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
▼ 51C0001013 Greenbrier Clinic, Inc 40823 Midland Trail, East White Sulphur Spring WV 3 (Philadelphia) 06/19/2019 7NXT11 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0109 EMERGENCY EQUIPMENT Standard
▼ 51C0001013 Greenbrier Clinic, Inc 40823 Midland Trail, East White Sulphur Spring WV 3 (Philadelphia) 06/18/2019 7NXT21 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
E0004 Develop EP Plan, Review and Update Annually Standard
K0353 Sprinkler System - Maintenance and Testing Standard
K0712 Fire Drills Standard
K0914 Electrical Systems - Maintenance and Testing Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
▼ 51C0001015 Ultimate Health Services, Inc. 5170 Us Route 60e Huntington WV 3 (Philadelphia) 06/12/2019 3CPQ11 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0063 ADMINISTRATION OF ANESTHESIA Standard
Q0101 PHYSICAL ENVIRONMENT Standard
Q0104 SAFETY FROM FIRE Standard
Q0241 SANITARY ENVIRONMENT Standard
Q0244 INFECTION CONTROL PROGRAM - QAPI Standard
▼ 51C0001015 Ultimate Health Services, Inc. 5170 Us Route 60e Huntington WV 3 (Philadelphia) 06/11/2019 3CPQ21 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
E0004 Develop EP Plan, Review and Update Annually Standard
K0131 Multiple Occupancies Standard
K0211 Means of Egress - General Standard
K0346 Fire Alarm System - Out of Service Standard
K0351 Sprinkler System - Installation Standard
K0353 Sprinkler System - Maintenance and Testing Standard
K0354 Sprinkler System - Out of Service Standard
K0712 Fire Drills Standard
K0914 Electrical Systems - Maintenance and Testing Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
K0923 Electrical Equipment ? Ground-Fault Circuit-Interrupter Protection Standard
K0926 Gas Equipment - Qualifications and Training Standard
▼ 51C0001016 Mgh Surgery, Llc 2000 Mon Health Medical Park Drive, Suite 2200 Morgantown WV 3 (Philadelphia) 02/28/2024 624EF-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
Q0104 SAFETY FROM FIRE Standard
▼ 51C0001016 Mgh Surgery, Llc 2000 Mon Health Medical Park Drive, Suite 2200 Morgantown WV 3 (Philadelphia) 02/28/2024 624EF-L1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
E0004 Develop EP Plan, Review and Update Annually Standard
K0353 Sprinkler System - Maintenance and Testing Standard
K0372 Subdivision of Building Spaces ? Smoke Barrier Construction Standard
K0712 Fire Drills Standard
K0781 Portable Space Heaters Standard
K0914 Electrical Systems - Maintenance and Testing Standard
▼ 51C0001016 Mgh Surgery, Llc 2000 Mon Health Medical Park Drive, Suite 2200 Morgantown WV 3 (Philadelphia) 03/24/2021 T2XM11 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0241 SANITARY ENVIRONMENT Standard
Q0242 INFECTION CONTROL PROGRAM Standard
Q0245 INFECTION CONTROL PROGRAM Standard
▼ 52C0001005 Dean Health Systems Inc. 2850 O'Keeffe Ave Sun Prairie WI 5 (Chicago) 05/23/2025 6636E-H1 Complaint
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0104 SAFETY FROM FIRE Standard
▼ 52C0001005 Dean Health Systems Inc. 2850 O'Keeffe Ave Sun Prairie WI 5 (Chicago) 05/22/2025 664A3-L1 Complaint
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0711 Evacuation and Relocation Plan Standard
▼ 52C0001006 North Shore Surgical Center 7007 N Range Line Rd Milwaukee WI 5 (Chicago) 08/14/2018 T9K611 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0100 ENVIRONMENT Condition
Q0061 ANESTHETIC RISK AND EVALUATION Standard
Q0101 PHYSICAL ENVIRONMENT Standard
Q0104 SAFETY FROM FIRE Standard
Q0162 FORM AND CONTENT OF RECORD Standard
Q0181 ADMINISTRATION OF DRUGS Standard
Q0221 NOTICE OF RIGHTS Standard
Q0245 INFECTION CONTROL PROGRAM Standard
Q0261 PATIENT ASSESSMENT AND ADMISSION Standard