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
142816 Shifa Dialysis 1540 W Chicago Ave Chicago IL 5 (Chicago) 03/08/2024 EKYY11 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
142816 Shifa Dialysis 1540 W Chicago Ave Chicago IL 5 (Chicago) 08/21/2025 EUUW11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
E0006 Plan Based On All Hazards Risk Assessment Standard
E0028 Dialysis Emergency Equipment Standard
V0000 Initial Comments - Not A Deficiency Citation Memo
V0122 Ic - Clean, Disinfect Surfaces & Equipment/Written Protocols Standard
V0543 Manage Volume Status Standard
V0556 Poc Completed/Signed By Idt & Patient Standard
V0587 Fac Receive/Review Self Monitoring Data Every 2 Months Standard
V0589 Monitor Home Adaptation,Home Visits - Poc Standard
V0628 Measure, Analyze And Track Quality Indicators Standard
V0715 Md Resp - Ensure All Adhere To P&P Standard
142817 Calumet City Dialysis 1200 Sibley Blvd Calumet City IL 5 (Chicago) 12/10/2020 0OUM11 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
142817 Calumet City Dialysis 1200 Sibley Blvd Calumet City IL 5 (Chicago) 12/06/2023 M06A11 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
V0407 Pe - Hemodialysis Patients In View During Treatments Standard
V0503 Appropriateness Of Dialysis Rx Standard
142818 O'Fallon Dialysis 1941 Frank Scott Pkwy E, Suite B Shiloh IL 5 (Chicago) 08/20/2019 B4Q011 Complaint
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0452 Respect & Dignity Standard
142818 O'Fallon Dialysis 1941 Frank Scott Pkwy E, Suite B Shiloh IL 5 (Chicago) 10/28/2020 672O11 Special, 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
V0143 Ic - Aseptic Techniques For Iv Meds Standard
V0187 Environment - Schematic Diagrams/Labels Standard
V0401 Pe - Safe, Functional, Comfortable Environment Standard
V0547 Manage Anemia/H/H Measured Monthly Standard
142818 O'Fallon Dialysis 1941 Frank Scott Pkwy E, Suite B Shiloh IL 5 (Chicago) 10/02/2024 LBGO11 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
V0504 Assess B/P & Fluid Management Needs Standard
V0544 Achieve Adequate Clearance Standard
142819 Fresenius Medical Care Koke Mill, Llc 2550 S Koke Mill Road Springfield IL 5 (Chicago) 12/02/2020 C2V811 Special, 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
142820 Angel Care Center, Llc 3405 Office Park Dr Ste B Marion IL 5 (Chicago) 11/10/2020 RGPI11 Special, 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
142821 Fresenius Kidney Care Humboldt Park 3520 West Grand Chicago IL 5 (Chicago) 01/14/2021 0CZF11 Special
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0142 Ic - Oversight: Monitor Activities & Implement Policies Standard