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
142607 Fresenius Medical Care Hazel Crest 17524 Carriage Way Hazel Crest IL 5 (Chicago) 07/23/2021 S6C311 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
V0715 Md Resp - Ensure All Adhere To P&P Standard
142608 Benton Dialysis 1151 Route 14w Benton IL 5 (Chicago) 03/10/2022 YU4H11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0544 Achieve Adequate Clearance Standard
142608 Benton Dialysis 1151 Route 14w Benton IL 5 (Chicago) 08/29/2025 21ZE11 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
V0117 Ic - Clean/Dirty Areas, Med Prep Area, No Common Med Carts Standard
V0143 Ic - Aseptic Techniques For Iv Meds Standard
142609 Centralia Dialysis 1231 Illinois State Route 161 Centralia IL 5 (Chicago) 11/06/2019 HRKV11 Complaint
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0634 Qapi Indicator - Medical Injuries/Errors Standard
142609 Centralia Dialysis 1231 Illinois State Route 161 Centralia IL 5 (Chicago) 11/06/2019 81JU11 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
V0403 Pe - Equipment Maintenance - Manufacturer'S Dfu Standard
V0587 Fac Receive/Review Self Monitoring Data Every 2 Months Standard
142610 Rcg Central Illinois Decatur Home Dialysis 302 West Hay St Suite 207 Decatur IL 5 (Chicago) 10/11/2018 EAKV11 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
142611 Midwest Kidney Center - Pontiac 804 W Madison Street Pontiac IL 5 (Chicago) 11/19/2020 K37U11 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
V0407 Pe - Hemodialysis Patients In View During Treatments Standard
V0543 Manage Volume Status Standard
142612 Fresenius Medical Care Elmhurst 133 East Brush Hill Road Elmhurst IL 5 (Chicago) 11/14/2018 JWDR11 Complaint
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0765 Internal Grievance Process Components & Implemented Standard
142612 Fresenius Medical Care Elmhurst 133 East Brush Hill Road Elmhurst IL 5 (Chicago) 11/15/2018 DEMI11 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
V0507 Assess Anemia Standard
V0543 Manage Volume Status Standard
V0544 Achieve Adequate Clearance Standard
142612 Fresenius Medical Care Elmhurst 133 East Brush Hill Road Elmhurst IL 5 (Chicago) 12/29/2021 ZV5O11 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