S&C QCOR ASC 2567s
d QCOR: Quality, Certification and Oversight Reports. S&C QCOR  
Home  |  Help  |  Resources  |  FAQs  |  Site Map  
   
ASCs 2567s
Selection Criteria ▸

Time Interval

Please select the calendar year or years for which you would like data.

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
▼ 50C0001089 Aesthetic Eye Associates Asc Pllc 625 4th Avenue, Suite 302 Kirkland WA 10 (Seattle) 06/13/2019 J3UP21 Recertification
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0346 Fire Alarm System - Out of Service Standard
K0353 Sprinkler System - Maintenance and Testing Standard
K0354 Sprinkler System - Out of Service Standard
K0914 Electrical Systems - Maintenance and Testing Standard
▼ 50C0001093 Eastside Endoscopy Center,Pllc 1135 116th Avenue Ne, Suite 570 Bellevue WA 10 (Seattle) 05/30/2024 6303A-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0104 SAFETY FROM FIRE Standard
Q0109 EMERGENCY EQUIPMENT Standard
▼ 50C0001093 Eastside Endoscopy Center,Pllc 1135 116th Avenue Ne, Suite 570 Bellevue WA 10 (Seattle) 05/30/2024 6303A-L1 Recertification
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0131 Multiple Occupancies Standard
K0293 Exit Signage Standard
K0353 Sprinkler System - Maintenance and Testing Standard
K0908 Gas and Vacuum Piped Systems ? Central Supply System Alarms Standard
K0914 Electrical Systems - Maintenance and Testing Standard
▼ 50C0001093 Eastside Endoscopy Center,Pllc 1135 116th Avenue Ne, Suite 570 Bellevue WA 10 (Seattle) 08/29/2019 RFIB21 Recertification
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0131 Multiple Occupancies Standard
▼ 50C0001095 Gh Evergreen Endoscopy Center Sub Llc 11800 128th St, Ste 100 Kirkland WA 10 (Seattle) 03/04/2026 1E44D4-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0104 SAFETY FROM FIRE Standard
▼ 50C0001095 Gh Evergreen Endoscopy Center Sub Llc 11800 128th St, Ste 100 Kirkland WA 10 (Seattle) 03/04/2026 1E44D4-L1 Recertification
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0131 Multiple Occupancies Standard
K0345 Fire Alarm System - Testing and Maintenance Standard
K0346 Fire Alarm System - Out of Service Standard
K0353 Sprinkler System - Maintenance and Testing Standard
K0354 Sprinkler System - Out of Service Standard
K0355 Portable Fire Extinguishers Standard
K0712 Fire Drills Standard
K0761 Maintenance, Inspection & Testing - Doors Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
▼ 50C0001095 Gh Evergreen Endoscopy Center Sub Llc 11800 128th St, Ste 100 Kirkland WA 10 (Seattle) 01/23/2023 5EAF8-L1 Recertification
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0131 Multiple Occupancies Standard
K0323 Anesthetizing Locations Standard
K0345 Fire Alarm System - Testing and Maintenance Standard
K0354 Sprinkler System - Out of Service Standard
K0908 Gas and Vacuum Piped Systems ? Central Supply System Alarms Standard
▼ 50C0001095 Gh Evergreen Endoscopy Center Sub Llc 11800 128th St, Ste 100 Kirkland WA 10 (Seattle) 01/12/2023 5EAF8-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
Q0001 BASIC REQUIREMENTS Condition
E0023 Policies/Procedures for Medical Documentation Standard
Q0002 DEFINITIONS Standard
Q0061 ANESTHETIC RISK AND EVALUATION Standard
Q0104 SAFETY FROM FIRE Standard
Q0141 ORGANIZATION AND STAFFING Standard
▼ 50C0001095 Gh Evergreen Endoscopy Center Sub Llc 11800 128th St, Ste 100 Kirkland WA 10 (Seattle) 05/10/2021 C42I11 Focused Infection Control, Other-Fed
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0242 INFECTION CONTROL PROGRAM Standard
Q0245 INFECTION CONTROL PROGRAM Standard
▼ 50C0001095 Gh Evergreen Endoscopy Center Sub Llc 11800 128th St, Ste 100 Kirkland WA 10 (Seattle) 04/27/2021 0WPB11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
E0024 Policies/Procedures-Volunteers and Staffing Standard
E0026 Roles Under a Waiver Declared by Secretary Standard
Q0002 DEFINITIONS Standard
Q0064 STANDARD LEVEL TAG FOR SURGICAL SERVICES Standard
Q0084 GOVERNING BODY RESPONSIBILITIES Standard
Q0101 PHYSICAL ENVIRONMENT Standard
Q0104 SAFETY FROM FIRE Standard
Q0141 ORGANIZATION AND STAFFING Standard
Q0241 SANITARY ENVIRONMENT Standard
Q0245 INFECTION CONTROL PROGRAM Standard