S&C QCOR ESRD 2567s
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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
▼ 492567 Kempsville Dialysis Center 6320 North Center Drive, Building 15, Suite 140 Norfolk VA 3 (Philadelphia) 08/14/2025 G6QR11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0115 Ic - Wear Gowns, Shields/Masks; Staff Not Eat/Drink In Tx Area Standard
V0503 Appropriateness Of Dialysis Rx Standard
V0504 Assess B/P & Fluid Management Needs Standard
V0556 Poc Completed/Signed By Idt & Patient Standard
V0715 Md Resp - Ensure All Adhere To P&P Standard
▼ 492570 Bma Crystal Springs Dialysis 404 Mcclanahan Street Sw Roanoke VA 3 (Philadelphia) 10/19/2018 RP7X11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0127 Ic - Hbv - Test Pts/Staff Post Last Dose Standard
V0196 Carbon Adsorption - Monitoring, Testing Frequency Standard
V0541 Patient Plan Of Care - Goals - Community-Based Standards Standard
V0544 Achieve Adequate Clearance Standard
V0713 Md Resp - Staff Ed, Training & Performance Standard
▼ 492570 Bma Crystal Springs Dialysis 404 Mcclanahan Street Sw Roanoke VA 3 (Philadelphia) 11/18/2021 W0VN11 Special, 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
V0147 Ic - Staff Education Re Catheters/Catheter Care Standard
V0407 Pe - Hemodialysis Patients In View During Treatments Standard
V0634 Qapi Indicator - Medical Injuries/Errors Standard
▼ 492570 Bma Crystal Springs Dialysis 404 Mcclanahan Street Sw Roanoke VA 3 (Philadelphia) 11/18/2021 W0VN21 Standard
Deficiency Tag Deficiency Description Tag Type
K0000 Initial Comments - Not A Deficiency Citation Memo
K0161 Building Construction Type And Height Standard
K0271 Discharge From Exits Standard
K0291 Emergency Lighting Standard
K0345 Fire Alarm System - Testing And Maintenance Standard
K0353 Sprinkler System - Maintenance And Testing Standard
K0355 Portable Fire Extinguishers Standard
K0511 Utilities - Gas And Electric Standard
K0521 Hvac Standard
K0531 Elevators Standard
K0711 Evacuation And Relocation Plan Standard
K0761 Maintenance, Inspection And Testing - Doors Standard
K0918 Electrical Systems - Essential Electric Syste Standard
K0923 Gas Equipment - Cylinder And Container Storag Standard
▼ 492570 Bma Crystal Springs Dialysis 404 Mcclanahan Street Sw Roanoke VA 3 (Philadelphia) 03/04/2025 07RF11 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
V0115 Ic - Wear Gowns, Shields/Masks; Staff Not Eat/Drink In Tx Area Standard
V0116 Ic - Items Taken To Station Disposed/Dedicated Or Disinfected Standard
V0122 Ic - Clean, Disinfect Surfaces & Equipment/Written Protocols Standard
V0401 Pe - Safe, Functional, Comfortable Environment Standard
V0543 Manage Volume Status Standard
V0544 Achieve Adequate Clearance Standard
▼ 492572 Russell County Dialysis Facility 150 East Main Street Lebanon VA 3 (Philadelphia) 11/29/2018 0U1Z11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0143 Ic - Aseptic Techniques For Iv Meds Standard
V0250 Dialysate Proportioning - Monitor Ph/Conductivity Standard
V0543 Manage Volume Status Standard
V0634 Qapi Indicator - Medical Injuries/Errors Standard
V0755 Adm Resp For Relationship With Esrd Nw Standard
▼ 492572 Russell County Dialysis Facility 150 East Main Street Lebanon VA 3 (Philadelphia) 01/21/2022 YMWH11 Special, 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
V0628 Measure, Analyze And Track Quality Indicators Standard
V0637 Qapi Indicator - Infection Control - Trend/Plan/Act Standard
▼ 492572 Russell County Dialysis Facility 150 East Main Street Lebanon VA 3 (Philadelphia) 06/18/2025 2WTQ11 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
V0147 Ic - Staff Education Re Catheters/Catheter Care Standard
V0550 Vascular Access - Monitor/Referrals Standard
▼ 492573 Front Royal Dialysis 1360 N Shenandoah Avenue Front Royal VA 3 (Philadelphia) 08/15/2023 0Y4811 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0132 Ic - Training And Education Standard
V0143 Ic - Aseptic Techniques For Iv Meds Standard
V0543 Manage Volume Status Standard
▼ 492574 Newport News Dialysis Center 711 79th Street Newport News VA 3 (Philadelphia) 07/11/2018 Z2E811 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
E0040 Esrd Patient Orientation Training Standard
V0000 Initial Comments - Not A Deficiency Citation Memo
V0111 Ic - Sanitary Environment Standard
V0113 Ic - Wear Gloves/Hand Hygiene Standard
V0115 Ic - Wear Gowns, Shields/Masks; Staff Not Eat/Drink In Tx Area Standard
V0117 Ic - Clean/Dirty Areas, Med Prep Area, No Common Med Carts Standard
V0122 Ic - Clean, Disinfect Surfaces & Equipment/Written Protocols Standard
V0147 Ic - Staff Education Re Catheters/Catheter Care Standard
V0504 Assess B/P & Fluid Management Needs Standard
V0511 Dialysis Access Type & Maintenance Standard
V0516 Frequency - Initial: 30 Days/13 Tx Standard
V0520 Frequency Reassessment - Unstable - Monthly Standard
V0556 Poc Completed/Signed By Idt & Patient Standard
V0557 Initial Poc Implemented - 30 Days/13 Tx Standard
V0562 Patient/Family Education & Training Standard
V0726 Medical Records - Complete, Accurate, Accessible Standard