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
102737 Four Freedoms Dialysis 289 Sw Range Ave Madison FL 4 (Atlanta) 03/16/2023 PGNZ11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0120 Ic - Transducer Protectors: Not Wetted/Changed Standard
V0122 Ic - Clean, Disinfect Surfaces & Equipment/Written Protocols Standard
V0520 Frequency Reassessment - Unstable - Monthly Standard
V0634 Qapi Indicator - Medical Injuries/Errors Standard
V0636 Qapi Indicator - Pt Satisfaction & Grievances Standard
102739 Universal Kidney Center Inc 4875 Ne 20th Terrace Fort Lauderdale FL 4 (Atlanta) 01/11/2021 W2OC11 Complaint
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0113 Ic - Wear Gloves/Hand Hygiene Standard
V0470 Rights Posted With State/Nw Contact #S And Addresses Standard
V0510 Msw - Psychosocial Needs Standard
V0767 Involuntary Discharge Process Requirements Standard
102739 Universal Kidney Center Inc 4875 Ne 20th Terrace Fort Lauderdale FL 4 (Atlanta) 06/16/2021 187B11 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
V0113 Ic - Wear Gloves/Hand Hygiene Standard
V0121 Ic - Handling Infectious Waste Standard
V0122 Ic - Clean, Disinfect Surfaces & Equipment/Written Protocols Standard
V0143 Ic - Aseptic Techniques For Iv Meds Standard
V0403 Pe - Equipment Maintenance - Manufacturer'S Dfu Standard
V0470 Rights Posted With State/Nw Contact #S And Addresses Standard
V0509 Rd - Nutritional Status Standard
V0519 Frequency Reassessment - Stable - Annual Standard
V0520 Frequency Reassessment - Unstable - Monthly Standard
V0544 Achieve Adequate Clearance Standard
V0681 Staff Licensed As Req/Qualified/Demonstrate Competencies Standard
V0684 Nurse Manager - 12 Mo Rn + 6 Mo Dialysis Standard
102739 Universal Kidney Center Inc 4875 Ne 20th Terrace Fort Lauderdale FL 4 (Atlanta) 08/02/2023 2RW311 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
E0023 Policies/Procedures For Medical Documentation Standard
E0028 Dialysis Emergency Equipment Standard
E0030 Names And Contact Information Standard
V0000 Initial Comments - Not A Deficiency Citation Memo
V0113 Ic - Wear Gloves/Hand Hygiene Standard
V0121 Ic - Handling Infectious Waste Standard
V0213 Dist Sys - Culture/Lal/Sample Sites/Frequency(New)/Log Standard
V0253 Microbial Monitoring - Mo Dialysate Sample/Collection/Freq Standard
V0403 Pe - Equipment Maintenance - Manufacturer'S Dfu Standard
V0405 Pe - Comfortable Temperature Standard
V0470 Rights Posted With State/Nw Contact #S And Addresses Standard
V0509 Rd - Nutritional Status Standard
V0516 Frequency - Initial: 30 Days/13 Tx Standard
V0520 Frequency Reassessment - Unstable - Monthly Standard
V0552 Psychosocial Counseling/Referrals/Assessment Tool Standard
V0556 Poc Completed/Signed By Idt & Patient Standard
V0560 Patients Seen By Med Staff Member Monthly Standard
V0689 Dietitian - Rd Standard
V0757 Staff # & Ratio Meet Patient Needs Standard
102740 Hunters Creek Dialysis 14050 Town Loop Blvd Ste 104a Orlando FL 4 (Atlanta) 03/23/2021 LWKU11 Special, Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0543 Manage Volume Status Standard
102741 Clewiston Dialysis Center Llc 851 W Ventura Ave Clewiston FL 4 (Atlanta) 05/30/2018 7OFW11 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
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
V0638 Continuously Monitor/Take Action/Track/Sustain Improve Standard
102742 Bay Breeze Dialysis 11550 Ulmerton Rd Largo FL 4 (Atlanta) 08/09/2018 IRBW11 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
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
V0726 Medical Records - Complete, Accurate, Accessible Standard
V0765 Internal Grievance Process Components & Implemented Standard
102742 Bay Breeze Dialysis 11550 Ulmerton Rd Largo FL 4 (Atlanta) 08/25/2022 7J8Z11 Complaint, Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0544 Achieve Adequate Clearance Standard
102744 Fort Myers South Dialysis 8850 Gladiolus Dr Fort Myers FL 4 (Atlanta) 11/06/2019 LOKO11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0402 Pe - Building - Constructed/Maintained To Ensure Safety Standard
102745 Renal Care Group - Cordova 5401 Corporate Woods Dr Ste 850 Pensacola FL 4 (Atlanta) 08/21/2025 ZYF411 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
V0147 Ic - Staff Education Re Catheters/Catheter Care Standard
V0543 Manage Volume Status Standard
V0544 Achieve Adequate Clearance Standard