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
▼ 15C0001178 Indiana University Health Ambulatory Surgery Centers, Llc 13100 East 136th Street Ste 1100 Fishers IN 5 (Chicago) 02/13/2024 6233D-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0162 FORM AND CONTENT OF RECORD Standard
Q0265 DISCHARGE - SUPPLIES AND INFORMATION Standard
▼ 15C0001178 Indiana University Health Ambulatory Surgery Centers, Llc 13100 East 136th Street Ste 1100 Fishers IN 5 (Chicago) 10/27/2020 QFBU21 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
K0353 Sprinkler System - Maintenance and Testing Standard
K0354 Sprinkler System - Out of Service Standard
K0372 Subdivision of Building Spaces ? Smoke Barrier Construction Standard
K0511 Utilities - Gas and Electric Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
▼ 15C0001178 Indiana University Health Ambulatory Surgery Centers, Llc 13100 East 136th Street Ste 1100 Fishers IN 5 (Chicago) 10/21/2020 QFBU11 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
Q0108 BUILDING SAFETY Standard
Q0242 INFECTION CONTROL PROGRAM Standard
▼ 15C0001180 Riverview Surgery Center 1276 North Plaza Drive Rockport IN 5 (Chicago) 07/26/2023 6086F-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0100 ENVIRONMENT Condition
Q0104 SAFETY FROM FIRE Standard
▼ 15C0001180 Riverview Surgery Center 1276 North Plaza Drive Rockport IN 5 (Chicago) 07/26/2023 6086F-L1 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
K0521 HVAC Standard
▼ 15C0001180 Riverview Surgery Center 1276 North Plaza Drive Rockport IN 5 (Chicago) 10/28/2019 4OZK21 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
E0004 Develop EP Plan, Review and Update Annually Standard
E0013 Development of EP Policies and Procedures Standard
E0024 Policies/Procedures-Volunteers and Staffing Standard
E0026 Roles Under a Waiver Declared by Secretary Standard
E0029 Development of Communication Plan Standard
E0036 EP Training and Testing Standard
E0037 EP Training Program Standard
E0039 EP Testing Requirements Standard
K0353 Sprinkler System - Maintenance and Testing Standard
K0712 Fire Drills Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
▼ 15C0001180 Riverview Surgery Center 1276 North Plaza Drive Rockport IN 5 (Chicago) 09/17/2019 4OZK11 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0084 GOVERNING BODY RESPONSIBILITIES Standard
Q0123 OTHER PRACTITIONERS Standard
Q0241 SANITARY ENVIRONMENT Standard
▼ 15C0001181 Columbus Specialty Surgery Center, Llc 2425 North Park Drive Suite 20 Columbus IN 5 (Chicago) 08/03/2023 608B3-L1 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
K0712 Fire Drills Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
▼ 15C0001181 Columbus Specialty Surgery Center, Llc 2425 North Park Drive Suite 20 Columbus IN 5 (Chicago) 09/04/2019 SGRV21 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
E0024 Policies/Procedures-Volunteers and Staffing Standard
E0026 Roles Under a Waiver Declared by Secretary Standard
K0291 Emergency Lighting Standard
K0346 Fire Alarm System - Out of Service Standard
K0353 Sprinkler System - Maintenance and Testing Standard
K0354 Sprinkler System - Out of Service Standard
K0372 Subdivision of Building Spaces ? Smoke Barrier Construction Standard
K0521 HVAC Standard
K0911 Electrical Systems - Other Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
▼ 15C0001181 Columbus Specialty Surgery Center, Llc 2425 North Park Drive Suite 20 Columbus IN 5 (Chicago) 08/13/2019 SGRV11 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0082 PROGRAM DATA; PROGRAM ACTIVITIES Standard
Q0084 GOVERNING BODY RESPONSIBILITIES Standard