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
552751 Satellite Wellbound Of North Modesto 4207 Bangs Avenue Ste 200 Modesto CA 9 (San Francisco) 07/11/2019 D3QK11 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
V0543 Manage Volume Status Standard
V0556 Poc Completed/Signed By Idt & Patient Standard
V0558 Implement Updates Of Poc - 15 Days P Pt Assessment Standard
V0560 Patients Seen By Med Staff Member Monthly Standard
V0587 Fac Receive/Review Self Monitoring Data Every 2 Months Standard
552752 Satellite Healthcare North Modesto 4207 Bangs Ave Suite 100 Modesto CA 9 (San Francisco) 10/30/2018 O5AE11 Complaint
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0111 Ic - Sanitary Environment Standard
552752 Satellite Healthcare North Modesto 4207 Bangs Ave Suite 100 Modesto CA 9 (San Francisco) 11/08/2018 G4SV21 Complaint
Deficiency Tag Deficiency Description Tag Type
K0000 Initial Comments - Not A Deficiency Citation Memo
K0211 Means Of Egress - General Standard
K0223 Doors With Self-Closing Devices Standard
552752 Satellite Healthcare North Modesto 4207 Bangs Ave Suite 100 Modesto CA 9 (San Francisco) 07/11/2019 MEDT11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
E0038 Esrd Ep Training Program Standard
E0039 Ep Testing Requirements Standard
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
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
V0465 Informed - Internal Grievance Process Standard
V0519 Frequency Reassessment - Stable - Annual Standard
V0520 Frequency Reassessment - Unstable - Monthly Standard
V0543 Manage Volume Status Standard
V0544 Achieve Adequate Clearance Standard
V0556 Poc Completed/Signed By Idt & Patient Standard
V0560 Patients Seen By Med Staff Member Monthly Standard
V0715 Md Resp - Ensure All Adhere To P&P Standard
552753 Arvin Dialysis 902 Bear Mountain Boulevard Arvin CA 9 (San Francisco) 07/08/2019 8QQY11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0101 Compliance With Fed/State/Local Laws Standard
V0112 Ic - Cdc Mmwr 2001 Standard
V0117 Ic - Clean/Dirty Areas, Med Prep Area, No Common Med Carts Standard
V0122 Ic - Clean, Disinfect Surfaces & Equipment/Written Protocols Standard
V0132 Ic - Training And Education Standard
V0196 Carbon Adsorption - Monitoring, Testing Frequency Standard
V0403 Pe - Equipment Maintenance - Manufacturer'S Dfu Standard
V0407 Pe - Hemodialysis Patients In View During Treatments Standard
V0417 Pe-Fire Safety-Life Safety Code Standard
V0503 Appropriateness Of Dialysis Rx Standard
V0542 Idt Develops Plan Of Care Standard
V0544 Achieve Adequate Clearance Standard
V0626 Covers Scope Of Services/Effective/Idt Involved Standard
V0628 Measure, Analyze And Track Quality Indicators Standard
V0637 Qapi Indicator - Infection Control - Trend/Plan/Act Standard
V0681 Staff Licensed As Req/Qualified/Demonstrate Competencies Standard
V0726 Medical Records - Complete, Accurate, Accessible Standard
552754 Satellite Healthcare Vallejo 4300 Sonoma Boulevard, Suite 25 Vallejo CA 9 (San Francisco) 02/23/2021 FYCT11 Complaint
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0111 Ic - Sanitary Environment Standard
552755 Newport Superior Dialysis 510 Superior Ave, Suite 150 Newport Beach CA 9 (San Francisco) 04/09/2018 V30N11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
E0028 Dialysis Emergency Equipment Standard
E0038 Esrd Ep Training Program Standard
V0000 Initial Comments - Not A Deficiency Citation Memo
V0111 Ic - Sanitary Environment Standard
V0113 Ic - Wear Gloves/Hand Hygiene Standard
V0143 Ic - Aseptic Techniques For Iv Meds Standard
V0407 Pe - Hemodialysis Patients In View During Treatments Standard
V0543 Manage Volume Status Standard
V0544 Achieve Adequate Clearance Standard
V0546 Manage Mineral Metabolism Standard
V0715 Md Resp - Ensure All Adhere To P&P Standard
552756 Satellite Wellbound Of Mountain View 247 W El Camino Real Suite 200 Mountain View CA 9 (San Francisco) 01/24/2019 JPVL11 Standard
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0124 Ic - Hbv - Test All Pts, Review Results/Pt Status Known Preadmit Standard
V0126 Ic - Hbv - Vaccinate Patients & Staff Standard
V0127 Ic - Hbv - Test Pts/Staff Post Last Dose Standard
V0142 Ic - Oversight: Monitor Activities & Implement Policies Standard
V0589 Monitor Home Adaptation,Home Visits - Poc Standard
V0595 Meet Rd 52 2004 Standard
V0715 Md Resp - Ensure All Adhere To P&P Standard
552758 Fresenius Medical Care Orange County Home 1401 S Brookhurst Rd, Suite 108 Fullerton CA 9 (San Francisco) 05/16/2018 6UY711 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
E0030 Names And Contact Information Standard
E0038 Esrd Ep Training Program Standard
V0000 Initial Comments - Not A Deficiency Citation Memo
552759 Bastanchury Dialysis 1950 Sunnycrest Drive Suite 1300 Fullerton CA 9 (San Francisco) 05/24/2018 YVYC11 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
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
V0143 Ic - Aseptic Techniques For Iv Meds Standard
V0403 Pe - Equipment Maintenance - Manufacturer'S Dfu Standard
V0543 Manage Volume Status Standard
V0544 Achieve Adequate Clearance Standard
V0676 Clia Labs/Meet Needs Of Patients Standard
V0714 Md Resp - Develop, Review& Approve P&P Standard
V0715 Md Resp - Ensure All Adhere To P&P Standard