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
112314 Colquitt Regional Medical Center Dialysis 449 31st Avenue Se Moultrie GA 4 (Atlanta) 08/05/2021 NDDA11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0114 Ic - Sinks Available Standard
V0117 Ic - Clean/Dirty Areas, Med Prep Area, No Common Med Carts Standard
V0629 Qapi Indicator - Adequacy Of Dialysis Standard
V0632 Qapi Indicator - Anemia Management Standard
112314 Colquitt Regional Medical Center Dialysis 449 31st Avenue Se Moultrie GA 4 (Atlanta) 08/24/2022 TN9B11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
E0039 Ep Testing Requirements Standard
V0000 Initial Comments - Not A Deficiency Citation Memo
V0113 Ic - Wear Gloves/Hand Hygiene Standard
V0115 Ic - Wear Gowns, Shields/Masks; Staff Not Eat/Drink In Tx Area Standard
V0631 Qapi Indicator - Mineral Metabolism/Bone Disease Standard
V0632 Qapi Indicator - Anemia Management Standard
112314 Colquitt Regional Medical Center Dialysis 449 31st Avenue Se Moultrie GA 4 (Atlanta) 09/07/2023 IBL811 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
V0407 Pe - Hemodialysis Patients In View During Treatments Standard
112314 Colquitt Regional Medical Center Dialysis 449 31st Avenue Se Moultrie GA 4 (Atlanta) 07/24/2025 PMGN11 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
V0115 Ic - Wear Gowns, Shields/Masks; Staff Not Eat/Drink In Tx Area Standard
V0122 Ic - Clean, Disinfect Surfaces & Equipment/Written Protocols Standard
V0124 Ic - Hbv - Test All Pts, Review Results/Pt Status Known Preadmit Standard
V0175 Cfc - Water And Dialysate Quality Condition
V0196 Carbon Adsorption - Monitoring, Testing Frequency Standard
V0750 Cfc - Governance Condition
112314 Colquitt Regional Medical Center Dialysis 449 31st Avenue Se Moultrie GA 4 (Atlanta) 09/02/2025 PMGN12 Standard
Deficiency Tag Deficiency Description Tag Type
V0126 Ic - Hbv - Vaccinate Patients & Staff Standard
112315 Tift Regional Dialysis Center 1010 Edgefield Drive Tifton GA 4 (Atlanta) 06/14/2018 D1U011 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0117 Ic - Clean/Dirty Areas, Med Prep Area, No Common Med Carts Standard
V0122 Ic - Clean, Disinfect Surfaces & Equipment/Written Protocols Standard
V0402 Pe - Building - Constructed/Maintained To Ensure Safety Standard
V0628 Measure, Analyze And Track Quality Indicators Standard
V0681 Staff Licensed As Req/Qualified/Demonstrate Competencies Standard
112315 Tift Regional Dialysis Center 1010 Edgefield Drive Tifton GA 4 (Atlanta) 03/03/2023 KPXN11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0115 Ic - Wear Gowns, Shields/Masks; Staff Not Eat/Drink In Tx Area Standard
V0117 Ic - Clean/Dirty Areas, Med Prep Area, No Common Med Carts Standard
V0402 Pe - Building - Constructed/Maintained To Ensure Safety Standard
V0630 Qapi Indicator - Nutritional Status Standard
112317 Crisp Regional Hospital Dialysis 1302 North 5th Street, Ext Cordele GA 4 (Atlanta) 11/28/2018 BLID11 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
V0260 Personnel - Training Program/Periodic Audits Standard
V0402 Pe - Building - Constructed/Maintained To Ensure Safety 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
V0552 Psychosocial Counseling/Referrals/Assessment Tool Standard
V0690 Dietitian - 1 Year Experience Standard
112317 Crisp Regional Hospital Dialysis 1302 North 5th Street, Ext Cordele GA 4 (Atlanta) 08/04/2021 BLID12 Standard
Deficiency Tag Deficiency Description Tag Type
E0028 Dialysis Emergency Equipment Standard
V0117 Ic - Clean/Dirty Areas, Med Prep Area, No Common Med Carts Standard
112317 Crisp Regional Hospital Dialysis 1302 North 5th Street, Ext Cordele GA 4 (Atlanta) 04/23/2025 F0TS11 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
V0407 Pe - Hemodialysis Patients In View During Treatments Standard