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
▼ 50C0001137 Inland Northwest Surgery Center, Llc North 526 Mullan Road, Suite A Spokane WA 10 (Seattle) 05/12/2022 N6FG21 Recertification
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0293 Exit Signage Standard
K0914 Electrical Systems - Maintenance and Testing Standard
▼ 50C0001140 Mountain West Derm Blackhart Pllc 1807 N Hutchinson Rd Spokane WA 10 (Seattle) 02/01/2023 5ECFC-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
E0039 EP Testing Requirements Standard
Q0121 MEMBERSHIP AND CLINICAL PRIVILEGES Standard
Q0141 ORGANIZATION AND STAFFING Standard
Q0162 FORM AND CONTENT OF RECORD Standard
Q0181 ADMINISTRATION OF DRUGS Standard
Q0241 SANITARY ENVIRONMENT Standard
Q0242 INFECTION CONTROL PROGRAM Standard
Q0246 COVID-19 Vaccination of Facility Staff Standard
▼ 50C0001140 Mountain West Derm Blackhart Pllc 1807 N Hutchinson Rd Spokane WA 10 (Seattle) 01/31/2023 5ECFC-L1 Recertification
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0131 Multiple Occupancies Standard
K0211 Means of Egress - General Standard
K0281 Illumination of Means of Egress 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
K0920 Electrical Equipment ? Power Cords and Extension Cords Standard
▼ 50C0001140 Mountain West Derm Blackhart Pllc 1807 N Hutchinson Rd Spokane WA 10 (Seattle) 10/03/2019 Q5S511 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0002 DEFINITIONS Standard
Q0101 PHYSICAL ENVIRONMENT Standard
Q0104 SAFETY FROM FIRE Standard
Q0121 MEMBERSHIP AND CLINICAL PRIVILEGES Standard
Q0141 ORGANIZATION AND STAFFING Standard
Q0241 SANITARY ENVIRONMENT Standard
▼ 50C0001140 Mountain West Derm Blackhart Pllc 1807 N Hutchinson Rd Spokane WA 10 (Seattle) 10/03/2019 Q5S521 Recertification
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0131 Multiple Occupancies Standard
K0345 Fire Alarm System - Testing and Maintenance Standard
K0353 Sprinkler System - Maintenance and Testing Standard
K0761 Maintenance, Inspection & Testing - Doors Standard
K0914 Electrical Systems - Maintenance and Testing Standard
K0920 Electrical Equipment ? Power Cords and Extension Cords Standard
▼ 50C0001141 Wenatchee Valley Hospital 916 Koala Drive Omak WA 10 (Seattle) 05/28/2026 22C42D-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
E0004 Develop EP Plan, Review and Update Annually Standard
Q0104 SAFETY FROM FIRE Standard
Q0241 SANITARY ENVIRONMENT Standard
▼ 50C0001141 Wenatchee Valley Hospital 916 Koala Drive Omak WA 10 (Seattle) 05/26/2026 22C42D-L1 Recertification
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0345 Fire Alarm System - Testing and Maintenance Standard
K0353 Sprinkler System - Maintenance and Testing Standard
K0712 Fire Drills Standard
K0761 Maintenance, Inspection & Testing - Doors Standard
▼ 50C0001141 Wenatchee Valley Hospital 916 Koala Drive Omak WA 10 (Seattle) 12/01/2022 5E20E-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
E0004 Develop EP Plan, Review and Update Annually Standard
E0022 Policies/Procedures for Sheltering in Place Standard
E0039 EP Testing Requirements Standard
Q0110 EMERGENCY PERSONNEL Standard
Q0162 FORM AND CONTENT OF RECORD Standard
Q0223 NOTICE - PHYSICIAN OWNERSHIP Standard
Q0230 EXERCISE OF RIGHTS BY OTHERS Standard
Q0242 INFECTION CONTROL PROGRAM Standard
Q0262 ADMISSION AND PRE-SURGICAL ASSESSMENT Standard
Q0263 ADMISSION ASSESSMENT - RECORD Standard
Q0265 DISCHARGE - SUPPLIES AND INFORMATION Standard
▼ 50C0001141 Wenatchee Valley Hospital 916 Koala Drive Omak WA 10 (Seattle) 11/29/2022 5E20E-L1 Recertification
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0211 Means of Egress - General Standard
K0353 Sprinkler System - Maintenance and Testing Standard
K0372 Subdivision of Building Spaces ? Smoke Barrier Construction Standard
K0521 HVAC Standard
K0761 Maintenance, Inspection & Testing - Doors Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
▼ 50C0001144 Pacific Cataract & Laser Institute Inc Pc 16818 E Desmet Ct Spokane Valley WA 10 (Seattle) 12/03/2020 IQ3J11 Focused Infection Control, Other-Fed
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0242 INFECTION CONTROL PROGRAM Standard