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
122527 Liberty Dialysis-Hawaii - Hawaii Kai Dialysis 7192 Kalanianaole Hwy, Suite Q-101 Hon HI 9 (San Francisco) 01/07/2020 DCJ111 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
V0115 Ic - Wear Gowns, Shields/Masks; Staff Not Eat/Drink In Tx Area Standard
V0143 Ic - Aseptic Techniques For Iv Meds Standard
V0403 Pe - Equipment Maintenance - Manufacturer'S Dfu Standard
V0407 Pe - Hemodialysis Patients In View During Treatments Standard
V0634 Qapi Indicator - Medical Injuries/Errors Standard
122527 Liberty Dialysis-Hawaii - Hawaii Kai Dialysis 7192 Kalanianaole Hwy, Suite Q-101 Hon HI 9 (San Francisco) 03/14/2025 3KRX11 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
V0147 Ic - Staff Education Re Catheters/Catheter Care Standard
V0196 Carbon Adsorption - Monitoring, Testing Frequency Standard
V0219 Bacterial Control - Disinfect Monthly/Disinfection Dwell Standard
V0401 Pe - Safe, Functional, Comfortable Environment 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
V0550 Vascular Access - Monitor/Referrals Standard
V0715 Md Resp - Ensure All Adhere To P&P Standard
V0726 Medical Records - Complete, Accurate, Accessible Standard
122528 Rainbow Dialysis-Lahaina 305 Keawe Street, Ste 503 Lahaina HI 9 (San Francisco) 12/10/2019 N9CQ11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0228 Mixing Systems - Labeling Standard
122528 Rainbow Dialysis-Lahaina 305 Keawe Street, Ste 503 Lahaina HI 9 (San Francisco) 05/25/2022 PYZ311 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
V0196 Carbon Adsorption - Monitoring, Testing Frequency Standard
V0401 Pe - Safe, Functional, Comfortable Environment Standard
V0503 Appropriateness Of Dialysis Rx Standard
V0516 Frequency - Initial: 30 Days/13 Tx Standard
V0638 Continuously Monitor/Take Action/Track/Sustain Improve Standard
122529 Us Renal Care West Oahu Dialysis 889 Kamokila Blvd Kapolei HI 9 (San Francisco) 08/15/2024 4RJF11 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
V0116 Ic - Items Taken To Station Disposed/Dedicated Or Disinfected Standard
V0117 Ic - Clean/Dirty Areas, Med Prep Area, No Common Med Carts Standard
V0122 Ic - Clean, Disinfect Surfaces & Equipment/Written Protocols Standard
V0196 Carbon Adsorption - Monitoring, Testing Frequency Standard
V0250 Dialysate Proportioning - Monitor Ph/Conductivity Standard
V0407 Pe - Hemodialysis Patients In View During Treatments Standard
V0470 Rights Posted With State/Nw Contact #S And Addresses Standard
V0504 Assess B/P & Fluid Management Needs Standard
V0542 Idt Develops Plan Of Care Standard
V0729 Mr - Complete Records Promptly Standard
122530 Liberty Dialysis Hawaii, Llc-Hawaii Salt Lake 4380 Lawehana Street, Suite 100 Honolulu HI 9 (San Francisco) 01/17/2020 S6K111 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
V0403 Pe - Equipment Maintenance - Manufacturer'S Dfu Standard
V0470 Rights Posted With State/Nw Contact #S And Addresses Standard
V0634 Qapi Indicator - Medical Injuries/Errors Standard
122530 Liberty Dialysis Hawaii, Llc-Hawaii Salt Lake 4380 Lawehana Street, Suite 100 Honolulu HI 9 (San Francisco) 08/22/2025 NIZ811 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0119 Ic - Supply Cart Distant/No Supplies In Pockets Standard
V0401 Pe - Safe, Functional, Comfortable Environment Standard
V0403 Pe - Equipment Maintenance - Manufacturer'S Dfu Standard
V0470 Rights Posted With State/Nw Contact #S And Addresses Standard
V0715 Md Resp - Ensure All Adhere To P&P Standard
122531 U S Renal Care Beretania Dialysis 1908 South Beretania Street, Suite 1 Honolulu HI 9 (San Francisco) 01/10/2020 MGT811 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
V0250 Dialysate Proportioning - Monitor Ph/Conductivity Standard
V0403 Pe - Equipment Maintenance - Manufacturer'S Dfu Standard
V0405 Pe - Comfortable Temperature Standard
V0407 Pe - Hemodialysis Patients In View During Treatments Standard
122531 U S Renal Care Beretania Dialysis 1908 South Beretania Street, Suite 1 Honolulu HI 9 (San Francisco) 10/04/2024 LCKO11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0130 Ic - Hbv - Isolation Of Machines/Equipment/Supplies Standard
V0196 Carbon Adsorption - Monitoring, Testing Frequency Standard
V0402 Pe - Building - Constructed/Maintained To Ensure Safety Standard
V0543 Manage Volume Status Standard
V0726 Medical Records - Complete, Accurate, Accessible Standard
V0729 Mr - Complete Records Promptly Standard
122532 Liberty Dialysis-Hawaii Ala Moana 500 Ala Moana Blvd, Suite 7302 Honolulu HI 9 (San Francisco) 03/05/2018 J2ZC11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0196 Carbon Adsorption - Monitoring, Testing Frequency Standard