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
142649 Montclare Dialysis 7009 W Belmont Chicago IL 5 (Chicago) 10/10/2019 WPXG11 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
V0132 Ic - Training And Education Standard
V0147 Ic - Staff Education Re Catheters/Catheter Care Standard
V0543 Manage Volume Status Standard
V0544 Achieve Adequate Clearance Standard
V0715 Md Resp - Ensure All Adhere To P&P Standard
142649 Montclare Dialysis 7009 W Belmont Chicago IL 5 (Chicago) 01/05/2023 LVW311 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
E0028 Dialysis Emergency Equipment Standard
V0000 Initial Comments - Not A Deficiency Citation Memo
V0132 Ic - Training And Education Standard
V0147 Ic - Staff Education Re Catheters/Catheter Care Standard
V0250 Dialysate Proportioning - Monitor Ph/Conductivity Standard
V0503 Appropriateness Of Dialysis Rx Standard
V0628 Measure, Analyze And Track Quality Indicators Standard
V0680 Cfc - Personnel Qualifications Condition
V0684 Nurse Manager - 12 Mo Rn + 6 Mo Dialysis Standard
V0715 Md Resp - Ensure All Adhere To P&P Standard
142651 Dixon Kidney Center 1131 N Galena Ave Dixon IL 5 (Chicago) 03/04/2021 E1E111 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
V0628 Measure, Analyze And Track Quality Indicators Standard
142653 Austin Community Kidney Center 4800 West Chicago Avenue, Ste 2a Chicago IL 5 (Chicago) 01/24/2020 MNOW11 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
V0544 Achieve Adequate Clearance Standard
142653 Austin Community Kidney Center 4800 West Chicago Avenue, Ste 2a Chicago IL 5 (Chicago) 08/25/2023 NQ9Y11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
E0028 Dialysis Emergency Equipment Standard
E0040 Esrd Patient Orientation Training Standard
V0000 Initial Comments - Not A Deficiency Citation Memo
V0113 Ic - Wear Gloves/Hand Hygiene Standard
V0456 Participate In Care, Discontinue/Refuse Treatment Standard
V0470 Rights Posted With State/Nw Contact #S And Addresses Standard
V0506 Immunization/Medication History Standard
V0543 Manage Volume Status Standard
V0715 Md Resp - Ensure All Adhere To P&P Standard
142654 Schaumburg Renal Center 1156 S Roselle Rd Schaumburg IL 5 (Chicago) 03/14/2024 LVN211 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
V0142 Ic - Oversight: Monitor Activities & Implement Policies Standard
V0147 Ic - Staff Education Re Catheters/Catheter Care Standard
V0511 Dialysis Access Type & Maintenance Standard
V0587 Fac Receive/Review Self Monitoring Data Every 2 Months Standard
142655 Concerto Dialysis Llc 4600 Touhy Avenue Lincolnwood IL 5 (Chicago) 01/26/2018 QUQR11 Complaint
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0581 Idt Resp - Services Equivalent To In-Center Patients Standard
142655 Concerto Dialysis Llc 4600 Touhy Avenue Lincolnwood IL 5 (Chicago) 06/28/2018 T6BE11 Standard
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0113 Ic - Wear Gloves/Hand Hygiene Standard
V0114 Ic - Sinks Available Standard
V0117 Ic - Clean/Dirty Areas, Med Prep Area, No Common Med Carts Standard
V0119 Ic - Supply Cart Distant/No Supplies In Pockets Standard
V0122 Ic - Clean, Disinfect Surfaces & Equipment/Written Protocols Standard
V0128 Ic - Hbv - Isolation (Existing Facility) 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
V0200 Ro - Monitor/Alarm/Prevent Use Of Unsafe Water Standard
V0403 Pe - Equipment Maintenance - Manufacturer'S Dfu Standard
V0407 Pe - Hemodialysis Patients In View During Treatments Standard
V0544 Achieve Adequate Clearance Standard
V0637 Qapi Indicator - Infection Control - Trend/Plan/Act Standard
142655 Concerto Dialysis Llc 4600 Touhy Avenue Lincolnwood IL 5 (Chicago) 08/06/2018 T6BE12 Standard
Deficiency Tag Deficiency Description Tag Type
E0003 Establishment Of The Ep Program Dialysis Condition
E0004 Develop Ep Plan, Review And Update Annually Standard
E0038 Esrd Ep Training Program Standard
E0039 Ep Testing Requirements Standard
142655 Concerto Dialysis Llc 4600 Touhy Avenue Lincolnwood IL 5 (Chicago) 07/26/2019 0I3411 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
V0115 Ic - Wear Gowns, Shields/Masks; Staff Not Eat/Drink In Tx Area Standard
V0142 Ic - Oversight: Monitor Activities & Implement Policies Standard
V0175 Cfc - Water And Dialysate Quality Condition
V0199 Ro - Meets Aami/Monitored, Recorded On Log Standard
V0213 Dist Sys - Culture/Lal/Sample Sites/Frequency(New)/Log Standard
V0250 Dialysate Proportioning - Monitor Ph/Conductivity Standard
V0402 Pe - Building - Constructed/Maintained To Ensure Safety Standard
V0503 Appropriateness Of Dialysis Rx Standard
V0544 Achieve Adequate Clearance Standard
V0581 Idt Resp - Services Equivalent To In-Center Patients Standard
V0715 Md Resp - Ensure All Adhere To P&P Standard