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- Click ‘Get Form’ to open the infection control surveyor in the editor.
- Begin by filling out Part 1, ASC Characteristics. Enter the ASC Name, Address, and CMS Certification Number as prompted.
- Provide details about the ASC's operation year and previous federal survey dates. Ensure accuracy for compliance tracking.
- In Section 7, indicate if the ASC participates in Medicare and specify the accreditation organization if applicable.
- Proceed to Part 2, Infection Control & Related Practices. Carefully assess each practice by selecting 'Yes' or 'No' based on observations during your site visit.
- Utilize the notes section to document any observations or explanations for practices that were not observed.
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| Versions | Form popularity | Fillable & printable |
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| 2015 | 4.8 Satisfied (195 Votes) |
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