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
142733 Springfield South Dialysis 2930 S 6th St Springfield IL 5 (Chicago) 11/01/2018 844A11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
E0004 Develop Ep Plan, Review And Update Annually Standard
E0009 Local, State, Tribal Collaboration Process Standard
V0000 Initial Comments - Not A Deficiency Citation Memo
V0116 Ic - Items Taken To Station Disposed/Dedicated Or Disinfected Standard
V0126 Ic - Hbv - Vaccinate Patients & Staff Standard
V0142 Ic - Oversight: Monitor Activities & Implement Policies Standard
V0401 Pe - Safe, Functional, Comfortable Environment Standard
V0407 Pe - Hemodialysis Patients In View During Treatments Standard
V0587 Fac Receive/Review Self Monitoring Data Every 2 Months Standard
142733 Springfield South Dialysis 2930 S 6th St Springfield IL 5 (Chicago) 10/28/2021 DQC211 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
V0126 Ic - Hbv - Vaccinate Patients & Staff Standard
V0132 Ic - Training And Education Standard
V0143 Ic - Aseptic Techniques For Iv Meds Standard
V0196 Carbon Adsorption - Monitoring, Testing Frequency Standard
V0403 Pe - Equipment Maintenance - Manufacturer'S Dfu Standard
V0543 Manage Volume Status Standard
V0544 Achieve Adequate Clearance Standard
V0681 Staff Licensed As Req/Qualified/Demonstrate Competencies Standard
V0696 Water Treatment System Techs Training Standard
142733 Springfield South Dialysis 2930 S 6th St Springfield IL 5 (Chicago) 07/03/2025 WC2111 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
V0122 Ic - Clean, Disinfect Surfaces & Equipment/Written Protocols Standard
V0403 Pe - Equipment Maintenance - Manufacturer'S Dfu Standard
V0715 Md Resp - Ensure All Adhere To P&P Standard
142734 Danville Home Training 3 Poland Rd Danville IL 5 (Chicago) 02/16/2022 UC8O11 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
V0122 Ic - Clean, Disinfect Surfaces & Equipment/Written Protocols Standard
V0401 Pe - Safe, Functional, Comfortable Environment Standard
V0464 Informed - Rules/Expectations Re Patient Conduct Standard
142735 Fresenius Medical Care River Forest 103 Forest Avenue River Forest IL 5 (Chicago) 12/20/2018 KF3Z11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
E0004 Develop Ep Plan, Review And Update Annually Standard
V0000 Initial Comments - Not A Deficiency Citation Memo
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
V0543 Manage Volume Status Standard
V0715 Md Resp - Ensure All Adhere To P&P Standard
142735 Fresenius Medical Care River Forest 103 Forest Avenue River Forest IL 5 (Chicago) 01/14/2022 MS2911 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
V0715 Md Resp - Ensure All Adhere To P&P Standard
142736 Barrington Creek Dialysis 28160 W Northwest Hwy Lk Barrington IL 5 (Chicago) 03/08/2019 Y5TN11 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
V0113 Ic - Wear Gloves/Hand Hygiene Standard
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
V0122 Ic - Clean, Disinfect Surfaces & Equipment/Written Protocols Standard
V0147 Ic - Staff Education Re Catheters/Catheter Care Standard
V0687 Rn/Lpn Charge Supervision Standard
V0688 Staff Nurse - Meet State Requirements Standard
142736 Barrington Creek Dialysis 28160 W Northwest Hwy Lk Barrington IL 5 (Chicago) 04/21/2022 4HZU11 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
V0122 Ic - Clean, Disinfect Surfaces & Equipment/Written Protocols Standard
V0503 Appropriateness Of Dialysis Rx Standard
V0504 Assess B/P & Fluid Management Needs Standard
142737 Mchenry Dialysis Center Llc 4209 West Shamrock Lane Mchenry IL 5 (Chicago) 03/14/2019 EBEU11 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
V0124 Ic - Hbv - Test All Pts, Review Results/Pt Status Known Preadmit Standard
V0132 Ic - Training And Education Standard
V0516 Frequency - Initial: 30 Days/13 Tx Standard
V0550 Vascular Access - Monitor/Referrals Standard
V0715 Md Resp - Ensure All Adhere To P&P Standard
142737 Mchenry Dialysis Center Llc 4209 West Shamrock Lane Mchenry IL 5 (Chicago) 07/27/2022 9CG011 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
E0006 Plan Based On All Hazards Risk Assessment Standard
V0000 Initial Comments - Not A Deficiency Citation Memo