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
▼ 36C0001195 Northern Ohio Surgery Center Llc 300 Allen Bradley Dr Ste 100 Mayfield Heights OH 5 (Chicago) 10/02/2024 644AD-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0100 ENVIRONMENT Condition
Q0104 SAFETY FROM FIRE Standard
▼ 36C0001195 Northern Ohio Surgery Center Llc 300 Allen Bradley Dr Ste 100 Mayfield Heights OH 5 (Chicago) 09/30/2024 644AD-L1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
K0161 Building Construction Type and Height Standard
K0211 Means of Egress - General Standard
K0345 Fire Alarm System - Testing and Maintenance Standard
K0511 Utilities - Gas and Electric Standard
K0521 HVAC Standard
K0751 Draperies, Curtains, and Loosely Hanging Fabrics Standard
K0761 Maintenance, Inspection & Testing - Doors Standard
K0909 Gas and Vacuum Piped Systems ? Central Supply System Valves Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
▼ 36C0001195 Northern Ohio Surgery Center Llc 300 Allen Bradley Dr Ste 100 Mayfield Heights OH 5 (Chicago) 08/23/2019 FTN921 Other-Fed
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
E0009 Local, State, Tribal Collaboration Process Standard
E0024 Policies/Procedures-Volunteers and Staffing Standard
E0031 Emergency Officials Contact Information Standard
K0345 Fire Alarm System - Testing and Maintenance Standard
K0712 Fire Drills Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
▼ 36C0001195 Northern Ohio Surgery Center Llc 300 Allen Bradley Dr Ste 100 Mayfield Heights OH 5 (Chicago) 08/22/2019 FTN911 Other-Fed
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0104 SAFETY FROM FIRE Standard
Q0181 ADMINISTRATION OF DRUGS Standard
Q0241 SANITARY ENVIRONMENT Standard
▼ 36C0001196 Stark Ambulatory Surgery Center, Llc 4360 Fulton Drive, Nw Canton OH 5 (Chicago) 10/07/2019 LUR211 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0080 QUALITY ASSESSMENT AND PERFORMANCE Condition
Q0100 ENVIRONMENT Condition
Q0140 NURSING SERVICES Condition
Q0081 PROGRAM SCOPE; PROGRAM ACTIVITIES Standard
Q0082 PROGRAM DATA; PROGRAM ACTIVITIES Standard
Q0083 PERFORMANCE IMPROVEMENT PROJECTS Standard
Q0084 GOVERNING BODY RESPONSIBILITIES Standard
Q0104 SAFETY FROM FIRE Standard
Q0108 BUILDING SAFETY Standard
Q0122 REAPPRAISALS Standard
Q0123 OTHER PRACTITIONERS Standard
Q0141 ORGANIZATION AND STAFFING Standard
Q0241 SANITARY ENVIRONMENT Standard
Q0261 PATIENT ASSESSMENT AND ADMISSION Standard
Q0263 ADMISSION ASSESSMENT - RECORD Standard
Q0264 POST-SURGICAL ASSESSMENT Standard
Q0265 DISCHARGE - SUPPLIES AND INFORMATION Standard
Q0266 DISCHARGE - ORDER Standard
▼ 36C0001196 Stark Ambulatory Surgery Center, Llc 4360 Fulton Drive, Nw Canton OH 5 (Chicago) 10/01/2019 LUR221 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
E0004 Develop EP Plan, Review and Update Annually Standard
E0013 Development of EP Policies and Procedures Standard
E0018 Procedures for Tracking of Staff and Patients Standard
E0023 Policies/Procedures for Medical Documentation Standard
E0024 Policies/Procedures-Volunteers and Staffing Standard
E0026 Roles Under a Waiver Declared by Secretary Standard
E0029 Development of Communication Plan Standard
E0036 EP Training and Testing Standard
K0223 Doors with Self-Closing Devices 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
K0711 Evacuation and Relocation Plan Standard
K0712 Fire Drills Standard
K0754 Soiled Linen and Trash Containers Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
K0920 Electrical Equipment ? Power Cords and Extension Cords Standard
▼ 36C0001197 Revision Advanced Surgery Center 240 West Cook Road Mansfield OH 5 (Chicago) 06/06/2019 DUSL11 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0100 ENVIRONMENT Condition
Q0104 SAFETY FROM FIRE Standard
Q0106 SPRINKLER SYSTEM Standard
Q0241 SANITARY ENVIRONMENT Standard
Q0262 ADMISSION AND PRE-SURGICAL ASSESSMENT Standard
▼ 36C0001197 Revision Advanced Surgery Center 240 West Cook Road Mansfield OH 5 (Chicago) 06/06/2019 DUSL21 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
E0009 Local, State, Tribal Collaboration Process Standard
E0024 Policies/Procedures-Volunteers and Staffing Standard
E0026 Roles Under a Waiver Declared by Secretary Standard
E0034 Information on Occupancy/Needs Standard
E0037 EP Training Program Standard
E0039 EP Testing Requirements Standard
K0345 Fire Alarm System - Testing and Maintenance Standard
K0346 Fire Alarm System - Out of Service Standard
K0351 Sprinkler System - Installation Standard
K0353 Sprinkler System - Maintenance and Testing Standard
K0354 Sprinkler System - Out of Service Standard
K0712 Fire Drills Standard
K0781 Portable Space Heaters Standard
K0900 Health Care Facilities Code - Other Standard
K0914 Electrical Systems - Maintenance and Testing Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
K0923 Electrical Equipment ? Ground-Fault Circuit-Interrupter Protection Standard
▼ 36C0001199 Athens Surgery Center, Ltd 75 Hospital Drive, Suite 100 Athens OH 5 (Chicago) 09/27/2018 0NYX11 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0100 ENVIRONMENT Condition
Q0104 SAFETY FROM FIRE Standard
Q0161 ORGANIZATION Standard
▼ 36C0001199 Athens Surgery Center, Ltd 75 Hospital Drive, Suite 100 Athens OH 5 (Chicago) 09/27/2018 0NYX21 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
E0004 Develop EP Plan, Review and Update Annually Standard
E0024 Policies/Procedures-Volunteers and Staffing Standard
K0131 Multiple Occupancies Standard
K0906 Gas and Vacuum Piped Systems ? Central Supply System Operations Standard