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
142318 Kankakee River Dialysis 455 W Court Street Ste 100 Kankakee IL 5 (Chicago) 03/15/2019 57MH11 Complaint
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0540 Cfc: Patient Plan Of Care Condition
V0550 Vascular Access - Monitor/Referrals Standard
V0559 Outcome Not Achieved - Adjust Poc Standard
142329 Loyola Center For Dialysis Roosevelt 1201 W Roosevelt Rd Maywood IL 5 (Chicago) 09/04/2019 SLQU11 Complaint
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0716 Md Resp - Ensure Involuntary Discharge P&P Followed Standard
142329 Loyola Center For Dialysis Roosevelt 1201 W Roosevelt Rd Maywood IL 5 (Chicago) 10/21/2020 6MIH11 Complaint
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0111 Ic - Sanitary Environment Standard
142329 Loyola Center For Dialysis Roosevelt 1201 W Roosevelt Rd Maywood IL 5 (Chicago) 10/21/2020 V4W411 Special
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0111 Ic - Sanitary Environment Standard
V0132 Ic - Training And Education Standard
V0772 Responds To Nw Requests/Works Toward Goals Standard
142329 Loyola Center For Dialysis Roosevelt 1201 W Roosevelt Rd Maywood IL 5 (Chicago) 10/22/2020 ENVK11 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
V0126 Ic - Hbv - Vaccinate Patients & Staff Standard
V0132 Ic - Training And Education Standard
V0147 Ic - Staff Education Re Catheters/Catheter Care Standard
V0175 Cfc - Water And Dialysate Quality Condition
V0196 Carbon Adsorption - Monitoring, Testing Frequency Standard
V0407 Pe - Hemodialysis Patients In View During Treatments Standard
V0587 Fac Receive/Review Self Monitoring Data Every 2 Months Standard
V0589 Monitor Home Adaptation,Home Visits - Poc Standard
142329 Loyola Center For Dialysis Roosevelt 1201 W Roosevelt Rd Maywood IL 5 (Chicago) 01/11/2024 FIWC11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
E0000 Initial Comments - Not A Deficiency Citation Memo
E0009 Local, State, Tribal Collaboration Process Standard
V0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0111 Ic - Sanitary Environment Standard
V0114 Ic - Sinks Available Standard
V0114 Ic - Sinks Available Standard
V0117 Ic - Clean/Dirty Areas, Med Prep Area, No Common Med Carts 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
V0178 Bacteriology Of Water-Maximum And Action Levels Standard
V0196 Carbon Adsorption - Monitoring, Testing Frequency Standard
V0250 Dialysate Proportioning - Monitor Ph/Conductivity Standard
V0250 Dialysate Proportioning - Monitor Ph/Conductivity Standard
V0254 Microbial Monitoring - Sample Before Disinfect 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
V0417 Pe-Fire Safety-Life Safety Code Standard
V0628 Measure, Analyze And Track Quality Indicators Standard
142337 Carle Health Home Dialysis Clinic 5401 N Knoxville Ave, Ste 300 Peoria IL 5 (Chicago) 04/10/2019 X06F11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0516 Frequency - Initial: 30 Days/13 Tx Standard
V0517 F/U Reassessment - Within 3 Months Of Initial Standard
V0729 Mr - Complete Records Promptly Standard
142337 Carle Health Home Dialysis Clinic 5401 N Knoxville Ave, Ste 300 Peoria IL 5 (Chicago) 06/09/2020 CPX011 Special
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0111 Ic - Sanitary Environment Standard
V0132 Ic - Training And Education Standard
142337 Carle Health Home Dialysis Clinic 5401 N Knoxville Ave, Ste 300 Peoria IL 5 (Chicago) 10/05/2022 0TWH11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0591 Home Patient Plan Of Care Dev/Updated Standard
V0725 Cfc - Medical Records Condition
V0726 Medical Records - Complete, Accurate, Accessible Standard
V0730 Mr - Centralize All Info, Each Member Of Idt Has Access Standard
142338 Carle Health Outpatient Dialysis Center 5401 N Knoxville Ave Ste 104 Peoria IL 5 (Chicago) 05/26/2020 QYGI11 Special, Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0503 Appropriateness Of Dialysis Rx Standard
V0504 Assess B/P & Fluid Management Needs Standard