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
15C0001074 Ophthalmology Consultants Of Fort Wayne Pc 7232 Engle Rd Fort Wayne IN 5 (Chicago) 02/19/2025 65412-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0100 ENVIRONMENT Condition
Q0104 SAFETY FROM FIRE Standard
15C0001074 Ophthalmology Consultants Of Fort Wayne Pc 7232 Engle Rd Fort Wayne IN 5 (Chicago) 02/19/2025 65412-L1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
K0372 Subdivision of Building Spaces ? Smoke Barrier Construction Standard
K0711 Evacuation and Relocation Plan Standard
15C0001078 Eyecare Consultants Surgery Center 101 Nw First St Ste 104 Evansville IN 5 (Chicago) 05/17/2022 4EABC-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0084 GOVERNING BODY RESPONSIBILITIES Standard
15C0001078 Eyecare Consultants Surgery Center 101 Nw First St Ste 104 Evansville IN 5 (Chicago) 07/17/2018 O6AS21 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
K0346 Fire Alarm System - Out of Service Standard
K0712 Fire Drills Standard
15C0001078 Eyecare Consultants Surgery Center 101 Nw First St Ste 104 Evansville IN 5 (Chicago) 06/21/2018 O6AS11 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
Q0242 INFECTION CONTROL PROGRAM Standard
15C0001079 Naab Road Surgery Center Llc 8260 Naab Road, Suite 100 Indianapolis IN 5 (Chicago) 06/09/2025 663DD-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
15C0001079 Naab Road Surgery Center Llc 8260 Naab Road, Suite 100 Indianapolis IN 5 (Chicago) 06/09/2025 663DD-L1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
K0323 Anesthetizing Locations Standard
K0345 Fire Alarm System - Testing and Maintenance Standard
K0353 Sprinkler System - Maintenance and Testing Standard
K0761 Maintenance, Inspection & Testing - Doors Standard
K0914 Electrical Systems - Maintenance and Testing Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
15C0001079 Naab Road Surgery Center Llc 8260 Naab Road, Suite 100 Indianapolis IN 5 (Chicago) 01/03/2022 P2CB21 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
K0511 Utilities - Gas and Electric Standard
15C0001079 Naab Road Surgery Center Llc 8260 Naab Road, Suite 100 Indianapolis IN 5 (Chicago) 02/20/2018 FXYR21 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
E0007 EP Program Patient Population Standard
E0009 Local, State, Tribal Collaboration Process Standard
E0026 Roles Under a Waiver Declared by Secretary Standard
E0030 Names and Contact Information Standard
E0031 Emergency Officials Contact Information Standard
E0037 EP Training Program Standard
E0039 EP Testing Requirements Standard
K0131 Multiple Occupancies Standard
K0223 Doors with Self-Closing Devices Standard
K0321 Hazardous Areas - Enclosure Standard
K0323 Anesthetizing Locations Standard
K0346 Fire Alarm System - Out of Service Standard
K0354 Sprinkler System - Out of Service Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
15C0001079 Naab Road Surgery Center Llc 8260 Naab Road, Suite 100 Indianapolis IN 5 (Chicago) 02/07/2018 FXYR11 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0100 ENVIRONMENT Condition
Q0082 PROGRAM DATA; PROGRAM ACTIVITIES Standard
Q0084 GOVERNING BODY RESPONSIBILITIES Standard
Q0104 SAFETY FROM FIRE Standard
Q0181 ADMINISTRATION OF DRUGS Standard
Q0241 SANITARY ENVIRONMENT Standard