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
▼ 53C0001007 Ambulatory Surgery Clinic 1150 Main St Lander WY 8 (Denver) 11/19/2019 DI9Y21 Recertification
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0345 Fire Alarm System - Testing and Maintenance Standard
▼ 53C0001008 Black Hills Surgical Hospital Llc 1307 West Third Street, Suite B Gillette WY 8 (Denver) 03/24/2022 HBBS11 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0184 VERBAL ORDERS Standard
Q0224 ADVANCED DIRECTIVES Standard
Q0246 COVID-19 Vaccination of Facility Staff Standard
▼ 53C0001008 Black Hills Surgical Hospital Llc 1307 West Third Street, Suite B Gillette WY 8 (Denver) 03/24/2022 HBBS21 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
E0031 Emergency Officials Contact Information Standard
K0321 Hazardous Areas - Enclosure Standard
K0341 Fire Alarm System - Installation Standard
K0346 Fire Alarm System - Out of Service Standard
K0353 Sprinkler System - Maintenance and Testing Standard
K0355 Portable Fire Extinguishers Standard
K0761 Maintenance, Inspection & Testing - Doors Standard
K0911 Electrical Systems - Other Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
K0923 Electrical Equipment ? Ground-Fault Circuit-Interrupter Protection Standard
▼ 53C0001009 Center For Dermatologic Surgery 123 Western Hills Blvd Cheyenne WY 8 (Denver) 09/07/2023 60F3D-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0140 NURSING SERVICES Condition
Q0225 SUBMISSION AND INVESTIGATION OF GRIEVANCES Standard
Q0241 SANITARY ENVIRONMENT Standard
▼ 53C0001009 Center For Dermatologic Surgery 123 Western Hills Blvd Cheyenne WY 8 (Denver) 09/06/2023 60F3D-L1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
E0030 Names and Contact Information Standard
E0031 Emergency Officials Contact Information Standard
K0131 Multiple Occupancies Standard
K0223 Doors with Self-Closing Devices Standard
K0321 Hazardous Areas - Enclosure Standard
K0345 Fire Alarm System - Testing and Maintenance Standard
K0346 Fire Alarm System - Out of Service Standard
K0761 Maintenance, Inspection & Testing - Doors Standard
K0781 Portable Space Heaters Standard
K0911 Electrical Systems - Other Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
K0923 Electrical Equipment ? Ground-Fault Circuit-Interrupter Protection Standard
▼ 53C0001009 Center For Dermatologic Surgery 123 Western Hills Blvd Cheyenne WY 8 (Denver) 07/18/2018 8X6311 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0064 STANDARD LEVEL TAG FOR SURGICAL SERVICES Standard
Q0122 REAPPRAISALS Standard
Q0233 SAFETY - ABUSE/HARASSMENT Standard
▼ 53C0001009 Center For Dermatologic Surgery 123 Western Hills Blvd Cheyenne WY 8 (Denver) 07/18/2018 8X6321 Recertification
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0321 Hazardous Areas - Enclosure Standard
K0345 Fire Alarm System - Testing and Maintenance Standard
K0355 Portable Fire Extinguishers Standard
▼ 53C0001010 Teton Outpatient Services Llc 150 Buffalo Way Jackson WY 8 (Denver) 09/24/2024 64462-L1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
K0345 Fire Alarm System - Testing and Maintenance Standard
K0916 Essential Electrical Systems ? Alarm Annunciator Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
▼ 53C0001010 Teton Outpatient Services Llc 150 Buffalo Way Jackson WY 8 (Denver) 09/12/2018 8XED11 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0062 ANESTHETIC - DISCHARGE Standard
Q0101 PHYSICAL ENVIRONMENT Standard
Q0241 SANITARY ENVIRONMENT Standard
▼ 53C0001010 Teton Outpatient Services Llc 150 Buffalo Way Jackson WY 8 (Denver) 09/12/2018 8XED21 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