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
142666 Lake Villa Dialysis 37809 N Route 59 Lake Villa IL 5 (Chicago) 12/27/2018 2ZI011 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
E0039 Ep Testing Requirements Standard
V0000 Initial Comments - Not A Deficiency Citation Memo
V0114 Ic - Sinks Available Standard
V0200 Ro - Monitor/Alarm/Prevent Use Of Unsafe Water Standard
V0503 Appropriateness Of Dialysis Rx Standard
142667 Renal Care Group - Merrionette Park 11630 South Kedzie Ave Merrionette Park IL 5 (Chicago) 08/24/2018 K3XL11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0147 Ic - Staff Education Re Catheters/Catheter Care Standard
V0543 Manage Volume Status Standard
V0692 Pct - State Requirements & Hs Diploma Standard
V0715 Md Resp - Ensure All Adhere To P&P Standard
142667 Renal Care Group - Merrionette Park 11630 South Kedzie Ave Merrionette Park IL 5 (Chicago) 11/04/2021 DAIL11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0637 Qapi Indicator - Infection Control - Trend/Plan/Act Standard
142668 Little Village Dialysis 2335 W Cermak Road Chicago IL 5 (Chicago) 01/11/2019 BKWI11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0715 Md Resp - Ensure All Adhere To P&P Standard
142668 Little Village Dialysis 2335 W Cermak Road Chicago IL 5 (Chicago) 02/17/2022 CP1E11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0175 Cfc - Water And Dialysate Quality Condition
V0218 Hot Water Disinfection Systems - Monitoring Standard
V0250 Dialysate Proportioning - Monitor Ph/Conductivity Standard
V0587 Fac Receive/Review Self Monitoring Data Every 2 Months Standard
V0628 Measure, Analyze And Track Quality Indicators Standard
142669 Fresenius Kidney Care Lake Bluff 101 Waukegan Rd Suite 700 Lake Bluff IL 5 (Chicago) 03/21/2018 8U9T11 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
V0132 Ic - Training And Education Standard
V0143 Ic - Aseptic Techniques For Iv Meds Standard
V0147 Ic - Staff Education Re Catheters/Catheter Care Standard
V0681 Staff Licensed As Req/Qualified/Demonstrate Competencies Standard
V0715 Md Resp - Ensure All Adhere To P&P Standard
142669 Fresenius Kidney Care Lake Bluff 101 Waukegan Rd Suite 700 Lake Bluff IL 5 (Chicago) 07/01/2021 LVVM11 Special
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0142 Ic - Oversight: Monitor Activities & Implement Policies Standard
142669 Fresenius Kidney Care Lake Bluff 101 Waukegan Rd Suite 700 Lake Bluff IL 5 (Chicago) 07/01/2021 QXF411 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
V0132 Ic - Training And Education Standard
V0407 Pe - Hemodialysis Patients In View During Treatments Standard
V0543 Manage Volume Status Standard
V0545 Effective Nutritional Status Standard
V0587 Fac Receive/Review Self Monitoring Data Every 2 Months Standard
142670 Ross Dialysis - Englewood, Llc 946 W 63rd St Chicago IL 5 (Chicago) 06/15/2018 2WKQ11 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
V0543 Manage Volume Status Standard
V0765 Internal Grievance Process Components & Implemented Standard
142670 Ross Dialysis - Englewood, Llc 946 W 63rd St Chicago IL 5 (Chicago) 10/21/2021 BBLW11 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
V0127 Ic - Hbv - Test Pts/Staff Post Last Dose Standard
V0132 Ic - Training And Education Standard
V0543 Manage Volume Status Standard