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
452731 Cleveland Dialysis Center 202 E Fort Worth St Cleveland TX 6 (Dallas) 05/08/2019 OK9S11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
E0013 Development Of Ep Policies And Procedures Standard
V0000 Initial Comments - Not A Deficiency Citation Memo
V0114 Ic - Sinks Available Standard
V0117 Ic - Clean/Dirty Areas, Med Prep Area, No Common Med Carts Standard
V0120 Ic - Transducer Protectors: Not Wetted/Changed Standard
V0122 Ic - Clean, Disinfect Surfaces & Equipment/Written Protocols Standard
V0143 Ic - Aseptic Techniques For Iv Meds Standard
V0219 Bacterial Control - Disinfect Monthly/Disinfection Dwell Standard
V0229 Mixing Systems - Permanent Record/Verification Testing Standard
V0250 Dialysate Proportioning - Monitor Ph/Conductivity Standard
V0401 Pe - Safe, Functional, Comfortable Environment Standard
V0502 Assess Current Health Status Inc Comorbids Standard
V0504 Assess B/P & Fluid Management Needs Standard
V0516 Frequency - Initial: 30 Days/13 Tx Standard
V0520 Frequency Reassessment - Unstable - Monthly Standard
V0543 Manage Volume Status Standard
V0560 Patients Seen By Med Staff Member Monthly Standard
V0628 Measure, Analyze And Track Quality Indicators Standard
V0634 Qapi Indicator - Medical Injuries/Errors Standard
452731 Cleveland Dialysis Center 202 E Fort Worth St Cleveland TX 6 (Dallas) 06/21/2023 PQTT11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0100 Cfc - Compliance With Fed/State/Local Laws Condition
V0111 Ic - Sanitary Environment Standard
V0147 Ic - Staff Education Re Catheters/Catheter Care Standard
V0470 Rights Posted With State/Nw Contact #S And Addresses Standard
V0558 Implement Updates Of Poc - 15 Days P Pt Assessment Standard
V0729 Mr - Complete Records Promptly Standard
V0757 Staff # & Ratio Meet Patient Needs Standard
V0765 Internal Grievance Process Components & Implemented Standard
452731 Cleveland Dialysis Center 202 E Fort Worth St Cleveland TX 6 (Dallas) 06/11/2024 HUNS11 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
V0114 Ic - Sinks Available Standard
V0117 Ic - Clean/Dirty Areas, Med Prep Area, No Common Med Carts Standard
V0122 Ic - Clean, Disinfect Surfaces & Equipment/Written Protocols Standard
V0190 Softeners - Automatically Regenerated/Timers/Salt/Salt Level Standard
V0222 Acid Bulk Storage Tanks - Safety Controls Standard
V0245 Acid Conc Distribution - Conc Labeled & Color-Coded Red Standard
V0246 Bicarb Conc Distribution - Color Coded Blue & Sealed Standard
V0250 Dialysate Proportioning - Monitor Ph/Conductivity Standard
V0402 Pe - Building - Constructed/Maintained To Ensure Safety Standard
V0403 Pe - Equipment Maintenance - Manufacturer'S Dfu Standard
V0502 Assess Current Health Status Inc Comorbids Standard
V0727 Mr - Protect Patient Records From Loss/Keep Confidential Standard
452731 Cleveland Dialysis Center 202 E Fort Worth St Cleveland TX 6 (Dallas) 06/11/2025 5KVY11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
E0028 Dialysis Emergency Equipment Standard
V0000 Initial Comments - Not A Deficiency Citation Memo
V0111 Ic - Sanitary Environment Standard
V0122 Ic - Clean, Disinfect Surfaces & Equipment/Written Protocols Standard
V0175 Cfc - Water And Dialysate Quality Condition
V0196 Carbon Adsorption - Monitoring, Testing Frequency Standard
V0219 Bacterial Control - Disinfect Monthly/Disinfection Dwell Standard
V0222 Acid Bulk Storage Tanks - Safety Controls Standard
