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
142643 Marengo City Dialysis 910 Greenlee Street Suite B Marengo IL 5 (Chicago) 03/27/2019 VVEY11 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
V0503 Appropriateness Of Dialysis Rx Standard
V0504 Assess B/P & Fluid Management Needs Standard
V0556 Poc Completed/Signed By Idt & Patient Standard
V0557 Initial Poc Implemented - 30 Days/13 Tx Standard
142643 Marengo City Dialysis 910 Greenlee Street Suite B Marengo IL 5 (Chicago) 07/20/2022 FUHD11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0543 Manage Volume Status Standard
142644 Maple Avenue Kidney Center 610 S Maple Avenue Oak Park IL 5 (Chicago) 03/12/2021 46L011 Special
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0142 Ic - Oversight: Monitor Activities & Implement Policies Standard
142644 Maple Avenue Kidney Center 610 S Maple Avenue Oak Park IL 5 (Chicago) 03/12/2021 FT5V11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0118 Ic - Single Use Vials Standard
V0122 Ic - Clean, Disinfect Surfaces & Equipment/Written Protocols Standard
V0143 Ic - Aseptic Techniques For Iv Meds Standard
V0147 Ic - Staff Education Re Catheters/Catheter Care Standard
V0503 Appropriateness Of Dialysis Rx Standard
V0543 Manage Volume Status Standard
142644 Maple Avenue Kidney Center 610 S Maple Avenue Oak Park IL 5 (Chicago) 05/16/2024 8C9211 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
V0111 Ic - Sanitary Environment Standard
V0113 Ic - Wear Gloves/Hand Hygiene Standard
V0115 Ic - Wear Gowns, Shields/Masks; Staff Not Eat/Drink In Tx Area Standard
V0119 Ic - Supply Cart Distant/No Supplies In Pockets Standard
V0122 Ic - Clean, Disinfect Surfaces & Equipment/Written Protocols Standard
V0124 Ic - Hbv - Test All Pts, Review Results/Pt Status Known Preadmit Standard
V0132 Ic - Training And Education Standard
V0147 Ic - Staff Education Re Catheters/Catheter Care Standard
V0175 Cfc - Water And Dialysate Quality Condition
V0250 Dialysate Proportioning - Monitor Ph/Conductivity Standard
V0407 Pe - Hemodialysis Patients In View During Treatments Standard
V0543 Manage Volume Status Standard
V0560 Patients Seen By Med Staff Member Monthly Standard
V0625 Cfc - Quality Assessment & Performance Improvement Condition
V0628 Measure, Analyze And Track Quality Indicators Standard
V0634 Qapi Indicator - Medical Injuries/Errors Standard
V0636 Qapi Indicator - Pt Satisfaction & Grievances Standard
V0715 Md Resp - Ensure All Adhere To P&P Standard
142644 Maple Avenue Kidney Center 610 S Maple Avenue Oak Park IL 5 (Chicago) 09/18/2025 J87811 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
V0114 Ic - Sinks Available Standard
V0122 Ic - Clean, Disinfect Surfaces & Equipment/Written Protocols Standard
V0147 Ic - Staff Education Re Catheters/Catheter Care Standard
V0403 Pe - Equipment Maintenance - Manufacturer'S Dfu Standard
V0407 Pe - Hemodialysis Patients In View During Treatments Standard
V0625 Cfc - Quality Assessment & Performance Improvement Condition
V0628 Measure, Analyze And Track Quality Indicators Standard
V0715 Md Resp - Ensure All Adhere To P&P Standard
142645 Fresenius Medical Care River Rock -Dixon 101 W 2nd St Ste 200 Dixon IL 5 (Chicago) 12/07/2022 F55F11 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
V0504 Assess B/P & Fluid Management Needs Standard
V0715 Md Resp - Ensure All Adhere To P&P Standard
142647 Rockford Dialysis 3339 North Rockton Ave Rockford IL 5 (Chicago) 01/17/2019 KNNO11 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
V0503 Appropriateness Of Dialysis Rx Standard
V0504 Assess B/P & Fluid Management Needs Standard
142647 Rockford Dialysis 3339 North Rockton Ave Rockford IL 5 (Chicago) 02/10/2022 RGFN11 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
142648 Whiteside Dialysis 4406 East Lincolnway Sterling IL 5 (Chicago) 03/22/2019 R1YF11 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
V0126 Ic - Hbv - Vaccinate Patients & Staff Standard
V0131 Ic - Hbv - Isolation - Staffing Standard
V0503 Appropriateness Of Dialysis Rx Standard