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
142541 Mount Vernon Dialysis 4102 N Water Tower Place Mount Vernon IL 5 (Chicago) 06/15/2022 TV7C11 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
142542 Fresenius Medical Care South Holland 17225 S Paxton Ave South Holland IL 5 (Chicago) 04/12/2018 GTT211 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
E0003 Establishment Of The Ep Program Dialysis Condition
E0006 Plan Based On All Hazards Risk Assessment Standard
E0009 Local, State, Tribal Collaboration Process Standard
E0028 Dialysis Emergency Equipment Standard
E0039 Ep Testing Requirements Standard
V0000 Initial Comments - Not A Deficiency Citation Memo
V0110 Cfc - Infection Control Condition
V0120 Ic - Transducer Protectors: Not Wetted/Changed Standard
V0122 Ic - Clean, Disinfect Surfaces & Equipment/Written Protocols Standard
V0132 Ic - Training And Education Standard
V0147 Ic - Staff Education Re Catheters/Catheter Care Standard
V0407 Pe - Hemodialysis Patients In View During Treatments Standard
V0543 Manage Volume Status Standard
V0767 Involuntary Discharge Process Requirements Standard
142542 Fresenius Medical Care South Holland 17225 S Paxton Ave South Holland IL 5 (Chicago) 07/01/2021 8VGY11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0127 Ic - Hbv - Test Pts/Staff Post Last Dose Standard
V0228 Mixing Systems - Labeling Standard
V0250 Dialysate Proportioning - Monitor Ph/Conductivity Standard
V0503 Appropriateness Of Dialysis Rx Standard
V0715 Md Resp - Ensure All Adhere To P&P Standard
142544 South Holland Renal Center 16110 Lasalle Street South Holland IL 5 (Chicago) 03/13/2018 D0DE11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0503 Appropriateness Of Dialysis Rx Standard
V0543 Manage Volume Status Standard
142544 South Holland Renal Center 16110 Lasalle Street South Holland IL 5 (Chicago) 04/02/2021 RBJV11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0110 Cfc - Infection Control Condition
V0122 Ic - Clean, Disinfect Surfaces & Equipment/Written Protocols Standard
V0127 Ic - Hbv - Test Pts/Staff Post Last Dose 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
V0196 Carbon Adsorption - Monitoring, Testing Frequency Standard
V0250 Dialysate Proportioning - Monitor Ph/Conductivity Standard
142544 South Holland Renal Center 16110 Lasalle Street South Holland IL 5 (Chicago) 08/15/2025 E6UZ11 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
V0503 Appropriateness Of Dialysis Rx Standard
V0520 Frequency Reassessment - Unstable - Monthly Standard
142546 Rai - Centre West - Springfield 1112 Centre West Dr Springfield IL 5 (Chicago) 06/21/2018 9UTX11 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
V0116 Ic - Items Taken To Station Disposed/Dedicated Or Disinfected Standard
V0122 Ic - Clean, Disinfect Surfaces & Equipment/Written Protocols Standard
V0132 Ic - Training And Education Standard
V0544 Achieve Adequate Clearance Standard
V0681 Staff Licensed As Req/Qualified/Demonstrate Competencies Standard
V0725 Cfc - Medical Records Condition
V0726 Medical Records - Complete, Accurate, Accessible Standard
142546 Rai - Centre West - Springfield 1112 Centre West Dr Springfield IL 5 (Chicago) 02/28/2019 GSG411 Complaint
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0175 Cfc - Water And Dialysate Quality Condition
V0197 Carbon Adsorption - Action If First Test Positive Standard
V0504 Assess B/P & Fluid Management Needs Standard
V0638 Continuously Monitor/Take Action/Track/Sustain Improve Standard
142546 Rai - Centre West - Springfield 1112 Centre West Dr Springfield IL 5 (Chicago) 10/07/2021 WBW411 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0111 Ic - Sanitary Environment Standard
V0113 Ic - Wear Gloves/Hand Hygiene Standard
V0116 Ic - Items Taken To Station Disposed/Dedicated Or Disinfected Standard
V0401 Pe - Safe, Functional, Comfortable Environment Standard
V0503 Appropriateness Of Dialysis Rx Standard
V0511 Dialysis Access Type & Maintenance Standard
142546 Rai - Centre West - Springfield 1112 Centre West Dr Springfield IL 5 (Chicago) 04/03/2025 PHJV11 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
V0143 Ic - Aseptic Techniques For Iv Meds Standard
V0402 Pe - Building - Constructed/Maintained To Ensure Safety Standard