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

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
14C0001050 Peoria Day Surgery Center 7309 N Knoxville Ave Ste 2 Peoria IL 5 (Chicago) 10/17/2018 MGXP21 Recertification
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0321 Hazardous Areas - Enclosure Standard
K0911 Electrical Systems - Other Standard
K0912 Electrical Systems - Receptacles Standard
14C0001052 Center For Health Ambulatory Surgery Center Llc 303 North Kumpf Boulevard Peoria IL 5 (Chicago) 01/18/2018 6JLJ11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
Q0100 ENVIRONMENT Condition
E0004 Develop EP Plan, Review and Update Annually Standard
E0007 EP Program Patient Population Standard
E0030 Names and Contact Information Standard
E0037 EP Training Program Standard
Q0082 PROGRAM DATA; PROGRAM ACTIVITIES Standard
Q0084 GOVERNING BODY RESPONSIBILITIES Standard
Q0101 PHYSICIAL ENVIRONMENT Standard
Q0104 SAFETY FROM FIRE Standard
Q0141 ORGANIZATION AND STAFFING Standard
Q0181 ADMINISTRATION OF DRUGS Standard
Q0241 SANITARY ENVIRONMENT Standard
Q0242 INFECTION CONTROL PROGRAM Standard
14C0001052 Center For Health Ambulatory Surgery Center Llc 303 North Kumpf Boulevard Peoria IL 5 (Chicago) 01/18/2018 6JLJ21 Recertification
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0291 Emergency Lighting Standard
K0321 Hazardous Areas - Enclosure Standard
K0351 Sprinkler System - Installation Standard
K0915 Essential Electrical Systems ? Type 1 and Type 2 Standard
14C0001053 Center For Orthopedic Med Llc,The 2502 East Empire St Ste B Bloomington IL 5 (Chicago) 03/10/2026 1E1E13-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
14C0001053 Center For Orthopedic Med Llc,The 2502 East Empire St Ste B Bloomington IL 5 (Chicago) 03/10/2026 1E1E13-L1 Recertification
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0131 Multiple Occupancies Standard
K0353 Sprinkler System - Maintenance and Testing Standard
K0761 Maintenance, Inspection & Testing - Doors Standard
K0911 Electrical Systems - Other Standard
14C0001053 Center For Orthopedic Med Llc,The 2502 East Empire St Ste B Bloomington IL 5 (Chicago) 12/07/2021 8XUP11 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
Q0241 SANITARY ENVIRONMENT Standard
14C0001053 Center For Orthopedic Med Llc,The 2502 East Empire St Ste B Bloomington IL 5 (Chicago) 12/07/2021 8XUP21 Recertification
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0222 Egress Doors Standard
K0345 Fire Alarm System - Testing and Maintenance Standard
K0712 Fire Drills Standard
14C0001053 Center For Orthopedic Med Llc,The 2502 East Empire St Ste B Bloomington IL 5 (Chicago) 12/21/2018 EVBL11 Complaint
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0040 GOVERNING BODY AND MANAGEMENT Condition
Q0060 SURGICAL SERVICES Condition
Q0160 MEDICAL RECORDS Condition
Q0219 PATIENT RIGHTS Condition
Q0041 CONTRACT SERVICES Standard
Q0061 ANESTHETIC RISK AND EVALUATION Standard
Q0082 PROGRAM DATA; PROGRAM ACTIVITIES Standard
Q0162 FORM AND CONTENT OF RECORD Standard
Q0229 EXERCISE OF RIGHTS - INFORMED CONSENT Standard
Q0242 INFECTION CONTROL PROGRAM Standard
14C0001053 Center For Orthopedic Med Llc,The 2502 East Empire St Ste B Bloomington IL 5 (Chicago) 04/05/2018 GUKO11 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0100 ENVIRONMENT Condition
Q0104 SAFETY FROM FIRE Standard
Q0122 REAPPRAISALS Standard
Q0162 FORM AND CONTENT OF RECORD Standard
Q0184 VERBAL ORDERS Standard
Q0221 NOTICE OF RIGHTS Standard
Q0223 NOTICE - PHYSICIAN OWNERSHIP Standard
Q0264 POST-SURGICAL ASSESSMENT Standard
14C0001053 Center For Orthopedic Med Llc,The 2502 East Empire St Ste B Bloomington IL 5 (Chicago) 04/05/2018 GUKO21 Recertification
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0311 Vertical Openings - Enclosure Standard
K0321 Hazardous Areas - Enclosure Standard
K0341 Fire Alarm System - Installation Standard
K0351 Sprinkler System - Installation Standard