Survey Materials

Download the 2020 Leapfrog ASC Survey PDF (version 1, Updated April 13, 2020)


Download the 2020 Leapfrog ASC Survey Word (version 1, Updated April 13, 2020)


Download the Summary of Changes to the 2020 Leapfrog ASC Survey document here.

Some additional changes have been made since publishing the Summary of Changes based on Leapfrog's response to COVID-19. Please review these changes here.

The hard copy of the ASC Survey contains important information that you will need to accurately respond to the ASC Survey questions and can be used to collect the information you will need to complete the Online ASC Survey Tool. The questions in the hard copy of the ASC Survey match the Online ASC Survey Tool exactly, so responses can be recorded on the hard copy of the ASC Survey and then entered into the Online ASC Survey Tool. The hard copy of the ASC Survey includes:

  • Survey Questions and Endnotes
  • Reporting Periods
  • Measure Specifications
  • Frequently Asked Questions 

Any changes to the 2020 Leapfrog ASC Survey that are published after April 1 will be listed here.


April 13, 2020:

  • Section 4A Medication and Allergy Documentation - Updated the definition of a ‘sufficient sample size’ from 60 to 30 cases. This update is intended to ease the burden of data abstraction while facilities are responding to COVID-19. 
  • Section 4B NHSN Outpatient Procedure Component Module - Updated the reporting period for Leapfrog’s October and December NHSN data downloads from 07/01/2019 – 06/30/2020 to 01/01/2019 – 12/31/2019. This update is based on CMS’ announcement that ASC quality reporting to NHSN is optional for all facilities from January 1 to June 30, 2020. Leapfrog will continue to download SSI and SDOM data from NHSN four times during the 2020 Survey Cycle to account for new ASCs that join our NHSN group and submit the Leapfrog ASC Survey. Facilities should continue to download their reports on each of the published dates to verify their data.


    The last NHSN download date will be on December 18, 2020. That data will be included in Survey Results for facilities that submit a Leapfrog ASC Survey by the Late Submission Deadline of December 31, 2020 (updated from November 30). 


Other Supporting Materials

The following documents provide critical information that you will need to complete the Leapfrog ASC Survey. Please review each document carefully before you begin.

Section Materials

Section 4

Patient Safety Practices


Instructions and FAQs for Joining Leapfrog’s NHSN Group for ASCs



2.2a AHRQ Patient Safety Culture (SOPS) Tool 


PDF iconNational Quality Forum's List of Serious Reportable Events


CANDOR Toolkit



RCA2 Improving Root Cause Analyses and Actions to Prevent Harm

Section 5


Leapfrog ASC Survey Binder

The Leapfrog ASC Survey Binder was originally designed for those facilities that have been selected for Leapfrog’s On-Site Data Verification Program administered by DHG Healthcare. Those facilites are mailed a binder to collect and organize the information (e.g., reports, documentation, notes, etc.) they used to complete their Leapfrog ASC Survey AND at the same time, they are preparing for their verification. DHG uses the information in the binder during the scheduled visit to verify a hospital’s Leapfrog ASC Survey responses. As part of Leapfrog's COVID-19 response, there will be no On-Site Data Verification in 2020. 

However, the Leapfrog ASC Survey Binder document (PDF) is available for use by all hospitals to collect, organize, and record information during the completion of the Leapfrog ASC Survey. The document, which is divided up into 5 tabs (or sections), one for each section of the Survey, can be printed and placed in a binder. The information is helpful when completing subsequent years' Surveys, in staff and leadership transitions, and as a historical record. 

Download iconDownload the 2020 Leapfrog ASC Survey Binder



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