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
442600 North Jackson Dialysis 217 Sterling Farms Dr Jackson TN 4 (Atlanta) 02/07/2018 H7DT11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
E0020 Policies For Evac. And Primary/Alt. Comm. Standard
E0028 Dialysis Emergency Equipment Standard
E0038 Esrd Ep Training Program Standard
V0000 Initial Comments - Not A Deficiency Citation Memo
V0110 Cfc - Infection Control Condition
V0113 Ic - Wear Gloves/Hand Hygiene Standard
V0122 Ic - Clean, Disinfect Surfaces & Equipment/Written Protocols Standard
V0147 Ic - Staff Education Re Catheters/Catheter Care Standard
V0450 Cfc - Patients' Rights Condition
V0452 Respect & Dignity Standard
V0540 Cfc: Patient Plan Of Care Condition
V0541 Patient Plan Of Care - Goals - Community-Based Standards Standard
V0543 Manage Volume Status Standard
V0544 Achieve Adequate Clearance Standard
V0547 Manage Anemia/H/H Measured Monthly Standard
V0580 Cfc: Care At Home Condition
V0587 Fac Receive/Review Self Monitoring Data Every 2 Months Standard
V0625 Cfc - Quality Assessment & Performance Improvement Condition
V0628 Measure, Analyze And Track Quality Indicators Standard
V0632 Qapi Indicator - Anemia Management Standard
V0637 Qapi Indicator - Infection Control - Trend/Plan/Act Standard
V0680 Cfc - Personnel Qualifications Condition
V0681 Staff Licensed As Req/Qualified/Demonstrate Competencies Standard
V0684 Nurse Manager - 12 Mo Rn + 6 Mo Dialysis Standard
V0688 Staff Nurse - Meet State Requirements Standard
442600 North Jackson Dialysis 217 Sterling Farms Dr Jackson TN 4 (Atlanta) 03/07/2018 OZWR11 Complaint
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0543 Manage Volume Status Standard
442600 North Jackson Dialysis 217 Sterling Farms Dr Jackson TN 4 (Atlanta) 02/17/2022 LLK611 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0543 Manage Volume Status Standard
442600 North Jackson Dialysis 217 Sterling Farms Dr Jackson TN 4 (Atlanta) 02/26/2025 HVR911 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
V0143 Ic - Aseptic Techniques For Iv Meds Standard
V0147 Ic - Staff Education Re Catheters/Catheter Care Standard
V0401 Pe - Safe, Functional, Comfortable Environment Standard
V0550 Vascular Access - Monitor/Referrals Standard
442600 North Jackson Dialysis 217 Sterling Farms Dr Jackson TN 4 (Atlanta) 09/04/2025 9DBR11 Complaint
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0111 Ic - Sanitary Environment Standard
V0452 Respect & Dignity Standard
442601 Bolivar Dialysis 515 Pecan Drive Bolivar TN 4 (Atlanta) 07/11/2018 KISE11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0110 Cfc - Infection Control Condition
V0111 Ic - Sanitary Environment Standard
V0113 Ic - Wear Gloves/Hand Hygiene Standard
V0114 Ic - Sinks Available Standard
V0143 Ic - Aseptic Techniques For Iv Meds Standard
V0407 Pe - Hemodialysis Patients In View During Treatments Standard
V0633 Qapi Indicator - Vascular Access Standard
442601 Bolivar Dialysis 515 Pecan Drive Bolivar TN 4 (Atlanta) 07/08/2021 JETI11 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
V0147 Ic - Staff Education Re Catheters/Catheter Care Standard
442601 Bolivar Dialysis 515 Pecan Drive Bolivar TN 4 (Atlanta) 02/12/2025 B49011 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0111 Ic - Sanitary Environment Standard
V0113 Ic - Wear Gloves/Hand Hygiene Standard
V0143 Ic - Aseptic Techniques For Iv Meds Standard
V0543 Manage Volume Status Standard
V0544 Achieve Adequate Clearance Standard
442603 Bma Tipton County 2047 Highway 51 South Covington TN 4 (Atlanta) 05/15/2019 0B0511 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
V0543 Manage Volume Status Standard
442603 Bma Tipton County 2047 Highway 51 South Covington TN 4 (Atlanta) 09/17/2025 MXD011 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0111 Ic - Sanitary Environment Standard
V0113 Ic - Wear Gloves/Hand Hygiene Standard