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
102775 Orange City Dialysis 2575 S Volusia Ave Ste 400 Orange City FL 4 (Atlanta) 04/02/2019 TIZ611 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
V0118 Ic - Single Use Vials Standard
V0407 Pe - Hemodialysis Patients In View During Treatments Standard
V0502 Assess Current Health Status Inc Comorbids Standard
V0503 Appropriateness Of Dialysis Rx Standard
V0504 Assess B/P & Fluid Management Needs Standard
V0543 Manage Volume Status Standard
102775 Orange City Dialysis 2575 S Volusia Ave Ste 400 Orange City FL 4 (Atlanta) 09/28/2021 RI7W11 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
V0250 Dialysate Proportioning - Monitor Ph/Conductivity Standard
V0502 Assess Current Health Status Inc Comorbids Standard
102775 Orange City Dialysis 2575 S Volusia Ave Ste 400 Orange City FL 4 (Atlanta) 05/21/2025 UXHZ11 Complaint, 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
V0544 Achieve Adequate Clearance Standard
102777 Pure Life Renal Of West Palm Beach Llc 1522 N Dixie Hwy West Palm Beach FL 4 (Atlanta) 09/07/2018 ZG1P11 Complaint
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0543 Manage Volume Status Standard
102777 Pure Life Renal Of West Palm Beach Llc 1522 N Dixie Hwy West Palm Beach FL 4 (Atlanta) 11/21/2019 YOBC11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
E0009 Local, State, Tribal Collaboration Process Standard
E0022 Policies/Procedures For Sheltering In Place Standard
E0025 Arrangement With Other Facilities Standard
E0032 Primary/Alternate Means For Communication Standard
E0033 Methods For Sharing Information Standard
V0000 Initial Comments - Not A Deficiency Citation Memo
V0113 Ic - Wear Gloves/Hand Hygiene Standard
V0196 Carbon Adsorption - Monitoring, Testing Frequency Standard
V0403 Pe - Equipment Maintenance - Manufacturer'S Dfu Standard
V0456 Participate In Care, Discontinue/Refuse Treatment Standard
V0501 Patient Assessment - Interdisciplinary Team Mbrs/Resp. Standard
V0502 Assess Current Health Status Inc Comorbids Standard
V0516 Frequency - Initial: 30 Days/13 Tx Standard
V0517 F/U Reassessment - Within 3 Months Of Initial Standard
V0520 Frequency Reassessment - Unstable - Monthly Standard
V0541 Patient Plan Of Care - Goals - Community-Based Standards Standard
V0543 Manage Volume Status Standard
V0544 Achieve Adequate Clearance Standard
V0547 Manage Anemia/H/H Measured Monthly Standard
V0552 Psychosocial Counseling/Referrals/Assessment Tool Standard
V0554 Transplantation Status Plan Or Why Not Standard
V0560 Patients Seen By Med Staff Member Monthly Standard
V0681 Staff Licensed As Req/Qualified/Demonstrate Competencies Standard
V0765 Internal Grievance Process Components & Implemented Standard
102777 Pure Life Renal Of West Palm Beach Llc 1522 N Dixie Hwy West Palm Beach FL 4 (Atlanta) 02/08/2023 XR0711 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
V0126 Ic - Hbv - Vaccinate Patients & Staff Standard
V0132 Ic - Training And Education Standard
V0142 Ic - Oversight: Monitor Activities & Implement Policies Standard
V0143 Ic - Aseptic Techniques For Iv Meds Standard
V0239 Bicarb Conc Distribution - Weekly Disinfect/Dwell Times/Conc Standard
V0254 Microbial Monitoring - Sample Before Disinfect Standard
V0402 Pe - Building - Constructed/Maintained To Ensure Safety Standard
V0502 Assess Current Health Status Inc Comorbids Standard
V0516 Frequency - Initial: 30 Days/13 Tx Standard
V0520 Frequency Reassessment - Unstable - Monthly Standard
V0543 Manage Volume Status Standard
V0544 Achieve Adequate Clearance Standard
V0557 Initial Poc Implemented - 30 Days/13 Tx Standard
V0638 Continuously Monitor/Take Action/Track/Sustain Improve Standard
V0715 Md Resp - Ensure All Adhere To P&P Standard
102778 Fmc Dialysis Services Winter Park 6848 Aloma Ave Winter Park FL 4 (Atlanta) 08/17/2021 P6SA11 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
