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
142581 Jacksonville Dialysis 1515 W Walnut Jacksonville IL 5 (Chicago) 01/16/2020 4XY811 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
E0006 Plan Based On All Hazards Risk Assessment Standard
E0007 Ep Program Patient Population Standard
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
V0403 Pe - Equipment Maintenance - Manufacturer'S Dfu Standard
V0543 Manage Volume Status Standard
V0628 Measure, Analyze And Track Quality Indicators Standard
V0680 Cfc - Personnel Qualifications Condition
V0681 Staff Licensed As Req/Qualified/Demonstrate Competencies Standard
V0692 Pct - State Requirements & Hs Diploma Standard
V0715 Md Resp - Ensure All Adhere To P&P Standard
V0726 Medical Records - Complete, Accurate, Accessible Standard
142581 Jacksonville Dialysis 1515 W Walnut Jacksonville IL 5 (Chicago) 04/20/2023 8OHB11 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
V0403 Pe - Equipment Maintenance - Manufacturer'S Dfu Standard
V0543 Manage Volume Status Standard
V0544 Achieve Adequate Clearance Standard
142582 Lincoln Dialysis 2100 W 5th St Lincoln IL 5 (Chicago) 10/31/2018 7VXU11 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
V0544 Achieve Adequate Clearance Standard
142582 Lincoln Dialysis 2100 W 5th St Lincoln IL 5 (Chicago) 12/22/2021 FJVU11 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
V0502 Assess Current Health Status Inc Comorbids Standard
V0543 Manage Volume Status Standard
V0544 Achieve Adequate Clearance Standard
V0637 Qapi Indicator - Infection Control - Trend/Plan/Act Standard
142582 Lincoln Dialysis 2100 W 5th St Lincoln IL 5 (Chicago) 05/01/2025 3RYY11 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
V0403 Pe - Equipment Maintenance - Manufacturer'S Dfu Standard
142584 Macon County Dialysis 1090 W Mckinley Decatur IL 5 (Chicago) 12/20/2019 BKZ811 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0504 Assess B/P & Fluid Management Needs Standard
V0544 Achieve Adequate Clearance Standard
142584 Macon County Dialysis 1090 W Mckinley Decatur IL 5 (Chicago) 09/15/2021 7HK311 Complaint, Special
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0543 Manage Volume Status Standard
V0715 Md Resp - Ensure All Adhere To P&P Standard
142584 Macon County Dialysis 1090 W Mckinley Decatur IL 5 (Chicago) 11/04/2021 05SV11 Complaint
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0400 Cfc - Physical Environment Condition
V0407 Pe - Hemodialysis Patients In View During Treatments Standard
142584 Macon County Dialysis 1090 W Mckinley Decatur IL 5 (Chicago) 04/06/2023 7W5F11 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
V0503 Appropriateness Of Dialysis Rx Standard
V0507 Assess Anemia Standard
V0543 Manage Volume Status Standard
V0544 Achieve Adequate Clearance Standard
142585 Mattoon Dialysis 6051 Development Drive Charleston IL 5 (Chicago) 03/22/2018 L7QL11 Standard
Deficiency Tag Deficiency Description Tag Type
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
V0143 Ic - Aseptic Techniques For Iv Meds Standard
V0403 Pe - Equipment Maintenance - Manufacturer'S Dfu Standard
V0503 Appropriateness Of Dialysis Rx Standard