S&C QCOR ASC 2567s
d QCOR: Quality, Certification and Oversight Reports. S&C QCOR  
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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
▼ 38C0001094 Wilshire Surgery Center Llc 9775 Sw Wilshire Street, Suite 250 Portland OR 10 (Seattle) 10/04/2022 4F81C-L1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
K0712 Fire Drills Standard
K0923 Electrical Equipment ? Ground-Fault Circuit-Interrupter Protection Standard
▼ 38C0001094 Wilshire Surgery Center Llc 9775 Sw Wilshire Street, Suite 250 Portland OR 10 (Seattle) 09/29/2022 4F81C-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0181 ADMINISTRATION OF DRUGS Standard
▼ 38C0001094 Wilshire Surgery Center Llc 9775 Sw Wilshire Street, Suite 250 Portland OR 10 (Seattle) 05/02/2018 7DZ921 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
E0013 Development of EP Policies and Procedures Standard
E0036 EP Training and Testing Standard
K0291 Emergency Lighting Standard
K0345 Fire Alarm System - Testing and Maintenance Standard
K0353 Sprinkler System - Maintenance and Testing Standard
K0355 Portable Fire Extinguishers Standard
K0374 Subdivision of Building Spaces ? Smoke Barrier Doors Standard
K0712 Fire Drills Standard
▼ 38C0001094 Wilshire Surgery Center Llc 9775 Sw Wilshire Street, Suite 250 Portland OR 10 (Seattle) 04/26/2018 7DZ911 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0222 NOTICE OF RIGHTS - POSTING Standard
Q0224 ADVANCED DIRECTIVES Standard
Q0241 SANITARY ENVIRONMENT Standard
Q0261 ADMISSION ASSESSMENT Standard
▼ 38C0001095 South Portland Surgical Center, Llc 6370 Sw Borland Road, Suite 100 Tualatin OR 10 (Seattle) 04/25/2023 5FC1C-H1 Focused Infection Control, Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0064 STANDARD LEVEL TAG FOR SURGICAL SERVICES Standard
▼ 38C0001095 South Portland Surgical Center, Llc 6370 Sw Borland Road, Suite 100 Tualatin OR 10 (Seattle) 08/16/2018 9HQ821 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
E0026 Roles Under a Waiver Declared by Secretary Standard
E0029 Development of Communication Plan Standard
E0031 Emergency Officials Contact Information Standard
E0032 Primary/Alternate Means for Communication Standard
E0036 EP Training and Testing Standard
E0037 EP Training Program Standard
E0039 EP Testing Requirements Standard
K0323 Anesthetizing Locations Standard
K0712 Fire Drills Standard
▼ 38C0001095 South Portland Surgical Center, Llc 6370 Sw Borland Road, Suite 100 Tualatin OR 10 (Seattle) 08/14/2018 9HQ811 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0241 SANITARY ENVIRONMENT Standard
▼ 38C0001098 Oregon Ear Nose And Throat Surgery Center, Llc 1170 Royal Avenue Medford OR 10 (Seattle) 08/22/2024 640DC-L1 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
▼ 38C0001098 Oregon Ear Nose And Throat Surgery Center, Llc 1170 Royal Avenue Medford OR 10 (Seattle) 08/15/2024 640DC-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0162 FORM AND CONTENT OF RECORD Standard
▼ 38C0001098 Oregon Ear Nose And Throat Surgery Center, Llc 1170 Royal Avenue Medford OR 10 (Seattle) 03/21/2019 2J3C21 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
E0013 Development of EP Policies and Procedures Standard
E0026 Roles Under a Waiver Declared by Secretary Standard
E0031 Emergency Officials Contact Information Standard
E0032 Primary/Alternate Means for Communication Standard
E0036 EP Training and Testing Standard
E0037 EP Training Program Standard
K0345 Fire Alarm System - Testing and Maintenance Standard
K0353 Sprinkler System - Maintenance and Testing Standard
K0712 Fire Drills Standard