V0228 Mixing Systems - Labeling Standard
V0230 Mixing Systems - Cleaning Standard
V0400 Cfc - Physical Environment Condition
V0402 Pe - Building - Constructed/Maintained To Ensure Safety Standard
V0403 Pe - Equipment Maintenance - Manufacturer'S Dfu Standard
V0503 Appropriateness Of Dialysis Rx Standard
452734 Gonzales Dialysis Center 1406 N Sarah Dewitt Gonzales TX 6 (Dallas) 08/24/2020 RUZT11 Complaint
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0504 Assess B/P & Fluid Management Needs Standard
452734 Gonzales Dialysis Center 1406 N Sarah Dewitt Gonzales TX 6 (Dallas) 09/09/2024 14XB11 Complaint
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0101 Compliance With Fed/State/Local Laws Standard
452734 Gonzales Dialysis Center 1406 N Sarah Dewitt Gonzales TX 6 (Dallas) 03/04/2025 WBRD11 Complaint
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0500 Cfc - Patient Assessment Condition
V0504 Assess B/P & Fluid Management Needs Standard
452735 Bay Area Dialysis Services At Southside 4112 South Staples Suite Ab Corpus Christi TX 6 (Dallas) 01/31/2018 7HIL11 Standard
Deficiency Tag Deficiency Description Tag Type
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
V0119 Ic - Supply Cart Distant/No Supplies In Pockets Standard
V0122 Ic - Clean, Disinfect Surfaces & Equipment/Written Protocols Standard
V0144 Ic - Staff Report Ic Issues Standard
V0175 Cfc - Water And Dialysate Quality Condition
V0260 Personnel - Training Program/Periodic Audits Standard
V0400 Cfc - Physical Environment Condition
V0401 Pe - Safe, Functional, Comfortable Environment Standard
V0450 Cfc - Patients' Rights Condition
V0463 Receive Services Outlined In Poc Standard
V0500 Cfc - Patient Assessment Condition
V0520 Frequency Reassessment - Unstable - Monthly Standard
V0540 Cfc: Patient Plan Of Care Condition
V0556 Poc Completed/Signed By Idt & Patient Standard
V0557 Initial Poc Implemented - 30 Days/13 Tx Standard
V0559 Outcome Not Achieved - Adjust Poc Standard
V0625 Cfc - Quality Assessment & Performance Improvement Condition
V0626 Covers Scope Of Services/Effective/Idt Involved Standard
V0680 Cfc - Personnel Qualifications Condition
V0696 Water Treatment System Techs Training Standard
V0725 Cfc - Medical Records Condition
V0726 Medical Records - Complete, Accurate, Accessible Standard
V0750 Cfc - Governance Condition
V0751 Identifiable Governing Body W/Full Authority/Responsibility Standard
452736 Ut Southwestern Dallas Dialysis 204 E Airport Freeway Irving TX 6 (Dallas) 03/16/2020 I8CE11 Complaint
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0634 Qapi Indicator - Medical Injuries/Errors Standard
V0680 Cfc - Personnel Qualifications Condition
V0681 Staff Licensed As Req/Qualified/Demonstrate Competencies Standard
V0710 Cfc - Responsibilities Of The Medical Director Condition
V0750 Cfc - Governance Condition
452736 Ut Southwestern Dallas Dialysis 204 E Airport Freeway Irving TX 6 (Dallas) 12/28/2020 SH2J11 Complaint
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0110 Cfc - Infection Control Condition
V0124 Ic - Hbv - Test All Pts, Review Results/Pt Status Known Preadmit Standard
V0400 Cfc - Physical Environment Condition
V0403 Pe - Equipment Maintenance - Manufacturer'S Dfu Standard
V0450 Cfc - Patients' Rights Condition
V0456 Participate In Care, Discontinue/Refuse Treatment Standard
V0710 Cfc - Responsibilities Of The Medical Director Condition