss Prevention Standard
▼ 28C0001054 Southwest Lincoln Surgery Center, Llc Dba Southwest Lincoln Surgery Center 2222 S 16th Street, Suite 315 Lincoln NE 7 (Kansas City) 08/05/2019 V0YI21 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
K0321 Hazardous Areas - Enclosure Standard
K0354 Sprinkler System - Out of Service Standard
K0761 Maintenance, Inspection & Testing - Doors Standard
▼ 28C0001055 Methodist Endoscopy Center, Llc 515 North 162nd Avenue, Suite 201 Omaha NE 7 (Kansas City) 01/10/2019 9IZO21 Recertification, Sample Validation
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0321 Hazardous Areas - Enclosure Standard
K0353 Sprinkler System - Maintenance and Testing Standard
K0712 Fire Drills Standard
▼ 28C0001056 Pacific Surgery Center, Llc 10707 Pacific Street, Suite 100 Omaha NE 7 (Kansas City) 03/14/2024 61F6D-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
Q0184 VERBAL ORDERS Standard
▼ 28C0001056 Pacific Surgery Center, Llc 10707 Pacific Street, Suite 100 Omaha NE 7 (Kansas City) 03/13/2024 61F6D-L1 Recertification
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0511 Utilities - Gas and Electric Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
K0921 Electrical Equipment ? Testing and Maintenance Requirements Standard
▼ 28C0001056 Pacific Surgery Center, Llc 10707 Pacific Street, Suite 100 Omaha NE 7 (Kansas City) 09/02/2020 MP3X21 Recertification
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0511 Utilities - Gas and Electric Standard
▼ 28C0001057 Kearney Pain Treatment Center Llc Dba Stone Ridge Surgery Center 920 East 56th Street, Suite D Kearney NE 7 (Kansas City) 01/29/2026 1DDC75-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
Q0109 EMERGENCY EQUIPMENT Standard
Q0262 ADMISSION AND PRE-SURGICAL ASSESSMENT Standard
Q0266 DISCHARGE - ORDER Standard
▼ 28C0001057 Kearney Pain Treatment Center Llc Dba Stone Ridge Surgery Center 920 East 56th Street, Suite D Kearney NE 7 (Kansas City) 01/29/2026 1DDC75-L1 Recertification
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0353 Sprinkler System - Maintenance and Testing Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard