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
▼ 15C0001182 Carmel Specialty Surgery Center Llc 11590 N Meridian St Suite 130 Carmel IN 5 (Chicago) 06/01/2023 5FC94-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
K0511 Utilities - Gas and Electric Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
▼ 15C0001182 Carmel Specialty Surgery Center Llc 11590 N Meridian St Suite 130 Carmel IN 5 (Chicago) 07/10/2019 NH3D21 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
K0131 Multiple Occupancies Standard
K0223 Doors with Self-Closing Devices Standard
K0323 Anesthetizing Locations Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
K0933 Features of Fire Protection ? Fire Loss Prevention Standard
▼ 15C0001182 Carmel Specialty Surgery Center Llc 11590 N Meridian St Suite 130 Carmel IN 5 (Chicago) 06/26/2019 NH3D11 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0220 NOTICE - POSTING Standard
Q0243 INFECTION CONTROL PROGRAM - DIRECTION Standard
▼ 15C0001183 Beltway Surgery Centers, Llc 10601 N Meridian St Suite 100 Carmel IN 5 (Chicago) 03/15/2021 4RVM21 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
K0291 Emergency Lighting Standard
K0345 Fire Alarm System - Testing and Maintenance Standard
K0351 Sprinkler System - Installation Standard
K0712 Fire Drills Standard
K0761 Maintenance, Inspection & Testing - Doors Standard
K0781 Portable Space Heaters Standard
K0907 Gas and Vacuum Piped Systems ? Central Supply System Location Standard
K0915 Essential Electrical Systems ? Type 1 and Type 2 Standard
K0923 Electrical Equipment ? Ground-Fault Circuit-Interrupter Protection Standard
▼ 15C0001183 Beltway Surgery Centers, Llc 10601 N Meridian St Suite 100 Carmel IN 5 (Chicago) 03/10/2021 4RVM11 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
Q0108 BUILDING SAFETY Standard
Q0241 SANITARY ENVIRONMENT Standard
Q0242 INFECTION CONTROL PROGRAM Standard
Q0245 INFECTION CONTROL PROGRAM Standard
▼ 15C0001184 Munster Specialty Surgery Center, Llc 9200 Calumet Ave, S-100 Munster IN 5 (Chicago) 01/30/2024 61E40-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0100 ENVIRONMENT Condition
Q0104 SAFETY FROM FIRE Standard
Q0108 BUILDING SAFETY Standard
▼ 15C0001184 Munster Specialty Surgery Center, Llc 9200 Calumet Ave, S-100 Munster IN 5 (Chicago) 01/30/2024 61E40-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
K0353 Sprinkler System - Maintenance and Testing Standard
K0712 Fire Drills Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
▼ 15C0001184 Munster Specialty Surgery Center, Llc 9200 Calumet Ave, S-100 Munster IN 5 (Chicago) 10/07/2020 KMHZ11 Focused Infection Control, Other-Fed, Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0100 ENVIRONMENT Condition
Q0104 SAFETY FROM FIRE Standard
Q0109 EMERGENCY EQUIPMENT Standard
Q0241 SANITARY ENVIRONMENT Standard
▼ 15C0001184 Munster Specialty Surgery Center, Llc 9200 Calumet Ave, S-100 Munster IN 5 (Chicago) 10/07/2020 KMHZ21 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
K0131 Multiple Occupancies Standard
K0291 Emergency Lighting Standard
K0323 Anesthetizing Locations Standard
K0353 Sprinkler System - Maintenance and Testing Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
▼ 15C0001185 South Bend Specialty Surgery Center Llc 335 Florence Avenue, Ste 1b Granger IN 5 (Chicago) 01/30/2025 65292-L1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
E0026 Roles Under a Waiver Declared by Secretary Standard
E0032 Primary/Alternate Means for Communication Standard