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
15C0001195 Interventional Pain Management-Hobart 201 Main Street Suite A Hobart IN 5 (Chicago) 04/23/2019 XWGU21 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
K0291 Emergency Lighting Standard
K0345 Fire Alarm System - Testing and Maintenance Standard
K0761 Maintenance, Inspection & Testing - Doors Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
15C0001198 Indiana University Health Ambulatory Surgery Centers, Llc 9660 East Washington Street, Suite 200 Indianapolis IN 5 (Chicago) 08/12/2024 63BAF-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
Q0242 INFECTION CONTROL PROGRAM Standard
15C0001198 Indiana University Health Ambulatory Surgery Centers, Llc 9660 East Washington Street, Suite 200 Indianapolis IN 5 (Chicago) 08/12/2024 63BAF-L1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
K0161 Building Construction Type and Height Standard
K0323 Anesthetizing Locations Standard
K0344 Fire Alarm - Control Functions Standard
K0345 Fire Alarm System - Testing and Maintenance Standard
K0353 Sprinkler System - Maintenance and Testing Standard
K0712 Fire Drills Standard
K0754 Soiled Linen and Trash Containers Standard
K0913 Electrical Systems - Wet Procedure Locations Standard
K0914 Electrical Systems - Maintenance and Testing Standard
K0916 Essential Electrical Systems ? Alarm Annunciator Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
15C0001198 Indiana University Health Ambulatory Surgery Centers, Llc 9660 East Washington Street, Suite 200 Indianapolis IN 5 (Chicago) 10/20/2020 U28I21 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
K0351 Sprinkler System - Installation Standard
K0372 Subdivision of Building Spaces ? Smoke Barrier Construction Standard
15C0001198 Indiana University Health Ambulatory Surgery Centers, Llc 9660 East Washington Street, Suite 200 Indianapolis IN 5 (Chicago) 10/15/2020 U28I11 Focused Infection Control, Other-Fed, Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0081 PROGRAM SCOPE; PROGRAM ACTIVITIES Standard
Q0241 SANITARY ENVIRONMENT Standard
Q0242 INFECTION CONTROL PROGRAM Standard
Q0262 ADMISSION AND PRE-SURGICAL ASSESSMENT Standard
15C0001199 Center For Southside Surgery, Llc 533 East County Line Road Greenwood IN 5 (Chicago) 05/08/2023 5F971-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
Q0141 ORGANIZATION AND STAFFING Standard
Q0181 ADMINISTRATION OF DRUGS Standard
15C0001199 Center For Southside Surgery, Llc 533 East County Line Road Greenwood IN 5 (Chicago) 05/08/2023 5F971-L1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
K0341 Fire Alarm System - Installation Standard
K0351 Sprinkler System - Installation Standard
K0712 Fire Drills Standard
K0907 Gas and Vacuum Piped Systems ? Central Supply System Location Standard
15C0001200 Lpc Surgery Center Llc 770 Park East Blvd Suite A Lafayette IN 5 (Chicago) 08/09/2024 63C11-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
15C0001200 Lpc Surgery Center Llc 770 Park East Blvd Suite A Lafayette IN 5 (Chicago) 08/01/2024 63C11-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0081 PROGRAM SCOPE; PROGRAM ACTIVITIES Standard
Q0162 FORM AND CONTENT OF RECORD Standard
Q0241 SANITARY ENVIRONMENT Standard
15C0001200 Lpc Surgery Center Llc 770 Park East Blvd Suite A Lafayette IN 5 (Chicago) 02/24/2021 T0CY21 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
K0291 Emergency Lighting Standard
K0321 Hazardous Areas - Enclosure Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard