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
▼ 34C0001164 Park Endoscopy Center, Llc 2602 N Heritage Street Kinston NC 4 (Atlanta) 02/20/2018 NBRS21 Recertification
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0321 Hazardous Areas - Enclosure Standard
K0345 Fire Alarm System - Testing and Maintenance Standard
▼ 34C0001167 Southeastern Gastroenterology Endoscopy Center, P 101 West 27th Street Lumberton NC 4 (Atlanta) 08/14/2018 YQH221 Recertification
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0923 Electrical Equipment ? Ground-Fault Circuit-Interrupter Protection Standard
▼ 34C0001167 Southeastern Gastroenterology Endoscopy Center, P 101 West 27th Street Lumberton NC 4 (Atlanta) 08/02/2018 YQH211 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
Q0109 EMERGENCY EQUIPMENT Standard
Q0242 INFECTION CONTROL PROGRAM Standard
▼ 34C0001171 Piedmont Healthcare, Pa 208 Old Mocksville Road Statesville NC 4 (Atlanta) 06/06/2018 KLY621 Recertification
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0131 Multiple Occupancies Standard
K0211 Means of Egress - General Standard
K0321 Hazardous Areas - Enclosure Standard
K0353 Sprinkler System - Maintenance and Testing Standard
▼ 34C0001171 Piedmont Healthcare, Pa 208 Old Mocksville Road Statesville NC 4 (Atlanta) 05/18/2018 KLY611 Recertification
Deficiency Tag Deficiency Description Tag Type
E0006 Plan Based on All Hazards Risk Assessment Standard
E0022 Policies/Procedures for Sheltering in Place Standard
Q0061 ANESTHETIC RISK AND EVALUATION Standard
Q0261 ADMISSION ASSESSMENT Standard
▼ 34C0001174 Rex Surgery Center Of Cary, Llc 1505 Sw Cary Parkway, Suite 100 Cary NC 4 (Atlanta) 11/27/2018 3LEW21 Recertification
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0131 Multiple Occupancies Standard
K0311 Vertical Openings - Enclosure Standard
K0345 Fire Alarm System - Testing and Maintenance Standard
K0351 Sprinkler System - Installation Standard
K0371 Subdivision of Building Spaces ? Smoke Compartments Standard
K0521 HVAC Standard
K0908 Gas and Vacuum Piped Systems ? Central Supply System Alarms Standard
K0914 Electrical Systems - Maintenance and Testing Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
▼ 34C0001175 Wake Endoscopy Center, Llc 2402 Camden St., Ste. 200 Wilson NC 4 (Atlanta) 06/13/2019 UT2H21 Recertification
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0712 Fire Drills Standard
K0920 Electrical Equipment ? Power Cords and Extension Cords Standard
▼ 34C0001175 Wake Endoscopy Center, Llc 2402 Camden St., Ste. 200 Wilson NC 4 (Atlanta) 06/06/2019 UT2H11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0006 Plan Based on All Hazards Risk Assessment Standard
Q0101 PHYSICAL ENVIRONMENT Standard
Q0245 INFECTION CONTROL PROGRAM Standard
▼ 34C0001176 W.F. Endoscopy Center, Llc 10540 Ligon Mill Rd., Ste. 109 Wake Forest NC 4 (Atlanta) 05/31/2018 HV5T11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
Q0121 MEMBERSHIP AND CLINICAL PRIVILEGES Standard
Q0224 ADVANCED DIRECTIVES Standard
▼ 34C0001177 Union Health Services Llc 6030 Hwy Bldg Suite A Indian Trail NC 4 (Atlanta) 05/05/2022 2LAO11 Complaint, Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
Q0181 ADMINISTRATION OF DRUGS Standard