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
552536 Satellite Healthcare Central Modesto 1315 10th Street, Suite 300 Modesto CA 9 (San Francisco) 03/15/2019 QFQ711 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
V0122 Ic - Clean, Disinfect Surfaces & Equipment/Written Protocols Standard
V0543 Manage Volume Status Standard
V0544 Achieve Adequate Clearance Standard
552537 Dci - Redding 180 Northpoint Drive Redding CA 9 (San Francisco) 06/26/2023 QJV611 Complaint
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0690 Dietitian - 1 Year Experience Standard
552540 Rai-Secret Ravine Parkway-Roseville 1451 Secret Ravine Parkway, Bldg D, Ste 130 Roseville CA 9 (San Francisco) 07/31/2018 KFKR11 Complaint
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0504 Assess B/P & Fluid Management Needs Standard
V0715 Md Resp - Ensure All Adhere To P&P Standard
552540 Rai-Secret Ravine Parkway-Roseville 1451 Secret Ravine Parkway, Bldg D, Ste 130 Roseville CA 9 (San Francisco) 01/08/2020 HY8X11 Standard
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0116 Ic - Items Taken To Station Disposed/Dedicated Or Disinfected Standard
V0726 Medical Records - Complete, Accurate, Accessible Standard
552541 Citrus Valley Dialysis 894 Hardt Street San Bernardino CA 9 (San Francisco) 01/27/2020 BZ1A11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0110 Cfc - Infection Control Condition
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
V0122 Ic - Clean, Disinfect Surfaces & Equipment/Written Protocols Standard
V0124 Ic - Hbv - Test All Pts, Review Results/Pt Status Known Preadmit Standard
V0147 Ic - Staff Education Re Catheters/Catheter Care Standard
V0323 Inventory Control Standard
V0403 Pe - Equipment Maintenance - Manufacturer'S Dfu Standard
V0407 Pe - Hemodialysis Patients In View During Treatments Standard
V0547 Manage Anemia/H/H Measured Monthly Standard
V0625 Cfc - Quality Assessment & Performance Improvement Condition
V0750 Cfc - Governance Condition
552542 Rai-Elk Grove Blvd-Elk Grove 8139 Elk Grove Blvd Suite 200 Elk Grove CA 9 (San Francisco) 07/13/2018 CYSC11 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
V0117 Ic - Clean/Dirty Areas, Med Prep Area, No Common Med Carts Standard
V0122 Ic - Clean, Disinfect Surfaces & Equipment/Written Protocols Standard
V0142 Ic - Oversight: Monitor Activities & Implement Policies Standard
V0503 Appropriateness Of Dialysis Rx Standard
V0504 Assess B/P & Fluid Management Needs Standard
V0543 Manage Volume Status Standard
V0715 Md Resp - Ensure All Adhere To P&P Standard
V0726 Medical Records - Complete, Accurate, Accessible Standard
552542 Rai-Elk Grove Blvd-Elk Grove 8139 Elk Grove Blvd Suite 200 Elk Grove CA 9 (San Francisco) 12/06/2018 1Y5H21 Complaint
Deficiency Tag Deficiency Description Tag Type
K0000 Initial Comments - Not A Deficiency Citation Memo
K0353 Sprinkler System - Maintenance And Testing Standard
K0355 Portable Fire Extinguishers Standard
K0920 Electrical Equipment - Power Cords And Extens Standard
K0923 Gas Equipment - Cylinder And Container Storag Standard
552542 Rai-Elk Grove Blvd-Elk Grove 8139 Elk Grove Blvd Suite 200 Elk Grove CA 9 (San Francisco) 06/09/2020 PLNM11 Special
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0520 Frequency Reassessment - Unstable - Monthly Standard
V0559 Outcome Not Achieved - Adjust Poc Standard
552543 Home Dialysis Therapies Of San Diego Inc 10672 Wexford Street, Suite 250 San Diego CA 9 (San Francisco) 05/02/2019 PUT011 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0124 Ic - Hbv - Test All Pts, Review Results/Pt Status Known Preadmit Standard
V0143 Ic - Aseptic Techniques For Iv Meds Standard
552544 Crossroads Dialysis 3214 Yorba Linda Blvd Fullerton CA 9 (San Francisco) 01/04/2018 2RNS11 Complaint
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
E0003 Establishment Of The Ep Program Dialysis Condition
E0004 Develop Ep Plan, Review And Update Annually Standard
E0038 Esrd Ep Training Program Standard
E0039 Ep Testing Requirements Standard
V0000 Initial Comments - Not A Deficiency Citation Memo
V0117 Ic - Clean/Dirty Areas, Med Prep Area, No Common Med Carts Standard
V0121 Ic - Handling Infectious Waste Standard
V0184 Environment: Secure And Restricted Standard
V0401 Pe - Safe, Functional, Comfortable Environment Standard
V0457 Execute Advance Directives, Facility Policy Re Ad Standard
V0465 Informed - Internal Grievance Process Standard
V0501 Patient Assessment - Interdisciplinary Team Mbrs/Resp. Standard
V0510 Msw - Psychosocial Needs Standard
V0516 Frequency - Initial: 30 Days/13 Tx Standard
V0520 Frequency Reassessment - Unstable - Monthly Standard
V0545 Effective Nutritional Status Standard
V0551 Va Monitor To Prevent Failure/Stenosis Standard
V0636 Qapi Indicator - Pt Satisfaction & Grievances Standard
V0715 Md Resp - Ensure All Adhere To P&P Standard
V0726 Medical Records - Complete, Accurate, Accessible Standard
V0726 Medical Records - Complete, Accurate, Accessible Standard
V0752 Appoint Ceo/Administrator Standard