S&C QCOR ESRD 2567s
d QCOR:  Quality, Certification and Oversight Reports.
ESRDs 2567s
Selection Criteria

Time Interval

Please select the calendar year or years for which you would like data.

Note: There is currently no ESRD 2567 data available past Feb 19, 2026 due to data system migrations.

Provider Characteristics

Use these filters if you want to limit the report to providers that have certain characteristics. To select more than one option, hold down the Ctrl (individual point-and-click) OR Shift keys (select through a range) while you click on the additional desired option(s).

Survey Type & Deficiency Tags

Use these filters if you want to limit the reports to providers on specific survey types, or to reports that were cited for specific ESRD deficiency tags and tag types. To select more than one option, hold down the Ctrl (individual point-and-click) OR Shift keys (select through a range) while you click on the additional desired option(s).

CCN and Facility Name

Use these filters if you know the name (or partial name) of the facility you are searching for, or the CMS Certification Number (CCN) for the facility you are searching for.

Other Survey Characteristics

Select one of the options below to filter by surveys that cite deficiencies or by surveys that are deficiency-free. By default, only surveys that cite deficiencies are displayed. Selecting "All" displays all surveys.

CMS Certification Number Facility Name Address City State CMS Region Date of CMS Survey Survey Event ID Survey Type Statement of Deficiencies Report
433507 Sanford Medical Center 323 Sw 10th St Madison SD 8 (Denver) 11/06/2019 6R2R11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
E0039 Ep Testing Requirements Standard
V0000 Initial Comments - Not A Deficiency Citation Memo
433510 Avera Dialysis Brookings 300 22nd Avenue Ste 101 Brookings SD 8 (Denver) 06/15/2022 KE3711 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0113 Ic - Wear Gloves/Hand Hygiene Standard
V0116 Ic - Items Taken To Station Disposed/Dedicated Or Disinfected Standard
V0122 Ic - Clean, Disinfect Surfaces & Equipment/Written Protocols Standard
V0184 Environment: Secure And Restricted Standard
V0402 Pe - Building - Constructed/Maintained To Ensure Safety Standard
V0407 Pe - Hemodialysis Patients In View During Treatments Standard
V0503 Appropriateness Of Dialysis Rx Standard
433511 Avera Dialysis Mitchell 1900 Grassland Dr Ste 102 Mitchell SD 8 (Denver) 06/07/2023 0XJQ11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0122 Ic - Clean, Disinfect Surfaces & Equipment/Written Protocols Standard
V0175 Cfc - Water And Dialysate Quality Condition
V0551 Va Monitor To Prevent Failure/Stenosis Standard
433512 Avera Dialysis Wagner 310 W Sd Highway 46 Wagner SD 8 (Denver) 09/09/2022 SSBO11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
E0006 Plan Based On All Hazards Risk Assessment Standard
E0042 Integrated Ep Program Standard
V0000 Initial Comments - Not A Deficiency Citation Memo
V0503 Appropriateness Of Dialysis Rx Standard
V0626 Covers Scope Of Services/Effective/Idt Involved Standard
433513 Monument Health Dialysis Center 955 East North Street Ste 200 Rapid City SD 8 (Denver) 08/20/2021 E5D511 Special, Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0120 Ic - Transducer Protectors: Not Wetted/Changed Standard
V0402 Pe - Building - Constructed/Maintained To Ensure Safety Standard
V0403 Pe - Equipment Maintenance - Manufacturer'S Dfu Standard
433513 Monument Health Dialysis Center 955 East North Street Ste 200 Rapid City SD 8 (Denver) 08/26/2021 E5D521 Standard
Deficiency Tag Deficiency Description Tag Type
K0000 Initial Comments - Not A Deficiency Citation Memo
K0100 General Requirements - Other Standard
K0222 Egress Doors Standard
433513 Monument Health Dialysis Center 955 East North Street Ste 200 Rapid City SD 8 (Denver) 04/03/2025 3M5P11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0117 Ic - Clean/Dirty Areas, Med Prep Area, No Common Med Carts Standard
V0142 Ic - Oversight: Monitor Activities & Implement Policies Standard
V0229 Mixing Systems - Permanent Record/Verification Testing Standard
V0562 Patient/Family Education & Training Standard
V0715 Md Resp - Ensure All Adhere To P&P Standard
433515 Avera Dialysis Sioux Falls 4210 West 53rd Street Sioux Falls SD 8 (Denver) 06/14/2023 SK6611 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0503 Appropriateness Of Dialysis Rx Standard
V0580 Cfc: Care At Home Condition
442307 Lebonheur Childrens Hospital Dialysis Center 50 North Dunlap Street Memphis TN 4 (Atlanta) 04/11/2018 BJJY11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
E0033 Methods For Sharing Information Standard
V0000 Initial Comments - Not A Deficiency Citation Memo
V0147 Ic - Staff Education Re Catheters/Catheter Care Standard
V0544 Achieve Adequate Clearance Standard
V0630 Qapi Indicator - Nutritional Status Standard
V0632 Qapi Indicator - Anemia Management Standard
V0681 Staff Licensed As Req/Qualified/Demonstrate Competencies Standard
442307 Lebonheur Childrens Hospital Dialysis Center 50 North Dunlap Street Memphis TN 4 (Atlanta) 04/16/2024 KIOE11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0113 Ic - Wear Gloves/Hand Hygiene Standard
V0201 Ro - Chemical Analysis - Frequency Standard