SOPS Ambulatory Surgery Center Survey Data Submission

Definition of an Ambulatory Surgery Center

• An ambulatory surgery center is defined as a facility (1) where patients have surgeries, procedures, and treatments and are not expected to need an inpatient stay, and (2) has been certified and approved to participate in the Centers for Medicare & Medicaid Services' ASC program.
NOTE: Visit the Quality Reporting Center website at:
http://www.qualityreportingcenter.com/en/ascqr-program/data-dashboard/asc-compare-tool-2017/ to find your facility and its CCN number. You can also look up your CCN number by entering in your facility's 10-digit NPI number at: http://www.qualityreportingcenter.com/en/ascqr-program/data-dashboard/ccn/
• Each ambulatory surgery center that is part of an ambulatory surgery center chain or health care system is considered a separate ambulatory surgery center.

1. Ambulatory Surgery Center Site Information: Users can upload ambulatory surgery center site information in one of two ways; one at a time through the online site information form or all at once in an Excel spreadsheet. Each ambulatory surgery center, including those from a health care system, is considered a separate ambulatory surgery center for submission purposes. Please use the Ambulatory Surgery Center Site-Level Data File Specifications (PDF, 232 KB, PDF HELP) as a guide when entering your site information
   • Sample Ambulatory Surgery Center Site-Level Data File (XLSX, 11 KB)

2. Copy of the Questionnaire(s) Administered: Users will need to upload a copy of the actual questionnaire(s) administered. If you used a copy of the Spanish questionnaire, please upload this questionnaire as well. We will review the submitted questionnaire(s) and users will receive an approved/not approved email within 3 business days.

   NOTE: Submitted questionnaires must follow the principles and standards established by AHRQ under the SOPS Trademark. Your questionnaire will not be approved if:
   • You made changes to any of the questionnaire item text and/or response options.
   • You reordered questionnaire items A1−G3.
   • You deleted one or more items between A1−G3.
   • You added new questions between items A1 and G3 (Please add any additional questions to the end of the questionnaire after Section G, before the demographic questions in Section H).
3. Data Use Agreement (DUA): Each ambulatory surgery center is required to submit a signed Data Use Agreement. Please sign and return a copy of your DUA via:
   • The Data Use Agreement (DUA) Submission Portal
   • Email DatabasesOnSafetyCulture@westat.com, or
   • Fax 1-888-852-8277
   • Ambulatory Surgery Center Data Use Agreement (PDF, 142 KB, PDF HELP)
4. Ambulatory Surgery Center Survey Data: Users will need to upload their ambulatory surgery center survey data, conforming to the Ambulatory Surgery Center Survey Data File Specifications (PDF, 202 KB, PDF HELP).
   • Sample Ambulatory Surgery Center Survey Data File (XLSX, 11 KB)

Benefits of Participation and Database Products

• Each participating ambulatory surgery center receives a feedback report comparing their results to the database.
• A free Database Report is produced providing aggregate facility-level statistics. The documents do not include any information identifying participating ambulatory surgery centers.