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
452776 Fourth Street Dialysis 3101 N 4th Street Ste B Longview TX 6 (Dallas) 05/15/2024 8JN711 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
V0110 Cfc - Infection Control Condition
V0111 Ic - Sanitary Environment Standard
V0113 Ic - Wear Gloves/Hand Hygiene Standard
V0121 Ic - Handling Infectious Waste Standard
V0124 Ic - Hbv - Test All Pts, Review Results/Pt Status Known Preadmit Standard
V0147 Ic - Staff Education Re Catheters/Catheter Care Standard
V0184 Environment: Secure And Restricted Standard
V0222 Acid Bulk Storage Tanks - Safety Controls Standard
V0402 Pe - Building - Constructed/Maintained To Ensure Safety Standard
V0403 Pe - Equipment Maintenance - Manufacturer'S Dfu Standard
V0450 Cfc - Patients' Rights Condition
V0451 Patients Informed Of Rights When Begin Treatment Standard
V0500 Cfc - Patient Assessment Condition
V0502 Assess Current Health Status Inc Comorbids Standard
V0503 Appropriateness Of Dialysis Rx Standard
V0504 Assess B/P & Fluid Management Needs Standard
V0507 Assess Anemia Standard
V0517 F/U Reassessment - Within 3 Months Of Initial Standard
V0519 Frequency Reassessment - Stable - Annual Standard
V0540 Cfc: Patient Plan Of Care Condition
V0558 Implement Updates Of Poc - 15 Days P Pt Assessment Standard
V0625 Cfc - Quality Assessment & Performance Improvement Condition
V0628 Measure, Analyze And Track Quality Indicators Standard
V0636 Qapi Indicator - Pt Satisfaction & Grievances Standard
V0750 Cfc - Governance Condition
V0760 Gb - Responsible For Staff Oriented To Facility & Resp Standard
452776 Fourth Street Dialysis 3101 N 4th Street Ste B Longview TX 6 (Dallas) 06/26/2024 8JN712 Standard
Deficiency Tag Deficiency Description Tag Type
V0117 Ic - Clean/Dirty Areas, Med Prep Area, No Common Med Carts Standard
V0245 Acid Conc Distribution - Conc Labeled & Color-Coded Red Standard
V0246 Bicarb Conc Distribution - Color Coded Blue & Sealed Standard
452778 Fort Bend Dialysis Center 3819 Cartwright Missouri City TX 6 (Dallas) 02/21/2023 8W7P11 Complaint
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0463 Receive Services Outlined In Poc Standard
V0713 Md Resp - Staff Ed, Training & Performance Standard
452778 Fort Bend Dialysis Center 3819 Cartwright Missouri City TX 6 (Dallas) 12/13/2023 LHW811 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
V0122 Ic - Clean, Disinfect Surfaces & Equipment/Written Protocols Standard
V0175 Cfc - Water And Dialysate Quality Condition
V0191 Softeners - Testing Hardness/Log Standard
V0239 Bicarb Conc Distribution - Weekly Disinfect/Dwell Times/Conc Standard
V0402 Pe - Building - Constructed/Maintained To Ensure Safety Standard
V0403 Pe - Equipment Maintenance - Manufacturer'S Dfu Standard
V0503 Appropriateness Of Dialysis Rx Standard
V0540 Cfc: Patient Plan Of Care Condition
V0556 Poc Completed/Signed By Idt & Patient Standard
V0558 Implement Updates Of Poc - 15 Days P Pt Assessment Standard
V0638 Continuously Monitor/Take Action/Track/Sustain Improve Standard
452778 Fort Bend Dialysis Center 3819 Cartwright Missouri City TX 6 (Dallas) 02/27/2024 EZP411 Complaint
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0117 Ic - Clean/Dirty Areas, Med Prep Area, No Common Med Carts Standard
V0122 Ic - Clean, Disinfect Surfaces & Equipment/Written Protocols Standard
V0549 Monitor Esa Response Standard
V0560 Patients Seen By Med Staff Member Monthly Standard
V0715 Md Resp - Ensure All Adhere To P&P Standard
452778 Fort Bend Dialysis Center 3819 Cartwright Missouri City TX 6 (Dallas) 04/15/2024 NQKH11 Complaint
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0560 Patients Seen By Med Staff Member Monthly Standard
452779 Nna - Round Rock 1499 E Old Settlers Boulevard Round Rock TX 6 (Dallas) 05/21/2019 MGC311 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0101 Compliance With Fed/State/Local Laws Standard
V0111 Ic - Sanitary Environment Standard
V0407 Pe - Hemodialysis Patients In View During Treatments Standard
V0640 Immediately Correct Any Ij Issues Standard
452780 Houston Kidney Center Southwes 9980 W Sam Houston Pkwy S, Ste 100 Houston TX 6 (Dallas) 01/11/2018 MYAJ12 Standard
Deficiency Tag Deficiency Description Tag Type
V0110 Cfc - Infection Control Condition
V0117 Ic - Clean/Dirty Areas, Med Prep Area, No Common Med Carts Standard
V0122 Ic - Clean, Disinfect Surfaces & Equipment/Written Protocols Standard
V0126 Ic - Hbv - Vaccinate Patients & Staff Standard
V0750 Cfc - Governance Condition
V0757 Staff # & Ratio Meet Patient Needs Standard
452780 Houston Kidney Center Southwes 9980 W Sam Houston Pkwy S, Ste 100 Houston TX 6 (Dallas) 01/05/2021 K11K11 Complaint, Special
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0113 Ic - Wear Gloves/Hand Hygiene Standard
V0463 Receive Services Outlined In Poc Standard
452780 Houston Kidney Center Southwes 9980 W Sam Houston Pkwy S, Ste 100 Houston TX 6 (Dallas) 03/16/2021 VCHX11 Complaint
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0502 Assess Current Health Status Inc Comorbids Standard