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DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES Form Approved OMB No. 0938-0266 AMBULATORY SURGICAL CENTER SURVEY REPORT MEDICARE SUPPLIER NUMBER FACILITY NAME AND

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Who needs ambulatory surgical center survey:

01

Healthcare professionals or organizations involved in operating ambulatory surgical centers may require ambulatory surgical center surveys.

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Regulatory bodies or accreditation agencies may use these surveys to assess the compliance and quality of ambulatory surgical centers.

03

Patients or their representatives may provide feedback through these surveys to evaluate their experiences and suggest improvements.

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What is ambulatory surgical center survey?

The ambulatory surgical center survey is a survey conducted to gather information about the operations and quality of care provided by ambulatory surgical centers.

Who is required to file ambulatory surgical center survey?

All ambulatory surgical centers are required to file the ambulatory surgical center survey.

How to fill out ambulatory surgical center survey?

The ambulatory surgical center survey can be filled out online or using the specified paper form. The center must provide accurate and complete information about their operations and quality of care.

What is the purpose of ambulatory surgical center survey?

The purpose of the ambulatory surgical center survey is to assess the compliance of ambulatory surgical centers with applicable regulations, evaluate the quality of care provided, and identify areas for improvement.

What information must be reported on ambulatory surgical center survey?

The ambulatory surgical center survey requires reporting information about the center's policies and procedures, patient safety protocols, staffing, patient outcomes, infection control practices, and other aspects of their operations.

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