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
▼ 52C0001039 Wisconsin Laser And Surgery Center 10200 W Innovation Dr Suite 700 Milwaukee WI 5 (Chicago) 04/03/2018 8H4S11 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
Q0061 ANESTHETIC RISK AND EVALUATION Standard
Q0104 SAFETY FROM FIRE Standard
Q0181 ADMINISTRATION OF DRUGS Standard
Q0241 SANITARY ENVIRONMENT Standard
▼ 52C0001039 Wisconsin Laser And Surgery Center 10200 W Innovation Dr Suite 700 Milwaukee WI 5 (Chicago) 04/02/2018 8H4S21 Recertification
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
▼ 52C0001043 Novamed Surgery Center Of Madison 1200 John Q Hammons Dr Ste 102 Madison WI 5 (Chicago) 09/11/2024 64181-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
Q0233 SAFETY - ABUSE/HARASSMENT Standard
Q0242 INFECTION CONTROL PROGRAM Standard
▼ 52C0001043 Novamed Surgery Center Of Madison 1200 John Q Hammons Dr Ste 102 Madison WI 5 (Chicago) 09/11/2024 64181-L1 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
K0223 Doors with Self-Closing Devices Standard
K0353 Sprinkler System - Maintenance and Testing Standard
K0761 Maintenance, Inspection & Testing - Doors Standard
K0911 Electrical Systems - Other Standard
K0912 Electrical Systems - Receptacles Standard
K0914 Electrical Systems - Maintenance and Testing Standard
K0918 Essential Electrical Systems ? Generator or Alternate Source Standard
K0920 Electrical Equipment ? Power Cords and Extension Cords Standard
▼ 52C0001043 Novamed Surgery Center Of Madison 1200 John Q Hammons Dr Ste 102 Madison WI 5 (Chicago) 02/23/2021 VM4J11 Focused Infection Control, Other-Fed, Recertification
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0100 ENVIRONMENT Condition
Q0061 ANESTHETIC RISK AND EVALUATION Standard
Q0101 PHYSICAL ENVIRONMENT Standard
Q0104 SAFETY FROM FIRE Standard
Q0162 FORM AND CONTENT OF RECORD Standard
Q0181 ADMINISTRATION OF DRUGS Standard
Q0242 INFECTION CONTROL PROGRAM Standard
Q0267 DISCHARGE WITH RESPONSIBLE ADULT Standard
▼ 52C0001043 Novamed Surgery Center Of Madison 1200 John Q Hammons Dr Ste 102 Madison WI 5 (Chicago) 02/23/2021 VM4J21 Recertification
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not a Deficiency Citation Memo
K0000 INITIAL COMMENTS Memo
K0131 Multiple Occupancies Standard
K0341 Fire Alarm System - Installation Standard
K0343 Fire Alarm System - Notification Standard
K0346 Fire Alarm System - Out of Service Standard
K0353 Sprinkler System - Maintenance and Testing Standard
K0354 Sprinkler System - Out of Service Standard
K0521 HVAC Standard
▼ 52C0001044 The Center For Aesthetic And Plastic Surgery Sc 425 S Commercial St Neenah WI 5 (Chicago) 02/12/2018 PWM911 Recertification, Sample Validation
Deficiency Tag Deficiency Description Tag Type
Q0000 Initial Comments - Not a Deficiency Citation Memo
Q0100 ENVIRONMENT Condition
Q0104 SAFETY FROM FIRE Standard
▼ 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