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
492593 Bma Of Bowling Green 102 West Broaddus Ave - Po Box 490 Bowling Green VA 3 (Philadelphia) 01/08/2021 0QGS11 Special, 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
V0403 Pe - Equipment Maintenance - Manufacturer'S Dfu Standard
V0504 Assess B/P & Fluid Management Needs Standard
V0520 Frequency Reassessment - Unstable - Monthly Standard
492593 Bma Of Bowling Green 102 West Broaddus Ave - Po Box 490 Bowling Green VA 3 (Philadelphia) 08/22/2023 S1IR11 Complaint, Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
E0009 Local, State, Tribal Collaboration Process Standard
E0031 Emergency Officials Contact Information Standard
V0000 Initial Comments - Not A Deficiency Citation Memo
V0113 Ic - Wear Gloves/Hand Hygiene Standard
V0121 Ic - Handling Infectious Waste Standard
V0184 Environment: Secure And Restricted Standard
V0407 Pe - Hemodialysis Patients In View During Treatments Standard
V0543 Manage Volume Status Standard
V0544 Achieve Adequate Clearance Standard
492594 Davita Petersburg Dialysis 20 Medical Park Boulevard Petersburg VA 3 (Philadelphia) 02/26/2019 L61B11 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
V0121 Ic - Handling Infectious Waste Standard
V0142 Ic - Oversight: Monitor Activities & Implement Policies Standard
V0143 Ic - Aseptic Techniques For Iv Meds Standard
V0454 Privacy & Confidentiality In Treatment Standard
V0504 Assess B/P & Fluid Management Needs Standard
V0544 Achieve Adequate Clearance Standard
V0551 Va Monitor To Prevent Failure/Stenosis Standard
492594 Davita Petersburg Dialysis 20 Medical Park Boulevard Petersburg VA 3 (Philadelphia) 01/09/2020 LJDI11 Complaint
Deficiency Tag Deficiency Description Tag Type
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
V0250 Dialysate Proportioning - Monitor Ph/Conductivity Standard
V0403 Pe - Equipment Maintenance - Manufacturer'S Dfu Standard
V0543 Manage Volume Status Standard
492594 Davita Petersburg Dialysis 20 Medical Park Boulevard Petersburg VA 3 (Philadelphia) 01/06/2022 Y0HI11 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
V0556 Poc Completed/Signed By Idt & Patient Standard
V0638 Continuously Monitor/Take Action/Track/Sustain Improve Standard
492594 Davita Petersburg Dialysis 20 Medical Park Boulevard Petersburg VA 3 (Philadelphia) 06/18/2025 LE0O11 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
V0113 Ic - Wear Gloves/Hand Hygiene Standard
V0122 Ic - Clean, Disinfect Surfaces & Equipment/Written Protocols Standard
V0143 Ic - Aseptic Techniques For Iv Meds Standard
V0502 Assess Current Health Status Inc Comorbids Standard
V0543 Manage Volume Status Standard
V0544 Achieve Adequate Clearance Standard
V0550 Vascular Access - Monitor/Referrals Standard
V0557 Initial Poc Implemented - 30 Days/13 Tx Standard
V0560 Patients Seen By Med Staff Member Monthly Standard
V0638 Continuously Monitor/Take Action/Track/Sustain Improve Standard
492595 Fmc Dialysis Services Montgomery County 106 Southpark Drive Blacksburg VA 3 (Philadelphia) 03/22/2018 K3IE11 Standard
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0250 Dialysate Proportioning - Monitor Ph/Conductivity Standard
492595 Fmc Dialysis Services Montgomery County 106 Southpark Drive Blacksburg VA 3 (Philadelphia) 03/17/2021 VXD311 Special, 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
V0403 Pe - Equipment Maintenance - Manufacturer'S Dfu Standard
V0543 Manage Volume Status Standard
V0544 Achieve Adequate Clearance Standard
V0546 Manage Mineral Metabolism Standard
492595 Fmc Dialysis Services Montgomery County 106 Southpark Drive Blacksburg VA 3 (Philadelphia) 03/06/2024 YQ9A11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0542 Idt Develops Plan Of Care Standard
V0726 Medical Records - Complete, Accurate, Accessible Standard
492596 Fresenius Medical Care Services - Potomac Mills 3057 Golansky Blvd Prince William VA 3 (Philadelphia) 02/28/2020 F5JD11 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
V0143 Ic - Aseptic Techniques For Iv Meds Standard
V0550 Vascular Access - Monitor/Referrals Standard