S&C QCOR ASC 2567s
d QCOR:  Quality, Certification and Oversight Reports.
ASCs 2567s
Selection Criteria

Time Interval

Please select the calendar year or years for which you would like data.

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
52C0001044 The Center For Aesthetic And Plastic Surgery Sc 425 S Commercial St Neenah WI 5 (Chicago) 02/12/2018 PWM921 Recertification, Sample Validation
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
K0321 Hazardous Areas - Enclosure Standard
K0341 Fire Alarm System - Installation Standard
K0345 Fire Alarm System - Testing and Maintenance Standard
K0355 Portable Fire Extinguishers Standard
K0712 Fire Drills Standard
K0911 Electrical Systems - Other Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
52C0001048 Woodland Surgery Ctr 2325 N Casaloma Dr Appleton WI 5 (Chicago) 08/29/2018 55XW11 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0100 ENVIRONMENT Condition
Q0104 SAFETY FROM FIRE Standard
Q0241 SANITARY ENVIRONMENT Standard
52C0001048 Woodland Surgery Ctr 2325 N Casaloma Dr Appleton WI 5 (Chicago) 08/29/2018 55XW21 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
K0131 Multiple Occupancies Standard
K0222 Egress Doors Standard
K0271 Discharge from Exits Standard
K0341 Fire Alarm System - Installation Standard
K0353 Sprinkler System - Maintenance and Testing Standard
K0712 Fire Drills Standard
K0754 Soiled Linen and Trash Containers Standard
52C0001053 Mayfair Digestive Healthcare Llc 1033 N Mayfair Rd Ste 104 Wauwatosa WI 5 (Chicago) 06/27/2024 63643-H1 Focused Infection Control, Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0100 ENVIRONMENT Condition
Q0104 SAFETY FROM FIRE Standard
Q0221 NOTICE OF RIGHTS Standard
52C0001053 Mayfair Digestive Healthcare Llc 1033 N Mayfair Rd Ste 104 Wauwatosa WI 5 (Chicago) 06/27/2024 63643-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
K0353 Sprinkler System - Maintenance and Testing Standard
K0711 Evacuation and Relocation Plan Standard
K0911 Electrical Systems - Other Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
52C0001057 East Mequon Surgery Ctr Llc 12203 Corporate Pkwy Mequon WI 5 (Chicago) 04/10/2024 6297A-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0100 ENVIRONMENT Condition
Q0104 SAFETY FROM FIRE Standard
Q0181 ADMINISTRATION OF DRUGS Standard
Q0242 INFECTION CONTROL PROGRAM Standard
52C0001057 East Mequon Surgery Ctr Llc 12203 Corporate Pkwy Mequon WI 5 (Chicago) 04/10/2024 6297A-L1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
K0521 HVAC Standard
K0911 Electrical Systems - Other Standard
K0923 Electrical Equipment ? Ground-Fault Circuit-Interrupter Protection Standard
52C0001059 Froedtert Surgery Center 840 North 87th Street Milwaukee WI 5 (Chicago) 08/20/2024 63B70-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0100 ENVIRONMENT Condition
Q0101 PHYSICAL ENVIRONMENT Standard
Q0104 SAFETY FROM FIRE Standard
Q0181 ADMINISTRATION OF DRUGS Standard
Q0241 SANITARY ENVIRONMENT Standard
Q0267 DISCHARGE WITH RESPONSIBLE ADULT Standard
52C0001059 Froedtert Surgery Center 840 North 87th Street Milwaukee WI 5 (Chicago) 08/20/2024 63B70-L1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
K0211 Means of Egress - General Standard
K0354 Sprinkler System - Out of Service Standard
K0374 Subdivision of Building Spaces ? Smoke Barrier Doors Standard
K0711 Evacuation and Relocation Plan Standard
K0712 Fire Drills Standard
K0914 Electrical Systems - Maintenance and Testing Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
52C0001059 Froedtert Surgery Center 840 North 87th Street Milwaukee WI 5 (Chicago) 05/08/2018 7OWY11 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0100 ENVIRONMENT Condition
Q0062 ANESTHETIC - DISCHARGE Standard
Q0104 SAFETY FROM FIRE Standard
Q0241 SANITARY ENVIRONMENT Standard
Q0261 ADMISSION ASSESSMENT Standard