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
▼ 50C0001146 The Everett Clinic Pllc 3927 Rucker Avenue Everett WA 10 (Seattle) 02/06/2025 6542B-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0104 SAFETY FROM FIRE Standard
▼ 50C0001146 The Everett Clinic Pllc 3927 Rucker Avenue Everett WA 10 (Seattle) 02/05/2025 6542B-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
K0355 Portable Fire Extinguishers Standard
K0511 Utilities - Gas and Electric Standard
K0781 Portable Space Heaters Standard
K0908 Gas and Vacuum Piped Systems ? Central Supply System Alarms Standard
K0915 Essential Electrical Systems ? Type 1 and Type 2 Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
K0923 Electrical Equipment ? Ground-Fault Circuit-Interrupter Protection Standard
▼ 50C0001146 The Everett Clinic Pllc 3927 Rucker Avenue Everett WA 10 (Seattle) 07/13/2022 7YOP-L1 Recertification
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0291 Emergency Lighting Standard
K0521 HVAC Standard
K0914 Electrical Systems - Maintenance and Testing Standard
K0923 Electrical Equipment ? Ground-Fault Circuit-Interrupter Protection Standard
▼ 50C0001146 The Everett Clinic Pllc 3927 Rucker Avenue Everett WA 10 (Seattle) 07/13/2022 CTBC-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0109 EMERGENCY EQUIPMENT Standard
Q0141 ORGANIZATION AND STAFFING Standard
Q0181 ADMINISTRATION OF DRUGS Standard
▼ 50C0001148 Bellingham Ear Nose Throat & Facial Plastic Surgery Inc Ps 2940 Squalicum Parkway Bellingham WA 10 (Seattle) 12/16/2024 649F0-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
E0006 Plan Based on All Hazards Risk Assessment Standard
E0022 Policies/Procedures for Sheltering in Place Standard
Q0064 STANDARD LEVEL TAG FOR SURGICAL SERVICES Standard
Q0109 EMERGENCY EQUIPMENT Standard
Q0122 REAPPRAISALS Standard
Q0241 SANITARY ENVIRONMENT Standard
Q0242 INFECTION CONTROL PROGRAM Standard
▼ 50C0001148 Bellingham Ear Nose Throat & Facial Plastic Surgery Inc Ps 2940 Squalicum Parkway Bellingham WA 10 (Seattle) 12/16/2024 649F0-L1 Recertification
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0291 Emergency Lighting Standard
K0353 Sprinkler System - Maintenance and Testing Standard
K0751 Draperies, Curtains, and Loosely Hanging Fabrics Standard
K0913 Electrical Systems - Wet Procedure Locations Standard
K0914 Electrical Systems - Maintenance and Testing Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
K0926 Gas Equipment - Qualifications and Training Standard
K0933 Features of Fire Protection ? Fire Loss Prevention Standard
▼ 50C0001148 Bellingham Ear Nose Throat & Facial Plastic Surgery Inc Ps 2940 Squalicum Parkway Bellingham WA 10 (Seattle) 04/04/2022 223Y11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
E0004 Develop EP Plan, Review and Update Annually Standard
E0024 Policies/Procedures-Volunteers and Staffing Standard
E0026 Roles Under a Waiver Declared by Secretary Standard
Q0101 PHYSICAL ENVIRONMENT Standard
Q0104 SAFETY FROM FIRE Standard
Q0109 EMERGENCY EQUIPMENT Standard
Q0121 MEMBERSHIP AND CLINICAL PRIVILEGES Standard
Q0162 FORM AND CONTENT OF RECORD Standard
Q0181 ADMINISTRATION OF DRUGS Standard
Q0201 LABORATORY SERVICES Standard
Q0242 INFECTION CONTROL PROGRAM Standard
Q0246 COVID-19 Vaccination of Facility Staff Standard
▼ 50C0001148 Bellingham Ear Nose Throat & Facial Plastic Surgery Inc Ps 2940 Squalicum Parkway Bellingham WA 10 (Seattle) 03/30/2022 223Y21 Recertification
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0281 Illumination of Means of Egress Standard
K0291 Emergency Lighting Standard
K0293 Exit Signage Standard
K0346 Fire Alarm System - Out of Service Standard
K0354 Sprinkler System - Out of Service Standard
K0741 Smoking Regulations Standard
▼ 50C0001153 Eye Care Specialists Ps 500 Port Drive Clarkston WA 10 (Seattle) 05/10/2024 TDZC-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0104 SAFETY FROM FIRE Standard
▼ 50C0001153 Eye Care Specialists Ps 500 Port Drive Clarkston WA 10 (Seattle) 05/10/2024 UDPX-L1 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
K0908 Gas and Vacuum Piped Systems ? Central Supply System Alarms Standard