# Quad A accreditation: surveys, standards and Patient Safety Data Reporting

> Quad A, formerly AAAASF, accredits office-based surgery sites, Medicare surgery centers and related programs. Facilities self-survey yearly, get an onsite survey every three years and must meet 100 percent of the standards. Quarterly Patient Safety Data Reporting is required, including every unanticipated sequela.

Source: https://incidentkit.ai/compliance/accreditation/quad-a · Updated Oct 5, 2026

## Key facts

- **Survey cycle:** Annual self-survey; onsite survey every three years
- **Initial survey:** 100 percent compliance required, with a plan of correction
- **Correction window:** 30 days after the survey
- **PSDR:** Quarterly: three random cases per surgeon plus all unanticipated sequelae
- **PSDR deadlines:** April 15, July 15, October 15, January 15
- **Late PSDR:** 60-day probation and $100 per noncompliant physician
- **Medicare programs:** ASC, outpatient physical therapy, rural health clinic
- **Medicare ASC recognition:** Since 1998, per Quad A

- **Citation:** Quad A accreditation standards (program standards manuals)
- **Authority:** Quad A (formerly AAAASF)
- **Applies to:** Office-based surgery and office-based procedural facilities, Medicare-certified ambulatory surgery centers, Oral maxillofacial surgery and pediatric dentistry facilities, Outpatient physical therapy and rural health clinics (Medicare programs)

## Who does Quad A accredit?

Quad A is a non-profit, physician-founded group that began in 1980. It became Quad A in a 2022 rebrand of AAAASF. Outpatient programs cover office-based surgery, office-based procedural care, oral maxillofacial surgery and pediatric dentistry. Medicare programs cover ambulatory surgery centers, outpatient physical therapy and rural health clinics. Quad A requires licensed and credentialed staff, board-certified surgeons with hospital privileges for their procedures, and anesthesia professionals for deeper levels of anesthesia.

## How does Quad A relate to CMS deemed status?

Quad A is on CMS's list of approved accreditors and says it has been a Medicare-recognized authority for ASCs since 1998. That means CMS accepts its survey in place of a state survey. An ASC applicant files CMS form 855B before applying. A deemed ASC must still meet the QAPI condition in [42 CFR 416.43](https://incidentkit.ai/compliance/cms-qapi/ambulatory-surgery-centers). Quad A sends final survey decisions to the right state or federal agencies.

## How do Quad A surveys work?

*The Quad A survey path*

| Step | What happens |
| --- | --- |
| Preparation | A dedicated accreditation specialist confirms survey availability, schedules the survey and provides an outline. |
| Onsite survey | Surveyors are board-certified physicians, dentists, licensed nurses or physical therapists. They judge each standard compliant or noncompliant, using the standards manual as a checklist. |
| Initial standard | A facility must show 100 percent compliance at the initial survey. |
| Deficiencies | Each gets a Statement of Deficiency. The facility has 30 days to correct and submit evidence under a plan of correction. |
| Decision | New facilities go to an accreditation committee for approval. |
| Ongoing | An annual self-survey and an onsite survey every three years, with continuous compliance between. |

## What is Patient Safety Data Reporting?

Patient Safety Data Reporting, or PSDR, is Quad A's required quality control process, introduced in 2001. It applies to the office-based surgery, office-based procedural, oral maxillofacial, pediatric dentistry, international surgical and Medicare ASC programs. An unanticipated sequela is an unexpected bad outcome after a procedure.

| Item | Requirement |
| --- | --- |
| What | Three random cases per surgeon or proceduralist each quarter, including the first case each month, plus all unanticipated sequelae |
| Deadlines | April 15, July 15, October 15 and January 15 for the quarter just ended |
| How | Entered directly in Quad A's online system. No paper forms. Sequelae can be entered as they happen. |
| Fewer than three cases | Report the exemption on Quad A's form and enter every case performed |
| Late | A 60-day probation and a $100 late fee per noncompliant physician |

## What quality work does Quad A expect?

Quad A uses PSDR data to monitor trends such as complications and mortalities and to revise its standards. Its surveyor materials include condition-level deficiency guidance and templates for immediate jeopardy reporting and removal plans. A Medicare ASC also needs the QAPI proof CMS asks for: tracked adverse events, root causes, fixes that last and project records.

