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
▼ 38C0001073 Salem Endoscopy Center 875 Oak Street Se, Suite C3095 Salem OR 10 (Seattle) 01/23/2024 62336-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0082 PROGRAM DATA; PROGRAM ACTIVITIES Standard
▼ 38C0001073 Salem Endoscopy Center 875 Oak Street Se, Suite C3095 Salem OR 10 (Seattle) 09/12/2018 6KDW11 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0002 DEFINITIONS Standard
▼ 38C0001073 Salem Endoscopy Center 875 Oak Street Se, Suite C3095 Salem OR 10 (Seattle) 09/12/2018 6KDW21 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
E0006 Plan Based on All Hazards Risk Assessment Standard
E0018 Procedures for Tracking of Staff and Patients Standard
E0031 Emergency Officials Contact Information Standard
E0036 EP Training and Testing Standard
E0037 EP Training Program Standard
E0039 EP Testing Requirements Standard
K0131 Multiple Occupancies Standard
K0211 Means of Egress - General Standard
K0323 Anesthetizing Locations Standard
K0374 Subdivision of Building Spaces ? Smoke Barrier Doors Standard
K0712 Fire Drills Standard
▼ 38C0001074 East Portland Surgery Center, Llc 9200 Se 91st Avenue, Suite 100 Portland OR 10 (Seattle) 04/07/2026 22B93E-L1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
K0712 Fire Drills Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
▼ 38C0001074 East Portland Surgery Center, Llc 9200 Se 91st Avenue, Suite 100 Portland OR 10 (Seattle) 03/26/2026 22B93E-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0181 ADMINISTRATION OF DRUGS Standard
▼ 38C0001074 East Portland Surgery Center, Llc 9200 Se 91st Avenue, Suite 100 Portland OR 10 (Seattle) 06/23/2023 60241-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0181 ADMINISTRATION OF DRUGS Standard
▼ 38C0001074 East Portland Surgery Center, Llc 9200 Se 91st Avenue, Suite 100 Portland OR 10 (Seattle) 04/07/2022 RZF521 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
K0291 Emergency Lighting Standard
K0351 Sprinkler System - Installation Standard
K0712 Fire Drills Standard
K0908 Gas and Vacuum Piped Systems ? Central Supply System Alarms Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
▼ 38C0001075 Cascade Surgery Center, Llc 120 Ne Manzanita Avenue Grants Pass OR 10 (Seattle) 10/27/2022 5E19A-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0245 INFECTION CONTROL PROGRAM Standard
Q0246 COVID-19 Vaccination of Facility Staff Standard
▼ 38C0001076 Samaritan Endoscopy Center, Llc 3509 Nw Samaritan Drive, Suite 201 Corvallis OR 10 (Seattle) 02/22/2023 5F123-H1 Complaint, Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0040 GOVERNING BODY AND MANAGEMENT Condition
Q0100 ENVIRONMENT Condition
Q0101 PHYSICAL ENVIRONMENT Standard
Q0181 ADMINISTRATION OF DRUGS Standard
▼ 38C0001076 Samaritan Endoscopy Center, Llc 3509 Nw Samaritan Drive, Suite 201 Corvallis OR 10 (Seattle) 02/22/2023 5F123-L1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
K0372 Subdivision of Building Spaces ? Smoke Barrier Construction Standard
K0761 Maintenance, Inspection & Testing - Doors Standard