S&C QCOR ASC 2567s
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ASCs 2567s
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Provider Characteristics

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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
▼ 50C0001325 Chesnut Institute Of Cosmetic & Reconstructive Surgery 510 S Cowley St Ste 201 Spokane WA 10 (Seattle) 06/12/2024 62CE8-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
K0374 Subdivision of Building Spaces ? Smoke Barrier Doors Standard
K0920 Electrical Equipment ? Power Cords and Extension Cords Standard
K0926 Gas Equipment - Qualifications and Training Standard
▼ 50C0001326 Blackburn And Whitney Md Ps 2500 Squalicum Pkwy #102 Bellingham WA 10 (Seattle) 01/09/2025 64E41-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
E0037 EP Training Program Standard
Q0101 PHYSICAL ENVIRONMENT Standard
Q0241 SANITARY ENVIRONMENT Standard
Q0242 INFECTION CONTROL PROGRAM Standard
▼ 50C0001326 Blackburn And Whitney Md Ps 2500 Squalicum Pkwy #102 Bellingham WA 10 (Seattle) 01/07/2025 64E41-L1 Recertification
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0353 Sprinkler System - Maintenance and Testing Standard
K0914 Electrical Systems - Maintenance and Testing Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
K0926 Gas Equipment - Qualifications and Training Standard
▼ 50C0001326 Blackburn And Whitney Md Ps 2500 Squalicum Pkwy #102 Bellingham WA 10 (Seattle) 05/31/2022 01I511 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
E0006 Plan Based on All Hazards Risk Assessment Standard
E0024 Policies/Procedures-Volunteers and Staffing Standard
Q0162 FORM AND CONTENT OF RECORD Standard
Q0241 SANITARY ENVIRONMENT Standard
Q0246 COVID-19 Vaccination of Facility Staff Standard
▼ 50C0001326 Blackburn And Whitney Md Ps 2500 Squalicum Pkwy #102 Bellingham WA 10 (Seattle) 05/10/2022 01I521 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
K0354 Sprinkler System - Out of Service Standard
K0712 Fire Drills Standard
K0761 Maintenance, Inspection & Testing - Doors Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
▼ 50C0001328 Evergreen Eye Center Inc Ps 502 S M St Tacoma WA 10 (Seattle) 05/01/2025 65C6E-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0104 SAFETY FROM FIRE Standard
Q0181 ADMINISTRATION OF DRUGS Standard
Q0241 SANITARY ENVIRONMENT Standard
Q0242 INFECTION CONTROL PROGRAM Standard
Q0261 PATIENT ASSESSMENT AND ADMISSION Standard
▼ 50C0001328 Evergreen Eye Center Inc Ps 502 S M St Tacoma WA 10 (Seattle) 04/30/2025 65C6E-L1 Recertification
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0100 General Requirements - Other Standard
K0211 Means of Egress - General Standard
K0281 Illumination of Means of Egress 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
K0374 Subdivision of Building Spaces ? Smoke Barrier Doors Standard
K0521 HVAC Standard
K0531 Elevators Standard
K0711 Evacuation and Relocation Plan Standard
K0741 Smoking Regulations Standard
K0761 Maintenance, Inspection & Testing - Doors Standard
K0908 Gas and Vacuum Piped Systems ? Central Supply System Alarms Standard
K0914 Electrical Systems - Maintenance and Testing Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
K0920 Electrical Equipment ? Power Cords and Extension Cords Standard
K0921 Electrical Equipment ? Testing and Maintenance Requirements Standard
K0926 Gas Equipment - Qualifications and Training Standard
▼ 50C0001329 Pain Care Physicians, Pllc 115 Lilly Rd Ne Ste B Olympia WA 10 (Seattle) 06/03/2025 65BED-L1 Recertification
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0291 Emergency Lighting Standard
K0345 Fire Alarm System - Testing and Maintenance Standard
K0353 Sprinkler System - Maintenance and Testing Standard
K0914 Electrical Systems - Maintenance and Testing Standard
K0926 Gas Equipment - Qualifications and Training Standard
▼ 50C0001329 Pain Care Physicians, Pllc 115 Lilly Rd Ne Ste B Olympia WA 10 (Seattle) 05/30/2025 65BED-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
Q0104 SAFETY FROM FIRE Standard
Q0109 EMERGENCY EQUIPMENT Standard
Q0241 SANITARY ENVIRONMENT Standard
▼ 50C0001334 Sight Partners Physicians, P.C 332 Ne Northgate Way Seattle WA 10 (Seattle) 03/25/2026 1E4678-L1 Recertification
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0131 Multiple Occupancies Standard
K0161 Building Construction Type and Height Standard
K0291 Emergency Lighting Standard
K0345 Fire Alarm System - Testing and Maintenance Standard
K0353 Sprinkler System - Maintenance and Testing Standard
K0521 HVAC Standard
K0711 Evacuation and Relocation Plan Standard
K0712 Fire Drills Standard
K0761 Maintenance, Inspection & Testing - Doors Standard
K0908 Gas and Vacuum Piped Systems ? Central Supply System Alarms Standard
K0913 Electrical Systems - Wet Procedure Locations Standard
K0915 Essential Electrical Systems ? Type 1 and Type 2 Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
K0921 Electrical Equipment ? Testing and Maintenance Requirements Standard
K0926 Gas Equipment - Qualifications and Training Standard
K0933 Features of Fire Protection ? Fire Loss Prevention Standard