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
▼ 34C0001130 Triangle Gastroenterology 2600 Atlantic Avenue Raleigh NC 4 (Atlanta) 03/09/2018 TSWI11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
Q0101 PHYSICIAL ENVIRONMENT Standard
Q0224 ADVANCED DIRECTIVES Standard
Q0241 SANITARY ENVIRONMENT Standard
Q0263 ADMISSION ASSESSMENT - RECORD Standard
▼ 34C0001131 Carolinaeast Health System 640 Mccarthy Blvd. New Bern NC 4 (Atlanta) 06/19/2018 D69K21 Recertification
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0200 Means of Egress Requirements - Other Standard
K0341 Fire Alarm System - Installation Standard
K0351 Sprinkler System - Installation Standard
K0916 Essential Electrical Systems ? Alarm Annunciator Standard
▼ 34C0001131 Carolinaeast Health System 640 Mccarthy Blvd. New Bern NC 4 (Atlanta) 05/24/2018 D69K11 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0040 GOVERNING BODY AND MANAGEMENT Condition
Q0080 QUALITY ASSESSMENT AND PERFORMANCE Condition
Q0240 INFECTION CONTROL Condition
E0004 Develop EP Plan, Review and Update Annually Standard
E0039 EP Testing Requirements Standard
Q0082 PROGRAM DATA; PROGRAM ACTIVITIES Standard
Q0083 PERFORMANCE IMPROVEMENT PROJECTS Standard
Q0121 MEMBERSHIP AND CLINICAL PRIVILEGES Standard
Q0242 INFECTION CONTROL PROGRAM Standard
Q0244 INFECTION CONTROL PROGRAM - QAPI Standard
▼ 34C0001132 Endoscopy Services Center-Pineville, Llc 10520 Park Road, Suite 105 Charlotte NC 4 (Atlanta) 07/10/2018 EL6J21 Recertification
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0291 Emergency Lighting Standard
K0325 Alcohol Based Hand Rub Dispenser (ABHR) Standard
K0712 Fire Drills Standard
K0920 Electrical Equipment ? Power Cords and Extension Cords Standard
▼ 34C0001132 Endoscopy Services Center-Pineville, Llc 10520 Park Road, Suite 105 Charlotte NC 4 (Atlanta) 06/27/2018 EL6J11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
Q0233 SAFETY - ABUSE/HARASSMENT Standard
▼ 34C0001134 Endoscopy Services Center-University, Llc 101 W T Harris Blvd, Suite 3215 Charlotte NC 4 (Atlanta) 04/17/2018 VW0W21 Recertification
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0131 Multiple Occupancies Standard
K0345 Fire Alarm System - Testing and Maintenance Standard
K0351 Sprinkler System - Installation Standard
K0353 Sprinkler System - Maintenance and Testing Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
▼ 34C0001134 Endoscopy Services Center-University, Llc 101 W T Harris Blvd, Suite 3215 Charlotte NC 4 (Atlanta) 04/11/2018 VW0W11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
Q0224 ADVANCED DIRECTIVES Standard
▼ 34C0001135 Endoscopy Services Center 1663 Campus Park Dr Ste A Monroe NC 4 (Atlanta) 04/05/2018 4XZH11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
Q0162 FORM AND CONTENT OF RECORD Standard
Q0184 VERBAL ORDERS Standard
Q0242 INFECTION CONTROL PROGRAM Standard
▼ 34C0001135 Endoscopy Services Center 1663 Campus Park Dr Ste A Monroe NC 4 (Atlanta) 04/04/2018 4XZH21 Recertification
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0161 Building Construction Type and Height Standard
K0271 Discharge from Exits Standard
K0353 Sprinkler System - Maintenance and Testing Standard
K0372 Subdivision of Building Spaces ? Smoke Barrier Construction Standard
K0511 Utilities - Gas and Electric Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
▼ 34C0001138 Carolinas Physicians Network, Inc, 1001 Blythe Blvd Suite 400 Charlotte NC 4 (Atlanta) 08/01/2018 7XH221 Recertification
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0131 Multiple Occupancies Standard
K0321 Hazardous Areas - Enclosure Standard
K0521 HVAC Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
K0923 Electrical Equipment ? Ground-Fault Circuit-Interrupter Protection Standard
K0924 Electrical Equipment ? Wet Procedure Locations Standard