102778 Fmc Dialysis Services Winter Park 6848 Aloma Ave Winter Park FL 4 (Atlanta) 08/27/2024 1B0711 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
V0196 Carbon Adsorption - Monitoring, Testing Frequency Standard
V0401 Pe - Safe, Functional, Comfortable Environment Standard
V0543 Manage Volume Status Standard
102782 Universal Kidney Center Of Boynton Beach 4895 Winward Passage Dr Ste 5 Boynton Beach FL 4 (Atlanta) 03/29/2019 7MJU11 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
V0114 Ic - Sinks Available Standard
V0121 Ic - Handling Infectious Waste Standard
V0122 Ic - Clean, Disinfect Surfaces & Equipment/Written Protocols Standard
V0126 Ic - Hbv - Vaccinate Patients & Staff Standard
V0128 Ic - Hbv - Isolation (Existing Facility) Standard
V0131 Ic - Hbv - Isolation - Staffing Standard
V0142 Ic - Oversight: Monitor Activities & Implement Policies Standard
V0143 Ic - Aseptic Techniques For Iv Meds Standard
V0184 Environment: Secure And Restricted Standard
V0196 Carbon Adsorption - Monitoring, Testing Frequency Standard
V0250 Dialysate Proportioning - Monitor Ph/Conductivity Standard
V0403 Pe - Equipment Maintenance - Manufacturer'S Dfu Standard
V0510 Msw - Psychosocial Needs Standard
V0516 Frequency - Initial: 30 Days/13 Tx Standard
V0517 F/U Reassessment - Within 3 Months Of Initial Standard
V0520 Frequency Reassessment - Unstable - Monthly Standard
V0544 Achieve Adequate Clearance Standard
V0547 Manage Anemia/H/H Measured Monthly Standard
V0557 Initial Poc Implemented - 30 Days/13 Tx Standard
V0558 Implement Updates Of Poc - 15 Days P Pt Assessment Standard
V0639 Prioritizing Improvement Activities Standard
V0715 Md Resp - Ensure All Adhere To P&P Standard
V0726 Medical Records - Complete, Accurate, Accessible Standard
V0758 Rn, Msw, & Rd Available To Meet Patient Needs Standard
102782 Universal Kidney Center Of Boynton Beach 4895 Winward Passage Dr Ste 5 Boynton Beach FL 4 (Atlanta) 08/25/2021 LOQG11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
E0006 Plan Based On All Hazards Risk Assessment Standard
E0028 Dialysis Emergency Equipment Standard
V0000 Initial Comments - Not A Deficiency Citation Memo
V0113 Ic - Wear Gloves/Hand Hygiene Standard
V0143 Ic - Aseptic Techniques For Iv Meds Standard
V0147 Ic - Staff Education Re Catheters/Catheter Care Standard
V0175 Cfc - Water And Dialysate Quality Condition
V0178 Bacteriology Of Water-Maximum And Action Levels Standard
V0184 Environment: Secure And Restricted Standard
V0196 Carbon Adsorption - Monitoring, Testing Frequency Standard
V0232 Bicarb Mixing Sys - Empty/Disinfect/Prevent Corrosion Standard
V0243 Bicarb Jugs Rinsed Daily/Stored Dry Standard
V0244 Bicarb Jug Maintenance/Disinfection Standard
V0254 Microbial Monitoring - Sample Before Disinfect Standard
V0260 Personnel - Training Program/Periodic Audits Standard
V0402 Pe - Building - Constructed/Maintained To Ensure Safety Standard
V0502 Assess Current Health Status Inc Comorbids Standard
V0506 Immunization/Medication History Standard
V0509 Rd - Nutritional Status Standard
V0517 F/U Reassessment - Within 3 Months Of Initial Standard
V0519 Frequency Reassessment - Stable - Annual Standard
V0520 Frequency Reassessment - Unstable - Monthly Standard
V0543 Manage Volume Status Standard
V0544 Achieve Adequate Clearance Standard
V0546 Manage Mineral Metabolism Standard
V0547 Manage Anemia/H/H Measured Monthly Standard
V0550 Vascular Access - Monitor/Referrals Standard
V0638 Continuously Monitor/Take Action/Track/Sustain Improve Standard
V0639 Prioritizing Improvement Activities Standard
V0681 Staff Licensed As Req/Qualified/Demonstrate Competencies Standard
V0715 Md Resp - Ensure All Adhere To P&P Standard
V0726 Medical Records - Complete, Accurate, Accessible Standard