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
▼ 14C0001070 Springfield Clinic Llp 1025 S 6th St Springfield IL 5 (Chicago) 07/30/2024 63722-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
▼ 14C0001070 Springfield Clinic Llp 1025 S 6th St Springfield IL 5 (Chicago) 07/30/2024 63722-L1 Recertification
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0291 Emergency Lighting Standard
K0902 Gas and Vacuum Piped Systems - Other Standard
K0906 Gas and Vacuum Piped Systems ? Central Supply System Operations Standard
K0915 Essential Electrical Systems ? Type 1 and Type 2 Standard
K0923 Electrical Equipment ? Ground-Fault Circuit-Interrupter Protection Standard
▼ 14C0001070 Springfield Clinic Llp 1025 S 6th St Springfield IL 5 (Chicago) 12/18/2019 0WC411 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
E0009 Local, State, Tribal Collaboration Process Standard
E0020 Policies for Evac. and Primary/Alt. Comm. Standard
E0022 Policies/Procedures for Sheltering in Place Standard
E0023 Policies/Procedures for Medical Documentation Standard
E0024 Policies/Procedures-Volunteers and Staffing Standard
E0036 EP Training and Testing Standard
E0037 EP Training Program Standard
E0039 EP Testing Requirements Standard
Q0101 PHYSICAL ENVIRONMENT Standard
Q0104 SAFETY FROM FIRE Standard
Q0109 EMERGENCY EQUIPMENT Standard
Q0162 FORM AND CONTENT OF RECORD Standard
Q0242 INFECTION CONTROL PROGRAM Standard
Q0261 PATIENT ASSESSMENT AND ADMISSION Standard
Q0262 ADMISSION AND PRE-SURGICAL ASSESSMENT Standard
▼ 14C0001070 Springfield Clinic Llp 1025 S 6th St Springfield IL 5 (Chicago) 12/18/2019 0WC421 Recertification
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0223 Doors with Self-Closing Devices Standard
K0341 Fire Alarm System - Installation Standard
K0911 Electrical Systems - Other 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
▼ 14C0001071 Rsc Illinois, Llc 545 Valley View Dr Moline IL 5 (Chicago) 05/30/2018 FFUY11 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
Q0002 DEFINITIONS Standard
Q0063 ADMINISTRATION OF ANESTHESIA Standard
Q0104 SAFETY FROM FIRE Standard
Q0162 FORM AND CONTENT OF RECORD Standard
Q0181 ADMINISTRATION OF DRUGS Standard
Q0221 NOTICE OF RIGHTS Standard
Q0223 NOTICE - PHYSICIAN OWNERSHIP Standard
Q0224 ADVANCED DIRECTIVES Standard
Q0241 SANITARY ENVIRONMENT Standard
Q0242 INFECTION CONTROL PROGRAM Standard
▼ 14C0001071 Rsc Illinois, Llc 545 Valley View Dr Moline IL 5 (Chicago) 05/30/2018 FFUY21 Recertification
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0131 Multiple Occupancies Standard
K0161 Building Construction Type and Height Standard
K0344 Fire Alarm - Control Functions Standard
K0712 Fire Drills Standard
K0911 Electrical Systems - Other Standard
K0912 Electrical Systems - Receptacles Standard
K0915 Essential Electrical Systems ? Type 1 and Type 2 Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
▼ 14C0001074 Effingham Ambul Surgical Treatment Cte 904 West Temple Avenue Effingham IL 5 (Chicago) 01/22/2025 65035-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
▼ 14C0001074 Effingham Ambul Surgical Treatment Cte 904 West Temple Avenue Effingham IL 5 (Chicago) 01/22/2025 65035-L1 Recertification
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0902 Gas and Vacuum Piped Systems - Other Standard
▼ 14C0001075 The Lake Bluff Il Endoscopy Asc Llc 101 S Waukegan Road, Suite 980 Lake Bluff IL 5 (Chicago) 01/05/2021 K1SA11 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
▼ 14C0001075 The Lake Bluff Il Endoscopy Asc Llc 101 S Waukegan Road, Suite 980 Lake Bluff IL 5 (Chicago) 01/05/2021 K1SA21 Recertification
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0341 Fire Alarm System - Installation Standard
K0343 Fire Alarm System - Notification Standard
K0351 Sprinkler System - Installation Standard