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
▼ 14C0001155 Barrington Ambulatory Surgery Center 600 Hart Rd, Suite 300 Barrington IL 5 (Chicago) 08/26/2024 63CAC-L1 Recertification
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0353 Sprinkler System - Maintenance and Testing Standard
K0521 HVAC Standard
K0712 Fire Drills Standard
K0902 Gas and Vacuum Piped Systems - Other Standard
▼ 14C0001155 Barrington Ambulatory Surgery Center 600 Hart Rd, Suite 300 Barrington IL 5 (Chicago) 11/19/2020 MT1P11 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
Q0223 NOTICE - PHYSICIAN OWNERSHIP Standard
Q0241 SANITARY ENVIRONMENT Standard
▼ 14C0001155 Barrington Ambulatory Surgery Center 600 Hart Rd, Suite 300 Barrington IL 5 (Chicago) 11/19/2020 MT1P21 Recertification
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0131 Multiple Occupancies Standard
K0311 Vertical Openings - Enclosure Standard
K0761 Maintenance, Inspection & Testing - Doors Standard
K0912 Electrical Systems - Receptacles Standard
K0915 Essential Electrical Systems ? Type 1 and Type 2 Standard
▼ 14C0001157 Physicians Surgery Center At Good Samaritan Llc 2 Good Samaritan Way, Ste 200 Mount Vernon IL 5 (Chicago) 12/02/2021 EZL911 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0203 RADIOLOGIC SERVICES Standard
Q0241 SANITARY ENVIRONMENT Standard
▼ 14C0001158 Oak Lawn Il Endoscopy Asc Llc 9921 Southwest Highway Oak Lawn IL 5 (Chicago) 07/08/2021 HR5Z11 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0240 INFECTION CONTROL Condition
Q0242 INFECTION CONTROL PROGRAM Standard
▼ 14C0001158 Oak Lawn Il Endoscopy Asc Llc 9921 Southwest Highway Oak Lawn IL 5 (Chicago) 07/08/2021 XL4E11 Focused Infection Control, Other-Fed
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0242 INFECTION CONTROL PROGRAM Standard
▼ 14C0001164 Winchester Endoscopy, Llc 1870 W Winchester Rd, Suite 146 Libertyville IL 5 (Chicago) 05/10/2019 E68V11 Recertification, Sample Validation
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
Q0042 HOSPITALIZATION Standard
Q0104 SAFETY FROM FIRE Standard
▼ 14C0001164 Winchester Endoscopy, Llc 1870 W Winchester Rd, Suite 146 Libertyville IL 5 (Chicago) 05/09/2019 E68V21 Recertification, Sample Validation
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0131 Multiple Occupancies Standard
K0906 Gas and Vacuum Piped Systems ? Central Supply System Operations Standard
▼ 14C0001165 Dekalb Surgical Services, Llc 2515 Klein Rd Sycamore IL 5 (Chicago) 11/14/2023 61724-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
▼ 14C0001165 Dekalb Surgical Services, Llc 2515 Klein Rd Sycamore IL 5 (Chicago) 11/14/2023 61724-L1 Recertification
Deficiency Tag Deficiency Description Tag Type
K0000 INITIAL COMMENTS Memo
K0291 Emergency Lighting Standard
K0293 Exit Signage Standard
K0341 Fire Alarm System - Installation Standard
K0712 Fire Drills Standard
K0761 Maintenance, Inspection & Testing - Doors Standard
K0902 Gas and Vacuum Piped Systems - Other Standard