## What documentation should a Quad A facility keep?

- Each PSDR submission and the internal case record behind it
- Every unanticipated sequela with its review and outcome
- The annual self-survey checklist
- Plan of correction evidence for every deficiency
- Credentials, board certification, hospital privileges and anesthesia provider records
- The accreditation certificate, displayed in public view
- For a Medicare ASC, the QAPI records under 416.43

## Where does IncidentKit fit with PSDR?

IncidentKit does not submit to Quad A's portal. It keeps the internal record: the sequela as [reported](https://incidentkit.ai/product/incident-reporting), the [investigation](https://incidentkit.ai/product/investigations) and the [corrective action](https://incidentkit.ai/product/corrective-actions). The PSDR entry and your internal review then match. PSDR random cases come from your case records, not from incident data.

## What the rule asks for, and how IncidentKit supports it

| Requirement | IncidentKit |
| --- | --- |
| PSDR: all unanticipated sequelae, entered as they happen | The event is recorded when reported, with its review. You make the PSDR entry in Quad A's portal from that record. IncidentKit does not submit to the portal. |
| PSDR: three random cases per surgeon each quarter | Not an IncidentKit feature. Random cases come from your case records and go straight into Quad A's portal. |
| Plan of correction: 30 days to correct and submit evidence | Corrective actions with owner, due date and attached evidence. Nothing closes until verified. |
| Medicare ASC: QAPI under 42 CFR 416.43 | Investigations and corrective actions produce the cause and fix records. See the ASC QAPI page. |
| Continuous compliance between surveys | Analytics and the audit trail show recurring problems and who changed what, so readiness does not depend on survey week. |

## Frequently asked questions

### How often does Quad A survey a facility?

A self-survey every year and an onsite survey every three years. After a survey, a facility has 30 days to correct deficiencies and submit evidence.

### What must be reported in Patient Safety Data Reporting?

Each quarter: three random cases per surgeon or proceduralist, including the first case each month, plus all unanticipated sequelae. Enter them in Quad A's online system.

### What happens if PSDR is late?

Probation for 60 calendar days after the extension period ends, plus a $100 late fee per noncompliant physician. A physician with fewer than three cases uses the exemption form.

### Is a Quad A survey unannounced?

Quad A's guidance describes scheduling with an accreditation specialist and a survey outline in advance. It does not state its notice policy for Medicare ASC surveys. CMS expects deemed surveys to be unannounced, so confirm with Quad A.

## Sources

- [Quad A: What is accreditation?](https://www.quada.org/what-is-accreditation)
- [Quad A: Patient Safety Data Reporting](https://www.quada.org/patient-safety-data-reporting)
- [Quad A: Medicare programs](https://www.quada.org/medicare-programs)
- [Quad A: Interested facilities](https://www.quada.org/prospective-facilities)
- [Quad A: Surveyors](https://www.quada.org/surveyors)
- [Quad A: About us](https://www.quada.org/about-us)
- [CMS: Accrediting organizations](https://www.cms.gov/medicare/health-safety-standards/accreditation-programs)

## Related

- [ASC QAPI requirements: 42 CFR 416.43 explained](https://incidentkit.ai/compliance/cms-qapi/ambulatory-surgery-centers)
- [AAAHC accreditation: surveys, deemed status and QI studies](https://incidentkit.ai/compliance/accreditation/aaahc)
- [Joint Commission accreditation: surveys and sentinel events](https://incidentkit.ai/compliance/accreditation/joint-commission)
- [ASC survey readiness: what surveyors ask for and check](https://incidentkit.ai/compliance/survey-readiness/asc-survey-readiness)
- [Plan of correction (CMS-2567): elements and 10-day deadline](https://incidentkit.ai/compliance/survey-readiness/plan-of-correction)
- [Incident reporting software for surgery centers](https://incidentkit.ai/solutions/ambulatory-surgery-centers)
- [Deemed status: definition and meaning](https://incidentkit.ai/glossary/deemed-status)