S&C QCOR ASC 2567s
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ASCs 2567s
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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
▼ 40C0001112 San Pablo Developers Edificio Arturo Cadilla, Oficina 107 Y 108 Bayamon PR 2 (New York) 07/22/2025 1D1CC2-L1 Initial Certification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
E0022 Policies/Procedures for Sheltering in Place Standard
E0024 Policies/Procedures-Volunteers and Staffing Standard
E0033 Methods for Sharing Information Standard
E0034 Information on Occupancy/Needs Standard
E0039 EP Testing Requirements Standard
K0291 Emergency Lighting Standard
K0293 Exit Signage Standard
K0355 Portable Fire Extinguishers Standard
K0916 Essential Electrical Systems ? Alarm Annunciator Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
▼ 41C0001000 Blackstone Valley Surgicare In 895 Chalkstone Ave Providence RI 1 (Boston) 01/23/2023 5EC27-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0243 INFECTION CONTROL PROGRAM - DIRECTION Standard
Q0261 PATIENT ASSESSMENT AND ADMISSION Standard
Q0263 ADMISSION ASSESSMENT - RECORD Standard
Q0266 DISCHARGE - ORDER Standard
▼ 41C0001000 Blackstone Valley Surgicare In 895 Chalkstone Ave Providence RI 1 (Boston) 07/22/2021 CC0K11 Complaint
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0060 SURGICAL SERVICES Condition
Q0064 STANDARD LEVEL TAG FOR SURGICAL SERVICES Standard
▼ 41C0001002 Koch Eye Surgicenter, Inc 444 Quaker Lane Warwick RI 1 (Boston) 03/14/2025 65A32-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0061 ANESTHETIC RISK AND EVALUATION Standard
Q0062 ANESTHETIC - DISCHARGE Standard
Q0162 FORM AND CONTENT OF RECORD Standard
Q0181 ADMINISTRATION OF DRUGS Standard
Q0229 EXERCISE OF RIGHTS - INFORMED CONSENT Standard
Q0241 SANITARY ENVIRONMENT Standard
Q0266 DISCHARGE - ORDER Standard
▼ 41C0001002 Koch Eye Surgicenter, Inc 444 Quaker Lane Warwick RI 1 (Boston) 03/14/2025 65A32-L1 Recertification
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0761 Maintenance, Inspection & Testing - Doors Standard
▼ 41C0001002 Koch Eye Surgicenter, Inc 444 Quaker Lane Warwick RI 1 (Boston) 04/04/2019 FG8311 Complaint, Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0242 INFECTION CONTROL PROGRAM Standard
Q0261 PATIENT ASSESSMENT AND ADMISSION Standard
▼ 41C0001007 Urological Specialists Of New England 207 Quaker Lane West Warwick RI 1 (Boston) 09/29/2023 611C6-H1 Complaint, Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0080 QUALITY ASSESSMENT AND PERFORMANCE Condition
Q0180 PHARMACEUTICAL SERVICES Condition
Q0240 INFECTION CONTROL Condition
Q0083 PERFORMANCE IMPROVEMENT PROJECTS Standard
Q0084 GOVERNING BODY RESPONSIBILITIES Standard
Q0181 ADMINISTRATION OF DRUGS Standard
Q0226 GRIEVANCES - MISTREATMENT, ABUSE Standard
Q0242 INFECTION CONTROL PROGRAM Standard
Q0243 INFECTION CONTROL PROGRAM - DIRECTION Standard
▼ 41C0001008 Endoscopy Associates Inc Dba West River Endscopy 44 West River Street Providence RI 1 (Boston) 02/06/2025 65504-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0181 ADMINISTRATION OF DRUGS Standard
Q0241 SANITARY ENVIRONMENT Standard
Q0266 DISCHARGE - ORDER Standard
▼ 41C0001008 Endoscopy Associates Inc Dba West River Endscopy 44 West River Street Providence RI 1 (Boston) 02/06/2025 65504-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
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
▼ 41C0001009 Bayside Endoscopy Center, Llc D/B/A East Greenwich Endoscopy Center 1407 South County Trail East Greenwich RI 1 (Boston) 05/24/2022 4EACE-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0001 Establishment of the Emergency Program (EP) Condition
Q0180 PHARMACEUTICAL SERVICES Condition
E0004 Develop EP Plan, Review and Update Annually Standard
E0039 EP Testing Requirements Standard
Q0041 CONTRACT SERVICES Standard
Q0121 MEMBERSHIP AND CLINICAL PRIVILEGES Standard
Q0181 ADMINISTRATION OF DRUGS Standard
Q0245 INFECTION CONTROL PROGRAM Standard