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
14C0001056 Quad City Ambulatory Surgery Center 520 Valley View Dr Moline IL 5 (Chicago) 04/20/2023 5F581-L1 Recertification
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0200 Means of Egress Requirements - Other Standard
K0712 Fire Drills Standard
14C0001056 Quad City Ambulatory Surgery Center 520 Valley View Dr Moline IL 5 (Chicago) 04/14/2023 5F581-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
Q0242 INFECTION CONTROL PROGRAM Standard
14C0001056 Quad City Ambulatory Surgery Center 520 Valley View Dr Moline IL 5 (Chicago) 06/21/2018 R6OR11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0060 SURGICAL SERVICES Condition
Q0100 ENVIRONMENT Condition
Q0104 SAFETY FROM FIRE Standard
Q0162 FORM AND CONTENT OF RECORD Standard
Q0181 ADMINISTRATION OF DRUGS Standard
Q0241 SANITARY ENVIRONMENT Standard
Q0261 ADMISSION ASSESSMENT Standard
Q0264 POST-SURGICAL ASSESSMENT Standard
14C0001056 Quad City Ambulatory Surgery Center 520 Valley View Dr Moline IL 5 (Chicago) 06/21/2018 R6OR21 Recertification
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0321 Hazardous Areas - Enclosure Standard
K0341 Fire Alarm System - Installation Standard
K0343 Fire Alarm System - Notification Standard
K0345 Fire Alarm System - Testing and Maintenance Standard
K0371 Subdivision of Building Spaces ? Smoke Compartments Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
14C0001057 Novamed Eye Surg Ctr Of Maryville Llc 12 Professional Park Dr Maryville IL 5 (Chicago) 12/17/2024 64C91-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
14C0001057 Novamed Eye Surg Ctr Of Maryville Llc 12 Professional Park Dr Maryville IL 5 (Chicago) 12/17/2024 64C91-L1 Recertification
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0341 Fire Alarm System - Installation Standard
K0902 Gas and Vacuum Piped Systems - Other Standard
14C0001057 Novamed Eye Surg Ctr Of Maryville Llc 12 Professional Park Dr Maryville IL 5 (Chicago) 12/09/2020 UOPU11 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
14C0001057 Novamed Eye Surg Ctr Of Maryville Llc 12 Professional Park Dr Maryville IL 5 (Chicago) 12/09/2020 UOPU21 Recertification
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0291 Emergency Lighting Standard
K0712 Fire Drills Standard
14C0001058 Soderstrom Dermatology Center 4909 N Glen Park Place Peoria IL 5 (Chicago) 01/29/2024 61C0F-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
Q0162 FORM AND CONTENT OF RECORD Standard
14C0001058 Soderstrom Dermatology Center 4909 N Glen Park Place Peoria IL 5 (Chicago) 01/29/2024 61C0F-L1 Recertification
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0291 Emergency Lighting Standard
K0345 Fire Alarm System - Testing and Maintenance Standard
K0712 Fire Drills Standard