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
▼ 36C0001105 Eye Surgery Center Of Western Ohio 855 Market Street Lima OH 5 (Chicago) 10/30/2018 UBEI21 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
K0712 Fire Drills Standard
▼ 36C0001117 Northwest Ohio Endoscopy Center 4841 Monroe Street, Suite 111 Toledo OH 5 (Chicago) 02/07/2019 03Z411 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0100 ENVIRONMENT Condition
Q0104 SAFETY FROM FIRE Standard
▼ 36C0001117 Northwest Ohio Endoscopy Center 4841 Monroe Street, Suite 111 Toledo OH 5 (Chicago) 02/05/2019 03Z421 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
K0131 Multiple Occupancies Standard
K0161 Building Construction Type and Height Standard
K0291 Emergency Lighting Standard
K0345 Fire Alarm System - Testing and Maintenance Standard
K0346 Fire Alarm System - Out of Service Standard
K0353 Sprinkler System - Maintenance and Testing Standard
K0354 Sprinkler System - Out of Service Standard
K0372 Subdivision of Building Spaces ? Smoke Barrier Construction Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
▼ 36C0001120 Cei Physicians Psc, Llc 518 West Avenue Tallmadge OH 5 (Chicago) 05/01/2018 WBFF21 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
K0345 Fire Alarm System - Testing and Maintenance Standard
K0353 Sprinkler System - Maintenance and Testing Standard
K0712 Fire Drills Standard
K0761 Maintenance, Inspection & Testing - Doors Standard
K0914 Electrical Systems - Maintenance and Testing Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
▼ 36C0001120 Cei Physicians Psc, Llc 518 West Avenue Tallmadge OH 5 (Chicago) 04/26/2018 WBFF11 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0100 ENVIRONMENT Condition
Q0240 INFECTION CONTROL Condition
Q0104 SAFETY FROM FIRE Standard
Q0241 SANITARY ENVIRONMENT Standard
Q0262 PRE-SURGICAL ASSESSMENT Standard
▼ 36C0001140 Premium Surgery Center 5319 Hoag Drive, Suite 120 Elyria OH 5 (Chicago) 07/26/2018 XL1I11 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0100 ENVIRONMENT Condition
Q0104 SAFETY FROM FIRE Standard
▼ 36C0001140 Premium Surgery Center 5319 Hoag Drive, Suite 120 Elyria OH 5 (Chicago) 07/24/2018 XL1I21 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
K0131 Multiple Occupancies Standard
K0291 Emergency Lighting Standard
K0321 Hazardous Areas - Enclosure Standard
K0712 Fire Drills Standard
K0901 Fundamentals - Building System Categories Standard
K0913 Electrical Systems - Wet Procedure Locations Standard
K0914 Electrical Systems - Maintenance and Testing Standard
K0933 Features of Fire Protection ? Fire Loss Prevention Standard
▼ 36C0001144 First Settlement Orthopaedic Institute 611 Second Street Marietta OH 5 (Chicago) 11/15/2018 JMXF11 Recertification, Sample Validation
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0100 ENVIRONMENT Condition
Q0104 SAFETY FROM FIRE Standard
Q0241 SANITARY ENVIRONMENT Standard
▼ 36C0001144 First Settlement Orthopaedic Institute 611 Second Street Marietta OH 5 (Chicago) 11/15/2018 JMXF21 Recertification, Sample Validation
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
K0131 Multiple Occupancies Standard
K0345 Fire Alarm System - Testing and Maintenance Standard
K0372 Subdivision of Building Spaces ? Smoke Barrier Construction Standard
▼ 36C0001154 Affiliated Ambulatory Surgery Center, L L C 650 Shawan Falls Drive Dublin OH 5 (Chicago) 12/19/2018 MJ9311 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0100 ENVIRONMENT Condition
Q0104 SAFETY FROM FIRE Standard