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
▼ 15C0001020 Eye Surgery Center Of New Albany, Llc 520 W First St New Albany IN 5 (Chicago) 05/09/2022 R78921 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
K0353 Sprinkler System - Maintenance and Testing Standard
K0911 Electrical Systems - Other Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
▼ 15C0001020 Eye Surgery Center Of New Albany, Llc 520 W First St New Albany IN 5 (Chicago) 04/19/2022 R78911 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0100 ENVIRONMENT Condition
Q0084 GOVERNING BODY RESPONSIBILITIES Standard
Q0101 PHYSICAL ENVIRONMENT Standard
Q0122 REAPPRAISALS Standard
▼ 15C0001020 Eye Surgery Center Of New Albany, Llc 520 W First St New Albany IN 5 (Chicago) 08/19/2020 QFL711 Complaint, Focused Infection Control, Other-Fed
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0121 MEMBERSHIP AND CLINICAL PRIVILEGES Standard
Q0123 OTHER PRACTITIONERS Standard
▼ 15C0001020 Eye Surgery Center Of New Albany, Llc 520 W First St New Albany IN 5 (Chicago) 02/18/2020 H1LZ11 Complaint
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0082 PROGRAM DATA; PROGRAM ACTIVITIES Standard
Q0232 SAFETY Standard
Q0242 INFECTION CONTROL PROGRAM Standard
▼ 15C0001020 Eye Surgery Center Of New Albany, Llc 520 W First St New Albany IN 5 (Chicago) 11/13/2019 X66R11 Complaint
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0141 ORGANIZATION AND STAFFING Standard
▼ 15C0001020 Eye Surgery Center Of New Albany, Llc 520 W First St New Albany IN 5 (Chicago) 06/21/2018 TOC521 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
K0321 Hazardous Areas - Enclosure Standard
K0353 Sprinkler System - Maintenance and Testing Standard
▼ 15C0001020 Eye Surgery Center Of New Albany, Llc 520 W First St New Albany IN 5 (Chicago) 05/23/2018 TOC511 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0100 ENVIRONMENT Condition
Q0082 PROGRAM DATA; PROGRAM ACTIVITIES 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
▼ 15C0001021 Scp Indianapolis Llc 7430 N Shadeland Ave Ste 100 Indianapolis IN 5 (Chicago) 01/07/2025 64C5D-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0100 ENVIRONMENT Condition
Q0101 PHYSICAL ENVIRONMENT Standard
Q0104 SAFETY FROM FIRE Standard
Q0162 FORM AND CONTENT OF RECORD Standard
▼ 15C0001021 Scp Indianapolis Llc 7430 N Shadeland Ave Ste 100 Indianapolis IN 5 (Chicago) 01/07/2025 64C5D-L1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
K0211 Means of Egress - General Standard
K0291 Emergency Lighting Standard
K0323 Anesthetizing Locations Standard
K0345 Fire Alarm System - Testing and Maintenance Standard
K0761 Maintenance, Inspection & Testing - Doors Standard
K0906 Gas and Vacuum Piped Systems ? Central Supply System Operations Standard
K0913 Electrical Systems - Wet Procedure Locations Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
K0920 Electrical Equipment ? Power Cords and Extension Cords Standard
▼ 15C0001021 Scp Indianapolis Llc 7430 N Shadeland Ave Ste 100 Indianapolis IN 5 (Chicago) 01/25/2021 036D21 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
K0345 Fire Alarm System - Testing and Maintenance Standard
K0914 Electrical Systems - Maintenance and Testing Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard