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
▼ 49C0001055 Northern Virginia Surgery Center, Llc 3620 Joseph Siewick Drive, Suite 202 Fairfax VA 3 (Philadelphia) 09/01/2021 HH5D21 Recertification
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0341 Fire Alarm System - Installation Standard
K0911 Electrical Systems - Other Standard
K0919 Electrical Equipment - Other Standard
▼ 49C0001055 Northern Virginia Surgery Center, Llc 3620 Joseph Siewick Drive, Suite 202 Fairfax VA 3 (Philadelphia) 07/07/2021 HH5D11 Focused Infection Control, Other-Fed, Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0062 ANESTHETIC - DISCHARGE Standard
Q0181 ADMINISTRATION OF DRUGS Standard
Q0241 SANITARY ENVIRONMENT Standard
Q0242 INFECTION CONTROL PROGRAM Standard
▼ 49C0001058 Surgicare Of Chippenham, Llc 1115 Boulders Parkway, Suite 210 Richmond VA 3 (Philadelphia) 03/22/2023 5F4C8-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0101 PHYSICAL ENVIRONMENT Standard
▼ 49C0001058 Surgicare Of Chippenham, Llc 1115 Boulders Parkway, Suite 210 Richmond VA 3 (Philadelphia) 03/21/2023 5F4C8-L1 Recertification
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0919 Electrical Equipment - Other Standard
▼ 49C0001058 Surgicare Of Chippenham, Llc 1115 Boulders Parkway, Suite 210 Richmond VA 3 (Philadelphia) 12/15/2020 U4PN21 Recertification
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0300 Protection - Other Standard
K0345 Fire Alarm System - Testing and Maintenance Standard
K0911 Electrical Systems - Other Standard
K0914 Electrical Systems - Maintenance and Testing Standard
▼ 49C0001058 Surgicare Of Chippenham, Llc 1115 Boulders Parkway, Suite 210 Richmond VA 3 (Philadelphia) 11/23/2020 U4PN11 Focused Infection Control, Other-Fed, Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
Q0000 Initial Comments - Not a Deficiency Citation Memo
E0004 Develop EP Plan, Review and Update Annually Standard
E0013 Development of EP Policies and Procedures Standard
E0029 Development of Communication Plan Standard
E0031 Emergency Officials Contact Information Standard
E0036 EP Training and Testing Standard
E0039 EP Testing Requirements Standard
Q0241 SANITARY ENVIRONMENT Standard
▼ 49C0001059 Lake Ridge Ambulatory Surgery Center, Llc 12825 Minnieville Road, Suite 204 Woodbridge VA 3 (Philadelphia) 05/15/2019 VPWQ21 Recertification, Sample Validation
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0325 Alcohol Based Hand Rub Dispenser (ABHR) Standard
K0341 Fire Alarm System - Installation Standard
K0353 Sprinkler System - Maintenance and Testing Standard
K0355 Portable Fire Extinguishers Standard
K0372 Subdivision of Building Spaces ? Smoke Barrier Construction Standard
K0511 Utilities - Gas and Electric Standard
K0926 Gas Equipment - Qualifications and Training Standard
▼ 49C0001059 Lake Ridge Ambulatory Surgery Center, Llc 12825 Minnieville Road, Suite 204 Woodbridge VA 3 (Philadelphia) 04/24/2019 VPWQ11 Recertification, Sample Validation
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
Q0000 Initial Comments - Not a Deficiency Citation Memo
E0026 Roles Under a Waiver Declared by Secretary Standard
Q0181 ADMINISTRATION OF DRUGS Standard
▼ 49C0001060 Inova Ambulatory Surgery Center At Lorton Llc 9321 Sanger Street Suite 200 Lorton VA 3 (Philadelphia) 07/25/2023 607E0-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0101 PHYSICAL ENVIRONMENT Standard
▼ 49C0001060 Inova Ambulatory Surgery Center At Lorton Llc 9321 Sanger Street Suite 200 Lorton VA 3 (Philadelphia) 01/19/2021 JMVR11 Focused Infection Control, Other-Fed, Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0001 BASIC REQUIREMENTS Condition