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
523517 Gundersen Lutheran Renal Dialysis Viroqua 407 S Main St Suite 300 Viroqua WI 5 (Chicago) 06/27/2018 K78G11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0112 Ic - Cdc Mmwr 2001 Standard
V0113 Ic - Wear Gloves/Hand Hygiene Standard
V0122 Ic - Clean, Disinfect Surfaces & Equipment/Written Protocols Standard
V0187 Environment - Schematic Diagrams/Labels Standard
V0196 Carbon Adsorption - Monitoring, Testing Frequency Standard
V0253 Microbial Monitoring - Mo Dialysate Sample/Collection/Freq Standard
V0636 Qapi Indicator - Pt Satisfaction & Grievances Standard
V0726 Medical Records - Complete, Accurate, Accessible Standard
523517 Gundersen Lutheran Renal Dialysis Viroqua 407 S Main St Suite 300 Viroqua WI 5 (Chicago) 10/19/2022 RPT711 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
523519 Mayo Clinic Dialysis Onalaska 191 Theater Rd Onalaska WI 5 (Chicago) 12/01/2020 Z30611 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
V0111 Ic - Sanitary Environment Standard
V0507 Assess Anemia Standard
V0520 Frequency Reassessment - Unstable - Monthly Standard
V0540 Cfc: Patient Plan Of Care Condition
V0543 Manage Volume Status Standard
V0544 Achieve Adequate Clearance Standard
V0547 Manage Anemia/H/H Measured Monthly Standard
V0559 Outcome Not Achieved - Adjust Poc Standard
V0628 Measure, Analyze And Track Quality Indicators Standard
V0714 Md Resp - Develop, Review& Approve P&P Standard
V0715 Md Resp - Ensure All Adhere To P&P Standard
V0726 Medical Records - Complete, Accurate, Accessible Standard
523519 Mayo Clinic Dialysis Onalaska 191 Theater Rd Onalaska WI 5 (Chicago) 09/08/2022 95MX11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0116 Ic - Items Taken To Station Disposed/Dedicated Or Disinfected Standard
V0407 Pe - Hemodialysis Patients In View During Treatments Standard
V0509 Rd - Nutritional Status Standard
V0543 Manage Volume Status Standard
V0550 Vascular Access - Monitor/Referrals Standard
V0634 Qapi Indicator - Medical Injuries/Errors Standard
V0715 Md Resp - Ensure All Adhere To P&P Standard
V0731 Mr - Maintain Home Patient Records Standard
523522 Mayo Clinic Dialysis London Rd 3845 London Rd Eau Claire WI 5 (Chicago) 02/19/2021 Z0K211 Special, Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0147 Ic - Staff Education Re Catheters/Catheter Care Standard
V0403 Pe - Equipment Maintenance - Manufacturer'S Dfu Standard
523522 Mayo Clinic Dialysis London Rd 3845 London Rd Eau Claire WI 5 (Chicago) 03/20/2024 KM4X11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0116 Ic - Items Taken To Station Disposed/Dedicated Or Disinfected Standard
V0184 Environment: Secure And Restricted Standard
523525 Fresenius Kidney Care Chippewa Falls 2661 County Highway I Chippewa Falls WI 5 (Chicago) 03/31/2021 DYBA11 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
V0111 Ic - Sanitary Environment Standard
V0403 Pe - Equipment Maintenance - Manufacturer'S Dfu Standard
V0543 Manage Volume Status Standard
523527 Aspirus Wausau Hospital Kidney Care 3000 Westhill Dr Suite 106 Wausau WI 5 (Chicago) 09/04/2018 6OV611 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
E0028 Dialysis Emergency Equipment Standard
E0039 Ep Testing Requirements Standard
V0000 Initial Comments - Not A Deficiency Citation Memo
V0116 Ic - Items Taken To Station Disposed/Dedicated Or Disinfected Standard
V0202 Di - Continuous Monitoring Resistivity/Logged 2 X Day Standard
V0250 Dialysate Proportioning - Monitor Ph/Conductivity Standard
V0260 Personnel - Training Program/Periodic Audits Standard
V0402 Pe - Building - Constructed/Maintained To Ensure Safety Standard
V0407 Pe - Hemodialysis Patients In View During Treatments Standard
V0503 Appropriateness Of Dialysis Rx Standard
V0504 Assess B/P & Fluid Management Needs Standard
V0543 Manage Volume Status Standard
V0586 Pt/Caregiver Demonstrated Comprehension Of Training Standard
V0599 Recordkeeping System Standard
V0628 Measure, Analyze And Track Quality Indicators Standard
V0632 Qapi Indicator - Anemia Management Standard
V0730 Mr - Centralize All Info, Each Member Of Idt Has Access Standard
523527 Aspirus Wausau Hospital Kidney Care 3000 Westhill Dr Suite 106 Wausau WI 5 (Chicago) 07/15/2022 P29P11 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
V0116 Ic - Items Taken To Station Disposed/Dedicated Or Disinfected Standard
V0541 Patient Plan Of Care - Goals - Community-Based Standards Standard
523528 Gundersen Lutheran Renal Dialysis Onalaska 3075 S Kinney Coulee Rd Onalaska WI 5 (Chicago) 01/25/2018 DQQP11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
E0009 Local, State, Tribal Collaboration Process Standard
E0013 Development Of Ep Policies And Procedures Standard
E0030 Names And Contact Information Standard
E0031 Emergency Officials Contact Information Standard
E0032 Primary/Alternate Means For Communication Standard
E0033 Methods For Sharing Information Standard
E0036 Ep Training And Testing Standard
E0039 Ep Testing Requirements Standard
E0040 Esrd Patient Orientation Training Standard
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
V0465 Informed - Internal Grievance Process Standard
V0503 Appropriateness Of Dialysis Rx Standard
V0542 Idt Develops Plan Of Care Standard
V0543 Manage Volume Status Standard
V0550 Vascular Access - Monitor/Referrals Standard
V0551 Va Monitor To Prevent Failure/Stenosis Standard
V0556 Poc Completed/Signed By Idt & Patient Standard
V0726 Medical Records - Complete, Accurate, Accessible Standard
V0765 Internal Grievance Process Components & Implemented Standard