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
▼ 34C0001177 Union Health Services Llc 6030 Hwy Bldg Suite A Indian Trail NC 4 (Atlanta) 07/24/2019 09VS11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
Q0181 ADMINISTRATION OF DRUGS Standard
▼ 34C0001177 Union Health Services Llc 6030 Hwy Bldg Suite A Indian Trail NC 4 (Atlanta) 07/23/2019 09VS21 Recertification
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0345 Fire Alarm System - Testing and Maintenance Standard
▼ 34C0001179 Piedmont Outpatient Surgery Center 2465 Hanestown Lane Winston Salem NC 4 (Atlanta) 06/06/2018 C41K21 Recertification
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0211 Means of Egress - General Standard
K0223 Doors with Self-Closing Devices Standard
K0281 Illumination of Means of Egress Standard
K0321 Hazardous Areas - Enclosure Standard
K0341 Fire Alarm System - Installation Standard
K0345 Fire Alarm System - Testing and Maintenance Standard
K0351 Sprinkler System - Installation Standard
K0353 Sprinkler System - Maintenance and Testing Standard
K0907 Gas and Vacuum Piped Systems ? Central Supply System Location Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
▼ 34C0001179 Piedmont Outpatient Surgery Center 2465 Hanestown Lane Winston Salem NC 4 (Atlanta) 05/23/2018 C41K11 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
E0006 Plan Based on All Hazards Risk Assessment Standard
▼ 34C0001180 Matthews Surgery Center, Llc 710 Park Center Dr., Ste. 100 Matthews NC 4 (Atlanta) 10/09/2018 C3NZ21 Recertification
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0223 Doors with Self-Closing Devices Standard
K0281 Illumination of Means of Egress Standard
K0372 Subdivision of Building Spaces ? Smoke Barrier Construction Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
▼ 34C0001181 Capital City Surgery Center Llc 23 Sunnybrook Road, Suite 100 Raleigh NC 4 (Atlanta) 05/07/2021 VES711 Complaint, Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
Q0245 INFECTION CONTROL PROGRAM Standard
▼ 34C0001181 Capital City Surgery Center Llc 23 Sunnybrook Road, Suite 100 Raleigh NC 4 (Atlanta) 09/05/2018 VODN21 Recertification
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0321 Hazardous Areas - Enclosure Standard
K0351 Sprinkler System - Installation Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
K0923 Electrical Equipment ? Ground-Fault Circuit-Interrupter Protection Standard
▼ 34C0001181 Capital City Surgery Center Llc 23 Sunnybrook Road, Suite 100 Raleigh NC 4 (Atlanta) 08/08/2018 VODN11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
Q0181 ADMINISTRATION OF DRUGS Standard
▼ 34C0001183 Digestive Health Specialists, P.A 112 Kinderton Blvd Suite 100 Advance NC 4 (Atlanta) 11/27/2018 0DB721 Recertification
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0372 Subdivision of Building Spaces ? Smoke Barrier Construction Standard
K0521 HVAC Standard
▼ 34C0001183 Digestive Health Specialists, P.A 112 Kinderton Blvd Suite 100 Advance NC 4 (Atlanta) 11/20/2018 0DB711 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
Q0242 INFECTION CONTROL PROGRAM Standard