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
▼ 52C0001059 Froedtert Surgery Center 840 North 87th Street Milwaukee WI 5 (Chicago) 05/08/2018 7OWY21 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
K0372 Subdivision of Building Spaces ? Smoke Barrier Construction Standard
K0511 Utilities - Gas and Electric Standard
▼ 52C0001060 Surgi Center Of Greater Madison Llc 34 Schroeder St #100 Madison WI 5 (Chicago) 03/12/2018 4YIP11 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0100 ENVIRONMENT Condition
Q0084 GOVERNING BODY RESPONSIBILITIES Standard
Q0104 SAFETY FROM FIRE Standard
▼ 52C0001060 Surgi Center Of Greater Madison Llc 34 Schroeder St #100 Madison WI 5 (Chicago) 03/12/2018 4YIP21 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
K0291 Emergency Lighting Standard
K0323 Anesthetizing Locations Standard
K0341 Fire Alarm System - Installation Standard
K0342 Fire Alarm System - Initiation Standard
K0345 Fire Alarm System - Testing and Maintenance Standard
K0351 Sprinkler System - Installation Standard
K0353 Sprinkler System - Maintenance and Testing Standard
K0355 Portable Fire Extinguishers Standard
▼ 52C0001065 Orthopedic And Sports Surgery Center 2105 East Enterprise Avenue Appleton WI 5 (Chicago) 03/06/2024 625BE-H1 Complaint, Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0100 ENVIRONMENT Condition
Q0104 SAFETY FROM FIRE Standard
▼ 52C0001065 Orthopedic And Sports Surgery Center 2105 East Enterprise Avenue Appleton WI 5 (Chicago) 03/05/2024 625BE-L1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
K0321 Hazardous Areas - Enclosure Standard
K0345 Fire Alarm System - Testing and Maintenance Standard
K0372 Subdivision of Building Spaces ? Smoke Barrier Construction Standard
K0374 Subdivision of Building Spaces ? Smoke Barrier Doors Standard
K0521 HVAC Standard
K0712 Fire Drills Standard
K0906 Gas and Vacuum Piped Systems ? Central Supply System Operations Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
▼ 52C0001067 Surgery Center Of Wisconsin Rapids 140 24th Street South Wisconsin Rapids WI 5 (Chicago) 03/14/2018 GBU711 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0100 ENVIRONMENT Condition
Q0120 MEDICAL STAFF Condition
Q0104 SAFETY FROM FIRE Standard
Q0123 OTHER PRACTITIONERS Standard
Q0181 ADMINISTRATION OF DRUGS Standard
Q0234 CONFIDENTIALITY OF CLINICAL RECORDS Standard
Q0241 SANITARY ENVIRONMENT Standard
▼ 52C0001067 Surgery Center Of Wisconsin Rapids 140 24th Street South Wisconsin Rapids WI 5 (Chicago) 03/13/2018 GBU721 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
K0321 Hazardous Areas - Enclosure Standard
K0345 Fire Alarm System - Testing and Maintenance Standard
K0353 Sprinkler System - Maintenance and Testing Standard
K0712 Fire Drills Standard
▼ 52C0001068 Ambulatory Surgical Center Of Stevens Point 500 Vincent St Ste A Stevens Point WI 5 (Chicago) 03/12/2026 1F2F11-L1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
K0321 Hazardous Areas - Enclosure Standard
K0341 Fire Alarm System - Installation Standard
K0372 Subdivision of Building Spaces ? Smoke Barrier Construction Standard
K0511 Utilities - Gas and Electric Standard
K0521 HVAC Standard
▼ 52C0001068 Ambulatory Surgical Center Of Stevens Point 500 Vincent St Ste A Stevens Point WI 5 (Chicago) 08/10/2022 4F296-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
K0223 Doors with Self-Closing Devices Standard
K0291 Emergency Lighting Standard
K0321 Hazardous Areas - Enclosure Standard
K0345 Fire Alarm System - Testing and Maintenance Standard
K0372 Subdivision of Building Spaces ? Smoke Barrier Construction Standard
K0521 HVAC Standard
K0909 Gas and Vacuum Piped Systems ? Central Supply System Valves Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
▼ 52C0001068 Ambulatory Surgical Center Of Stevens Point 500 Vincent St Ste A Stevens Point WI 5 (Chicago) 02/13/2019 J9VE11 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0040 GOVERNING BODY AND MANAGEMENT Condition
Q0100 ENVIRONMENT Condition
Q0062 ANESTHETIC - DISCHARGE Standard
Q0104 SAFETY FROM FIRE Standard
Q0224 ADVANCED DIRECTIVES Standard
Q0241 SANITARY ENVIRONMENT Standard
Q0261 PATIENT ASSESSMENT AND ADMISSION Standard
Q0262 ADMISSION AND PRE-SURGICAL ASSESSMENT Standard
Q0264 POST-SURGICAL ASSESSMENT Standard