S&C QCOR ASC 2567s
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ASCs 2567s
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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
▼ 34C0001118 Bethany Medical Center, P.A., The Lindsay Facility 1580 Skeet Club Road High Point NC 4 (Atlanta) 03/28/2019 BNE611 Recertification
Deficiency Tag Deficiency Description Tag Type
E0004 Develop EP Plan, Review and Update Annually Standard
Q0121 MEMBERSHIP AND CLINICAL PRIVILEGES Standard
Q0141 ORGANIZATION AND STAFFING Standard
Q0181 ADMINISTRATION OF DRUGS Standard
Q0266 DISCHARGE - ORDER Standard
▼ 34C0001118 Bethany Medical Center, P.A., The Lindsay Facility 1580 Skeet Club Road High Point NC 4 (Atlanta) 03/27/2019 BNE621 Recertification
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0712 Fire Drills Standard
K0920 Electrical Equipment ? Power Cords and Extension Cords Standard
▼ 34C0001119 Catawba Valley Medical Group, Inc. 415 N. Center St., Ste. 300 Hickory NC 4 (Atlanta) 07/11/2018 LYQW21 Recertification
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0353 Sprinkler System - Maintenance and Testing Standard
K0372 Subdivision of Building Spaces ? Smoke Barrier Construction Standard
▼ 34C0001119 Catawba Valley Medical Group, Inc. 415 N. Center St., Ste. 300 Hickory NC 4 (Atlanta) 06/21/2018 LYQW11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0006 Plan Based on All Hazards Risk Assessment Standard
▼ 34C0001121 Salem Gastroenterology Associates Pa 875 Bethesda Road Winston Salem NC 4 (Atlanta) 04/09/2019 LTFZ21 Recertification
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0353 Sprinkler System - Maintenance and Testing Standard
K0916 Essential Electrical Systems ? Alarm Annunciator Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
▼ 34C0001121 Salem Gastroenterology Associates Pa 875 Bethesda Road Winston Salem NC 4 (Atlanta) 04/03/2019 LTFZ11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
Q0061 ANESTHETIC RISK AND EVALUATION Standard
Q0181 ADMINISTRATION OF DRUGS Standard
Q0261 PATIENT ASSESSMENT AND ADMISSION Standard
▼ 34C0001122 Cchc Endoscopy Center, Inc. 975 Newman Rd. New Bern NC 4 (Atlanta) 05/09/2018 M6FI21 Recertification
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0321 Hazardous Areas - Enclosure Standard
K0345 Fire Alarm System - Testing and Maintenance Standard
▼ 34C0001123 Raleigh Endoscopy Center-North 8300 Health Park, Suite 210 Raleigh NC 4 (Atlanta) 07/11/2019 TKFL21 Recertification
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0291 Emergency Lighting Standard
▼ 34C0001123 Raleigh Endoscopy Center-North 8300 Health Park, Suite 210 Raleigh NC 4 (Atlanta) 06/27/2019 TKFL11 Complaint, 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
▼ 34C0001125 Mid Carolina Gastroenterology Assoc., P.A. 110 Dennis Drive Sanford NC 4 (Atlanta) 06/26/2018 HOB621 Recertification
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0291 Emergency Lighting Standard
K0345 Fire Alarm System - Testing and Maintenance Standard