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
492646 Rai Care Center Of Gloucester 6740 Main Street Gloucester VA 3 (Philadelphia) 02/17/2021 0VTM11 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
V0122 Ic - Clean, Disinfect Surfaces & Equipment/Written Protocols Standard
V0504 Assess B/P & Fluid Management Needs Standard
V0562 Patient/Family Education & Training Standard
492646 Rai Care Center Of Gloucester 6740 Main Street Gloucester VA 3 (Philadelphia) 10/26/2023 O1DA11 Complaint, Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
E0039 Ep Testing Requirements Standard
V0000 Initial Comments - Not A Deficiency Citation Memo
V0110 Cfc - Infection Control Condition
V0113 Ic - Wear Gloves/Hand Hygiene Standard
V0115 Ic - Wear Gowns, Shields/Masks; Staff Not Eat/Drink In Tx Area Standard
V0122 Ic - Clean, Disinfect Surfaces & Equipment/Written Protocols Standard
V0504 Assess B/P & Fluid Management Needs Standard
V0519 Frequency Reassessment - Stable - Annual Standard
V0556 Poc Completed/Signed By Idt & Patient Standard
V0562 Patient/Family Education & Training Standard
V0681 Staff Licensed As Req/Qualified/Demonstrate Competencies Standard
V0750 Cfc - Governance Condition
V0757 Staff # & Ratio Meet Patient Needs Standard
492647 Us Renal Care Woodbridge Dialysis 14000 Crown Court Suite 110 Woodbridge VA 3 (Philadelphia) 09/19/2018 6L4E11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
E0023 Policies/Procedures For Medical Documentation Standard
E0025 Arrangement With Other Facilities Standard
E0028 Dialysis Emergency Equipment Standard
E0039 Ep Testing Requirements Standard
V0000 Initial Comments - Not A Deficiency Citation Memo
V0122 Ic - Clean, Disinfect Surfaces & Equipment/Written Protocols Standard
V0124 Ic - Hbv - Test All Pts, Review Results/Pt Status Known Preadmit Standard
V0143 Ic - Aseptic Techniques For Iv Meds Standard
V0147 Ic - Staff Education Re Catheters/Catheter Care Standard
V0541 Patient Plan Of Care - Goals - Community-Based Standards 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
492647 Us Renal Care Woodbridge Dialysis 14000 Crown Court Suite 110 Woodbridge VA 3 (Philadelphia) 09/16/2021 P82C11 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
V0117 Ic - Clean/Dirty Areas, Med Prep Area, No Common Med Carts Standard
V0504 Assess B/P & Fluid Management Needs Standard
V0550 Vascular Access - Monitor/Referrals Standard
V0562 Patient/Family Education & Training Standard
492647 Us Renal Care Woodbridge Dialysis 14000 Crown Court Suite 110 Woodbridge VA 3 (Philadelphia) 09/10/2024 RCJM11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0117 Ic - Clean/Dirty Areas, Med Prep Area, No Common Med Carts Standard
V0544 Achieve Adequate Clearance Standard
V0550 Vascular Access - Monitor/Referrals Standard
492648 South Laburnum Dialysis, Llc 4817 South Laburnum Avenue Richmond VA 3 (Philadelphia) 08/07/2019 RDRK11 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
V0117 Ic - Clean/Dirty Areas, Med Prep Area, No Common Med Carts Standard
V0132 Ic - Training And Education Standard
V0143 Ic - Aseptic Techniques For Iv Meds Standard
V0260 Personnel - Training Program/Periodic Audits Standard
V0511 Dialysis Access Type & Maintenance Standard
V0544 Achieve Adequate Clearance Standard
V0546 Manage Mineral Metabolism Standard
V0562 Patient/Family Education & Training Standard
V0714 Md Resp - Develop, Review& Approve P&P Standard
492648 South Laburnum Dialysis, Llc 4817 South Laburnum Avenue Richmond VA 3 (Philadelphia) 03/17/2021 2Y8T11 Complaint, Special, 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
V0124 Ic - Hbv - Test All Pts, Review Results/Pt Status Known Preadmit Standard
V0175 Cfc - Water And Dialysate Quality Condition
V0250 Dialysate Proportioning - Monitor Ph/Conductivity Standard
V0401 Pe - Safe, Functional, Comfortable Environment Standard
492648 South Laburnum Dialysis, Llc 4817 South Laburnum Avenue Richmond VA 3 (Philadelphia) 01/12/2022 VT9Q11 Special, Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0121 Ic - Handling Infectious Waste Standard
V0122 Ic - Clean, Disinfect Surfaces & Equipment/Written Protocols Standard
V0638 Continuously Monitor/Take Action/Track/Sustain Improve Standard
492648 South Laburnum Dialysis, Llc 4817 South Laburnum Avenue Richmond VA 3 (Philadelphia) 02/25/2025 S0D911 Complaint, Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
E0030 Names And Contact Information Standard
E0032 Primary/Alternate Means For Communication Standard
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
V0147 Ic - Staff Education Re Catheters/Catheter Care Standard
V0401 Pe - Safe, Functional, Comfortable Environment Standard
V0544 Achieve Adequate Clearance Standard
V0550 Vascular Access - Monitor/Referrals Standard
V0634 Qapi Indicator - Medical Injuries/Errors Standard
V0715 Md Resp - Ensure All Adhere To P&P Standard
V0771 Electronic Data Submission Required For Program Adm Standard
492649 Fresenius Medical Care Services - Spotsylvania 10718 Ballantraye Drive, Suite 406 Fredericksburg VA 3 (Philadelphia) 07/26/2018 9UPN11 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
V0254 Microbial Monitoring - Sample Before Disinfect Standard
V0715 Md Resp - Ensure All Adhere To P&P Standard