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
▼ 44C0001159 Holston Valley Surgery Center, Llc 103 West Stone Drive Kingsport TN 4 (Atlanta) 11/06/2019 96VC21 Recertification
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0211 Means of Egress - General Standard
K0351 Sprinkler System - Installation Standard
▼ 44C0001160 Patient Partners, Llc 890 North Blue Jay Lane Gallatin TN 4 (Atlanta) 09/06/2018 5ST921 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0345 Fire Alarm System - Testing and Maintenance Standard
K0353 Sprinkler System - Maintenance and Testing Standard
K0902 Gas and Vacuum Piped Systems - Other Standard
K0911 Electrical Systems - Other Standard
▼ 44C0001160 Patient Partners, Llc 890 North Blue Jay Lane Gallatin TN 4 (Atlanta) 08/28/2018 5ST911 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
Q0000 Initial Comments - Not a Deficiency Citation Memo
E0007 EP Program Patient Population Standard
E0018 Procedures for Tracking of Staff and Patients Standard
E0023 Policies/Procedures for Medical Documentation Standard
E0026 Roles Under a Waiver Declared by Secretary Standard
E0029 Development of Communication Plan Standard
E0030 Names and Contact Information Standard
E0031 Emergency Officials Contact Information Standard
E0032 Primary/Alternate Means for Communication Standard
E0033 Methods for Sharing Information Standard
E0034 Information on Occupancy/Needs Standard
Q0181 ADMINISTRATION OF DRUGS Standard
Q0223 NOTICE - PHYSICIAN OWNERSHIP Standard
▼ 44C0001161 Franklin Endoscopy Center, Llc 9160 Carothers Franklin TN 4 (Atlanta) 07/10/2019 63ES11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0109 EMERGENCY EQUIPMENT Standard
Q0241 SANITARY ENVIRONMENT Standard
▼ 44C0001161 Franklin Endoscopy Center, Llc 9160 Carothers Franklin TN 4 (Atlanta) 07/08/2019 63ES21 Recertification
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0291 Emergency Lighting Standard
K0345 Fire Alarm System - Testing and Maintenance Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
▼ 44C0001165 Hamilton Eye Institute Surgery Center, Lp 930 Madison Avenue, 3rd Floor Memphis TN 4 (Atlanta) 07/22/2019 DMV721 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
K0131 Multiple Occupancies Standard
K0761 Maintenance, Inspection & Testing - Doors Standard
▼ 44C0001170 Clarksville Eye Surgery Center 141 Chesapeake Lane Suite 200 Clarksville TN 4 (Atlanta) 02/28/2024 6255D-L1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
E0039 EP Testing Requirements Standard
K0346 Fire Alarm System - Out of Service Standard
K0353 Sprinkler System - Maintenance and Testing Standard
K0761 Maintenance, Inspection & Testing - Doors Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
▼ 44C0001170 Clarksville Eye Surgery Center 141 Chesapeake Lane Suite 200 Clarksville TN 4 (Atlanta) 02/27/2024 6255D-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0240 INFECTION CONTROL Condition
Q0064 STANDARD LEVEL TAG FOR SURGICAL SERVICES Standard
Q0181 ADMINISTRATION OF DRUGS Standard
Q0223 NOTICE - PHYSICIAN OWNERSHIP Standard
Q0242 INFECTION CONTROL PROGRAM Standard
▼ 44C0001172 Athens Regional Cancer Center Pllc 680 South White Street Athens TN 4 (Atlanta) 07/10/2019 KJFL11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
Q0000 Initial Comments - Not a Deficiency Citation Memo
E0001 Establishment of the Emergency Program (EP) Condition
Q0241 SANITARY ENVIRONMENT Standard
Q0261 PATIENT ASSESSMENT AND ADMISSION Standard
▼ 44C0001172 Athens Regional Cancer Center Pllc 680 South White Street Athens TN 4 (Atlanta) 07/10/2019 KJFL21 Recertification
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0291 Emergency Lighting Standard