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
522554 Bay Shore Dialysis 5650 N Green Bay Ave Suite 150 Glendale WI 5 (Chicago) 12/05/2019 XL8H11 Complaint
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0145 Ic - Report Communicable Diseases Standard
V0634 Qapi Indicator - Medical Injuries/Errors Standard
V0726 Medical Records - Complete, Accurate, Accessible Standard
522554 Bay Shore Dialysis 5650 N Green Bay Ave Suite 150 Glendale WI 5 (Chicago) 11/02/2021 V3ZI11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
E0038 Esrd Ep Training Program Standard
V0000 Initial Comments - Not A Deficiency Citation Memo
V0113 Ic - Wear Gloves/Hand Hygiene Standard
V0117 Ic - Clean/Dirty Areas, Med Prep Area, No Common Med Carts Standard
V0121 Ic - Handling Infectious Waste Standard
V0143 Ic - Aseptic Techniques For Iv Meds Standard
V0147 Ic - Staff Education Re Catheters/Catheter Care Standard
V0407 Pe - Hemodialysis Patients In View During Treatments Standard
V0503 Appropriateness Of Dialysis Rx Standard
V0507 Assess Anemia Standard
V0543 Manage Volume Status Standard
V0544 Achieve Adequate Clearance Standard
V0726 Medical Records - Complete, Accurate, Accessible Standard
522554 Bay Shore Dialysis 5650 N Green Bay Ave Suite 150 Glendale WI 5 (Chicago) 10/09/2024 0R4N11 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
V0147 Ic - Staff Education Re Catheters/Catheter Care Standard
V0504 Assess B/P & Fluid Management Needs Standard
522555 Fresenius Kidney Care Fitchburg 3034 Fish Hatchery Rd Fitchburg WI 5 (Chicago) 03/09/2022 NQIH11 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
V0503 Appropriateness Of Dialysis Rx Standard
522555 Fresenius Kidney Care Fitchburg 3034 Fish Hatchery Rd Fitchburg WI 5 (Chicago) 06/15/2023 ZHZW11 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
V0122 Ic - Clean, Disinfect Surfaces & Equipment/Written Protocols Standard
V0407 Pe - Hemodialysis Patients In View During Treatments Standard
V0503 Appropriateness Of Dialysis Rx Standard
V0544 Achieve Adequate Clearance Standard
V0550 Vascular Access - Monitor/Referrals Standard
522555 Fresenius Kidney Care Fitchburg 3034 Fish Hatchery Rd Fitchburg WI 5 (Chicago) 12/06/2024 9PTD11 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
V0401 Pe - Safe, Functional, Comfortable Environment Standard
V0503 Appropriateness Of Dialysis Rx Standard
V0556 Poc Completed/Signed By Idt & Patient Standard
V0715 Md Resp - Ensure All Adhere To P&P Standard
522556 Sturgeon Bay Dialysis 108 S 10th Ave Sturgeon Bay WI 5 (Chicago) 05/21/2019 GC6D11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
E0003 Establishment Of The Ep Program Dialysis Condition
V0000 Initial Comments - Not A Deficiency Citation Memo
V0113 Ic - Wear Gloves/Hand Hygiene Standard
V0117 Ic - Clean/Dirty Areas, Med Prep Area, No Common Med Carts Standard
V0119 Ic - Supply Cart Distant/No Supplies In Pockets Standard
V0147 Ic - Staff Education Re Catheters/Catheter Care Standard
V0503 Appropriateness Of Dialysis Rx Standard
V0543 Manage Volume Status Standard
V0544 Achieve Adequate Clearance Standard
V0634 Qapi Indicator - Medical Injuries/Errors Standard
V0715 Md Resp - Ensure All Adhere To P&P Standard
V0730 Mr - Centralize All Info, Each Member Of Idt Has Access Standard
522556 Sturgeon Bay Dialysis 108 S 10th Ave Sturgeon Bay WI 5 (Chicago) 08/28/2025 AF5N11 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
V0147 Ic - Staff Education Re Catheters/Catheter Care Standard
V0503 Appropriateness Of Dialysis Rx Standard
V0543 Manage Volume Status Standard
V0544 Achieve Adequate Clearance Standard
V0550 Vascular Access - Monitor/Referrals Standard
V0628 Measure, Analyze And Track Quality Indicators Standard
V0715 Md Resp - Ensure All Adhere To P&P Standard
V0761 Staff Have Access To Continuing Education Standard
522558 Titletown Dialysis 120 Siegler St Green Bay WI 5 (Chicago) 02/25/2020 63L111 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
V0543 Manage Volume Status Standard
V0628 Measure, Analyze And Track Quality Indicators Standard
522558 Titletown Dialysis 120 Siegler St Green Bay WI 5 (Chicago) 11/03/2023 MUVV11 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
V0147 Ic - Staff Education Re Catheters/Catheter Care Standard
V0503 Appropriateness Of Dialysis Rx Standard
V0519 Frequency Reassessment - Stable - Annual Standard
V0520 Frequency Reassessment - Unstable - Monthly Standard
V0543 Manage Volume Status Standard
V0544 Achieve Adequate Clearance Standard
V0550 Vascular Access - Monitor/Referrals Standard
V0562 Patient/Family Education & Training Standard
V0628 Measure, Analyze And Track Quality Indicators Standard
V0632 Qapi Indicator - Anemia Management Standard
V0634 Qapi Indicator - Medical Injuries/Errors Standard
V0681 Staff Licensed As Req/Qualified/Demonstrate Competencies Standard
V0715 Md Resp - Ensure All Adhere To P&P Standard