S&C QCOR ESRD 2567s
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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
▼ 112636 Williams Street Dialysis 2812 Williams Street Savannah GA 4 (Atlanta) 12/13/2018 IR2Z11 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
V0400 Cfc - Physical Environment Condition
V0402 Pe - Building - Constructed/Maintained To Ensure Safety Standard
V0403 Pe - Equipment Maintenance - Manufacturer'S Dfu Standard
▼ 112637 Dialysis Clinic, Inc- Fayetteville 155 Brandywine Blvd. Fayetteville GA 4 (Atlanta) 05/15/2019 VD5D11 Complaint
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0400 Cfc - Physical Environment Condition
V0403 Pe - Equipment Maintenance - Manufacturer'S Dfu Standard
▼ 112637 Dialysis Clinic, Inc- Fayetteville 155 Brandywine Blvd. Fayetteville GA 4 (Atlanta) 12/09/2020 IBGZ11 Complaint
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0547 Manage Anemia/H/H Measured Monthly Standard
V0757 Staff # & Ratio Meet Patient Needs Standard
▼ 112637 Dialysis Clinic, Inc- Fayetteville 155 Brandywine Blvd. Fayetteville GA 4 (Atlanta) 05/14/2021 E3GB11 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
V0402 Pe - Building - Constructed/Maintained To Ensure Safety Standard
V0587 Fac Receive/Review Self Monitoring Data Every 2 Months Standard
▼ 112637 Dialysis Clinic, Inc- Fayetteville 155 Brandywine Blvd. Fayetteville GA 4 (Atlanta) 07/27/2022 X8C111 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
V0557 Initial Poc Implemented - 30 Days/13 Tx Standard
V0632 Qapi Indicator - Anemia Management Standard
V0715 Md Resp - Ensure All Adhere To P&P Standard
▼ 112637 Dialysis Clinic, Inc- Fayetteville 155 Brandywine Blvd. Fayetteville GA 4 (Atlanta) 06/07/2024 56OM11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
E0028 Dialysis Emergency Equipment Standard
E0040 Esrd Patient Orientation Training Standard
V0000 Initial Comments - Not A Deficiency Citation Memo
V0113 Ic - Wear Gloves/Hand Hygiene Standard
V0114 Ic - Sinks Available Standard
V0115 Ic - Wear Gowns, Shields/Masks; Staff Not Eat/Drink In Tx Area Standard
V0147 Ic - Staff Education Re Catheters/Catheter Care Standard
V0175 Cfc - Water And Dialysate Quality Condition
V0250 Dialysate Proportioning - Monitor Ph/Conductivity Standard
V0402 Pe - Building - Constructed/Maintained To Ensure Safety Standard
V0407 Pe - Hemodialysis Patients In View During Treatments Standard
V0750 Cfc - Governance Condition
▼ 112638 Baxley Dialysis 539 Fair Street Baxley GA 4 (Atlanta) 06/10/2021 Y8Y111 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
▼ 112639 Derenne Dialysis 5303 Montgomery Street Savannah GA 4 (Atlanta) 08/11/2023 ZRPN11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0143 Ic - Aseptic Techniques For Iv Meds Standard
V0401 Pe - Safe, Functional, Comfortable Environment Standard
V0403 Pe - Equipment Maintenance - Manufacturer'S Dfu Standard
V0550 Vascular Access - Monitor/Referrals Standard
V0556 Poc Completed/Signed By Idt & Patient Standard
▼ 112640 Greensboro Dialysis Center 1041 Willow Run Road Greensboro GA 4 (Atlanta) 04/04/2019 O3N211 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
V0121 Ic - Handling Infectious Waste Standard
V0122 Ic - Clean, Disinfect Surfaces & Equipment/Written Protocols Standard
V0126 Ic - Hbv - Vaccinate Patients & Staff Standard
V0402 Pe - Building - Constructed/Maintained To Ensure Safety Standard
V0715 Md Resp - Ensure All Adhere To P&P Standard
V0772 Responds To Nw Requests/Works Toward Goals Standard
▼ 112640 Greensboro Dialysis Center 1041 Willow Run Road Greensboro GA 4 (Atlanta) 08/04/2020 PCOI11 Special
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0113 Ic - Wear Gloves/Hand Hygiene Standard