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
33C0001125 Syracuse Surgery Center, Llc 3400 Vickery Rd Syracuse NY 2 (New York) 01/07/2020 SIRT11 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0162 FORM AND CONTENT OF RECORD Standard
Q0181 ADMINISTRATION OF DRUGS Standard
Q0184 VERBAL ORDERS Standard
Q0220 NOTICE - POSTING Standard
Q0224 ADVANCED DIRECTIVES Standard
Q0241 SANITARY ENVIRONMENT Standard
Q0264 POST-SURGICAL ASSESSMENT Standard
33C0001125 Syracuse Surgery Center, Llc 3400 Vickery Rd Syracuse NY 2 (New York) 01/07/2020 SIRT21 Recertification
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0293 Exit Signage Standard
K0321 Hazardous Areas - Enclosure Standard
33C0001131 Queens Boulevard Asc, Llc 95-25 Queens Boulevard 3rd Floor Flushing NY 2 (New York) 06/07/2019 1WXR11 Recertification, Sample Validation
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0082 PROGRAM DATA; PROGRAM ACTIVITIES Standard
Q0101 PHYSICAL ENVIRONMENT Standard
Q0161 ORGANIZATION Standard
Q0162 FORM AND CONTENT OF RECORD Standard
Q0225 SUBMISSION AND INVESTIGATION OF GRIEVANCES Standard
Q0229 EXERCISE OF RIGHTS - INFORMED CONSENT Standard
Q0234 CONFIDENTIALITY OF CLINICAL RECORDS Standard
33C0001131 Queens Boulevard Asc, Llc 95-25 Queens Boulevard 3rd Floor Flushing NY 2 (New York) 06/07/2019 1WXR21 Recertification, Sample Validation
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0291 Emergency Lighting Standard
K0321 Hazardous Areas - Enclosure Standard
K0711 Evacuation and Relocation Plan Standard
K0761 Maintenance, Inspection & Testing - Doors Standard
K0907 Gas and Vacuum Piped Systems ? Central Supply System Location Standard
K0915 Essential Electrical Systems ? Type 1 and Type 2 Standard
33C0001145 Cortland Asc, Llc 64 Pomeroy Street Cortland NY 2 (New York) 03/07/2018 WKL811 Recertification, Sample Validation
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0105 EMERGENCY EQUIPMENT Standard
Q0123 OTHER PRACTITIONERS Standard
Q0162 FORM AND CONTENT OF RECORD Standard
Q0181 ADMINISTRATION OF DRUGS Standard
Q0184 VERBAL ORDERS Standard
Q0241 SANITARY ENVIRONMENT Standard
Q0242 INFECTION CONTROL PROGRAM Standard
33C0001154 Avicenna Asc Inc 2522 Hughes Avenue Bronx NY 2 (New York) 09/14/2018 W53M11 Recertification, Sample Validation
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0080 QUALITY ASSESSMENT AND PERFORMANCE Condition
Q0082 PROGRAM DATA; PROGRAM ACTIVITIES Standard
Q0084 GOVERNING BODY RESPONSIBILITIES Standard
Q0220 NOTICE - POSTING Standard
Q0221 NOTICE OF RIGHTS Standard
Q0222 NOTICE OF RIGHTS - POSTING Standard
Q0232 SAFETY Standard
Q0242 INFECTION CONTROL PROGRAM Standard
33C0001154 Avicenna Asc Inc 2522 Hughes Avenue Bronx NY 2 (New York) 09/14/2018 W53M21 Recertification, Sample Validation
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0211 Means of Egress - General Standard
K0353 Sprinkler System - Maintenance and Testing Standard
K0372 Subdivision of Building Spaces ? Smoke Barrier Construction Standard
K0712 Fire Drills Standard
K0915 Essential Electrical Systems ? Type 1 and Type 2 Standard
K0919 Electrical Equipment - Other Standard
33C0001155 Westmoreland Asc, Llc 5325 State Route 233 Westmoreland NY 2 (New York) 07/11/2023 6055B-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0040 GOVERNING BODY AND MANAGEMENT Condition
Q0080 QUALITY ASSESSMENT AND PERFORMANCE Condition
Q0240 INFECTION CONTROL Condition
Q0081 PROGRAM SCOPE; PROGRAM ACTIVITIES Standard
Q0241 SANITARY ENVIRONMENT Standard
Q0242 INFECTION CONTROL PROGRAM Standard
Q0244 INFECTION CONTROL PROGRAM - QAPI Standard
33C0001165 Richmond Asc 1360 Hyland Boulevard Staten Island NY 2 (New York) 01/09/2020 K53A21 Recertification, Sample Validation
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0131 Multiple Occupancies Standard
K0311 Vertical Openings - Enclosure Standard
34C0001010 Eye Surgery & Laser Clinic 500 Lake Concord Rd Ne Concord NC 4 (Atlanta) 03/20/2018 8Z6S21 Recertification
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0211 Means of Egress - General Standard
K0223 Doors with Self-Closing Devices Standard
K0321 Hazardous Areas - Enclosure Standard
K0345 Fire Alarm System - Testing and Maintenance Standard
K0511 Utilities - Gas and Electric Standard