S&C QCOR ASC 2567s
d QCOR: Quality, Certification and Oversight Reports. S&C QCOR  
Home  |  Help  |  Resources  |  FAQs  |  Site Map  
   
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
▼ 52C0001109 Wisconsin Specialty Surgery Center Llc 7401 104th Ave, Suite 100 Kenosha WI 5 (Chicago) 01/03/2018 3JYK21 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
K0353 Sprinkler System - Maintenance and Testing Standard
K0712 Fire Drills Standard
▼ 52C0001112 Glsd Medical Llc 8153 S 27th St, Suite 500 Franklin WI 5 (Chicago) 01/30/2018 X1QF11 Recertification, Sample Validation
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0001 BASIC REQUIREMENTS Condition
Q0040 GOVERNING BODY AND MANAGEMENT Condition
Q0060 SURGICAL SERVICES Condition
Q0080 QUALITY ASSESSMENT AND PERFORMANCE Condition
Q0100 ENVIRONMENT Condition
Q0200 LABORATORY AND RADIOLOGIC SERVICES Condition
Q0061 ANESTHETIC RISK AND EVALUATION Standard
Q0064 STANDARD LEVEL TAG FOR SURGICAL SERVICES Standard
Q0082 PROGRAM DATA; PROGRAM ACTIVITIES Standard
Q0083 PERFORMANCE IMPROVEMENT PROJECTS Standard
Q0084 GOVERNING BODY RESPONSIBILITIES Standard
Q0104 SAFETY FROM FIRE Standard
Q0162 FORM AND CONTENT OF RECORD Standard
Q0181 ADMINISTRATION OF DRUGS Standard
Q0204 RADIOLOGIC SERVICES Standard
Q0224 ADVANCED DIRECTIVES Standard
Q0241 SANITARY ENVIRONMENT Standard
Q0262 PRE-SURGICAL ASSESSMENT Standard
Q0264 POST-SURGICAL ASSESSMENT Standard
Q0265 DISCHARGE - SUPPLIES AND INFORMATION Standard
Q0266 DISCHARGE - ORDER Standard
▼ 52C0001112 Glsd Medical Llc 8153 S 27th St, Suite 500 Franklin WI 5 (Chicago) 01/30/2018 X1QF21 Recertification, Sample Validation
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
K0211 Means of Egress - General Standard
K0346 Fire Alarm System - Out of Service Standard
K0353 Sprinkler System - Maintenance and Testing Standard
K0354 Sprinkler System - Out of Service Standard
K0712 Fire Drills Standard
▼ 52C0001134 Eye Surgery Center Of Wisconsin, Llc 10148 S 27th St Oak Creek WI 5 (Chicago) 01/15/2025 65123-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
Q0262 ADMISSION AND PRE-SURGICAL ASSESSMENT Standard
Q0264 POST-SURGICAL ASSESSMENT Standard
▼ 52C0001134 Eye Surgery Center Of Wisconsin, Llc 10148 S 27th St Oak Creek WI 5 (Chicago) 01/15/2025 65123-L1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
E0039 EP Testing Requirements 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
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
▼ 52C0001140 Pharos Enterprises Of Wisconsin, Llc 2356 S 102nd St West Allis WI 5 (Chicago) 04/03/2025 65C34-H1 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
Q0242 INFECTION CONTROL PROGRAM Standard
Q0262 ADMISSION AND PRE-SURGICAL ASSESSMENT Standard
▼ 52C0001140 Pharos Enterprises Of Wisconsin, Llc 2356 S 102nd St West Allis WI 5 (Chicago) 04/03/2025 65C34-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
K0521 HVAC Standard
K0711 Evacuation and Relocation Plan Standard
▼ 53C0001002 Internal Medicine Group Ambulatory Surgery Center 7220 Commons Circle Cheyenne WY 8 (Denver) 09/20/2023 610F0-H1 Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0041 CONTRACT SERVICES Standard
Q0241 SANITARY ENVIRONMENT Standard
▼ 53C0001002 Internal Medicine Group Ambulatory Surgery Center 7220 Commons Circle Cheyenne WY 8 (Denver) 09/20/2023 610F0-L1 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
E0029 Development of Communication Plan Standard
E0030 Names and Contact Information Standard
E0031 Emergency Officials Contact Information 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
K0346 Fire Alarm System - Out of Service Standard
K0355 Portable Fire Extinguishers Standard
K0712 Fire Drills Standard
K0761 Maintenance, Inspection & Testing - Doors Standard
K0911 Electrical Systems - Other Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
K0919 Electrical Equipment - Other Standard
▼ 53C0001005 Casper Wy Endoscopy Asc, Llc 1441 Wilkins Circle Casper WY 8 (Denver) 08/11/2022 4F1ED-L1 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
K0345 Fire Alarm System - Testing and Maintenance Standard
K0351 Sprinkler System - Installation Standard
K0761 Maintenance, Inspection & Testing - Doors Standard
K0911 Electrical Systems - Other Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard