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
15C0001151 Broadwest Specialty Surgical Center Llc 315 W 89th Ave Merrillville IN 5 (Chicago) 05/20/2024 62EC0-L1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
K0131 Multiple Occupancies Standard
K0161 Building Construction Type and Height Standard
K0321 Hazardous Areas - Enclosure Standard
K0341 Fire Alarm System - Installation Standard
K0345 Fire Alarm System - Testing and Maintenance Standard
K0351 Sprinkler System - Installation Standard
K0511 Utilities - Gas and Electric Standard
K0521 HVAC Standard
K0915 Essential Electrical Systems ? Type 1 and Type 2 Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
K0920 Electrical Equipment ? Power Cords and Extension Cords Standard
15C0001151 Broadwest Specialty Surgical Center Llc 315 W 89th Ave Merrillville IN 5 (Chicago) 11/24/2020 Y0F321 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
K0131 Multiple Occupancies Standard
K0211 Means of Egress - General Standard
K0323 Anesthetizing Locations Standard
K0345 Fire Alarm System - Testing and Maintenance Standard
K0351 Sprinkler System - Installation Standard
K0353 Sprinkler System - Maintenance and Testing Standard
K0761 Maintenance, Inspection & Testing - Doors Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
K0920 Electrical Equipment ? Power Cords and Extension Cords Standard
15C0001151 Broadwest Specialty Surgical Center Llc 315 W 89th Ave Merrillville IN 5 (Chicago) 11/20/2020 Y0F311 Focused Infection Control, Other-Fed, 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
Q0242 INFECTION CONTROL PROGRAM Standard
15C0001151 Broadwest Specialty Surgical Center Llc 315 W 89th Ave Merrillville IN 5 (Chicago) 01/17/2018 Z9FE11 Complaint
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0245 INFECTION CONTROL PROGRAM Standard
15C0001156 Indiana Skin Cancer Ambulatory Surgical Center Llc 701 E County Line Rd Ste 208 Greenwood IN 5 (Chicago) 09/08/2025 1D4F07-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
15C0001156 Indiana Skin Cancer Ambulatory Surgical Center Llc 701 E County Line Rd Ste 208 Greenwood IN 5 (Chicago) 09/08/2025 1D4F07-L1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
K0100 General Requirements - Other Standard
K0131 Multiple Occupancies Standard
K0291 Emergency Lighting Standard
K0345 Fire Alarm System - Testing and Maintenance Standard
15C0001156 Indiana Skin Cancer Ambulatory Surgical Center Llc 701 E County Line Rd Ste 208 Greenwood IN 5 (Chicago) 01/31/2022 1OCE21 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
E0013 Development of EP Policies and Procedures Standard
K0100 General Requirements - Other Standard
K0131 Multiple Occupancies Standard
K0911 Electrical Systems - Other Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
K0920 Electrical Equipment ? Power Cords and Extension Cords Standard
15C0001156 Indiana Skin Cancer Ambulatory Surgical Center Llc 701 E County Line Rd Ste 208 Greenwood IN 5 (Chicago) 01/25/2022 1OCE11 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0100 ENVIRONMENT Condition
Q0104 SAFETY FROM FIRE Standard
15C0001156 Indiana Skin Cancer Ambulatory Surgical Center Llc 701 E County Line Rd Ste 208 Greenwood IN 5 (Chicago) 05/31/2018 BH5321 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
15C0001156 Indiana Skin Cancer Ambulatory Surgical Center Llc 701 E County Line Rd Ste 208 Greenwood IN 5 (Chicago) 05/16/2018 BH5311 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0082 PROGRAM DATA; PROGRAM ACTIVITIES Standard
Q0242 INFECTION CONTROL PROGRAM Standard