S&C QCOR ASC 2567s
d QCOR:  Quality, Certification and Oversight Reports.
ASCs 2567s
Selection Criteria

Time Interval

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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
14C0001031 Valley Ambulatory Surgery Center 2475 Dean Street Saint Charles IL 5 (Chicago) 08/03/2023 607F7-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0100 ENVIRONMENT Condition
Q0104 SAFETY FROM FIRE Standard
14C0001031 Valley Ambulatory Surgery Center 2475 Dean Street Saint Charles IL 5 (Chicago) 08/03/2023 607F7-L1 Recertification
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0293 Exit Signage Standard
K0353 Sprinkler System - Maintenance and Testing Standard
K0355 Portable Fire Extinguishers Standard
K0902 Gas and Vacuum Piped Systems - Other Standard
14C0001031 Valley Ambulatory Surgery Center 2475 Dean Street Saint Charles IL 5 (Chicago) 05/28/2019 YTBB11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0100 ENVIRONMENT Condition
Q0240 INFECTION CONTROL Condition
Q0104 SAFETY FROM FIRE Standard
Q0242 INFECTION CONTROL PROGRAM Standard
14C0001031 Valley Ambulatory Surgery Center 2475 Dean Street Saint Charles IL 5 (Chicago) 05/28/2019 YTBB21 Recertification
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0131 Multiple Occupancies Standard
K0222 Egress Doors Standard
K0291 Emergency Lighting Standard
K0321 Hazardous Areas - Enclosure Standard
K0345 Fire Alarm System - Testing and Maintenance Standard
K0351 Sprinkler System - Installation Standard
K0712 Fire Drills Standard
K0911 Electrical Systems - Other Standard
K0912 Electrical Systems - Receptacles Standard
K0917 Electrical Systems - Essential Electric Syste Standard
14C0001033 Novamed Surgery Center Of Chicago Northshore, Llc 3034 W Peterson Ave Chicago IL 5 (Chicago) 01/30/2024 61FEC-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0100 ENVIRONMENT Condition
Q0240 INFECTION CONTROL Condition
Q0104 SAFETY FROM FIRE Standard
Q0242 INFECTION CONTROL PROGRAM Standard
Q0243 INFECTION CONTROL PROGRAM - DIRECTION Standard
Q0266 DISCHARGE - ORDER Standard
14C0001033 Novamed Surgery Center Of Chicago Northshore, Llc 3034 W Peterson Ave Chicago IL 5 (Chicago) 01/30/2024 61FEC-L1 Recertification
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0321 Hazardous Areas - Enclosure Standard
K0345 Fire Alarm System - Testing and Maintenance Standard
K0761 Maintenance, Inspection & Testing - Doors Standard
K0912 Electrical Systems - Receptacles Standard
14C0001033 Novamed Surgery Center Of Chicago Northshore, Llc 3034 W Peterson Ave Chicago IL 5 (Chicago) 02/27/2020 T4FL11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0100 ENVIRONMENT Condition
Q0104 SAFETY FROM FIRE Standard
14C0001033 Novamed Surgery Center Of Chicago Northshore, Llc 3034 W Peterson Ave Chicago IL 5 (Chicago) 02/27/2020 T4FL21 Recertification
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0321 Hazardous Areas - Enclosure Standard
K0341 Fire Alarm System - Installation Standard
14C0001037 Midwest Eye Care & Surgery Ctr 1700 East West Rd Calumet City IL 5 (Chicago) 02/24/2021 VYOO11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
Q0000 Initial Comments - Not a Deficiency Citation Memo
E0001 Establishment of the Emergency Program (EP) Condition
Q0040 GOVERNING BODY AND MANAGEMENT Condition
Q0080 QUALITY ASSESSMENT AND PERFORMANCE Condition
Q0100 ENVIRONMENT Condition
Q0240 INFECTION CONTROL Condition
E0006 Plan Based on All Hazards Risk Assessment Standard
E0009 Local, State, Tribal Collaboration Process Standard
E0037 EP Training Program Standard
E0039 EP Testing Requirements Standard
Q0062 ANESTHETIC - DISCHARGE Standard
Q0082 PROGRAM DATA; PROGRAM ACTIVITIES Standard
Q0104 SAFETY FROM FIRE Standard
Q0245 INFECTION CONTROL PROGRAM Standard
Q0264 POST-SURGICAL ASSESSMENT Standard
14C0001037 Midwest Eye Care & Surgery Ctr 1700 East West Rd Calumet City IL 5 (Chicago) 02/24/2021 VYOO21 Recertification
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0211 Means of Egress - General Standard
K0281 Illumination of Means of Egress Standard
K0291 Emergency Lighting Standard
K0293 Exit Signage Standard
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
K0913 Electrical Systems - Wet Procedure Locations Standard
K0915 Essential Electrical Systems ? Type 1 and Type 2 Standard
K0917 Electrical Systems - Essential Electric Syste Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
K0923 Electrical Equipment ? Ground-Fault Circuit-Interrupter Protection Standard