On July 23, 2016, the NRC issued a Notice of Violation to QHG of Indiana, Inc., for a Severity Level III violation involving the failure to develop, implement, and maintain written procedures to provide high confidence that each administration is in accordance with the written directive as required by 10 CFR 35.41(a). Specifically, on January 7, 2016, during two separate medical administrations, the licensee used an instrument that was not capable of measuring with high confidence the amount of yttrium-90 remaining in the equipment used to deliver the dose. Therefore, the licensee could not determine that the two administrations were in accordance with the written directive. The licensee's procedures did not specify the instrumentation needed to provide high confidence that the administration would be performed in accordance with the written directive.