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
152523 Jasper Dialysis 671 3rd Avenue, Suite A Jasper IN 5 (Chicago) 10/10/2019 Y1J811 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
V0122 Ic - Clean, Disinfect Surfaces & Equipment/Written Protocols Standard
V0146 Ic - Catheters; General Standard
V0504 Assess B/P & Fluid Management Needs Standard
V0505 Assess Lab Profile Standard
V0506 Immunization/Medication History Standard
V0559 Outcome Not Achieved - Adjust Poc Standard
V0726 Medical Records - Complete, Accurate, Accessible Standard
152523 Jasper Dialysis 671 3rd Avenue, Suite A Jasper IN 5 (Chicago) 09/12/2022 L10P11 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
V0196 Carbon Adsorption - Monitoring, Testing Frequency Standard
V0403 Pe - Equipment Maintenance - Manufacturer'S Dfu Standard
V0800 Covid-19 Vaccination Of Facility Staff Standard
152524 Us Renal Care Northwest Indianapolis Dialysis 6488 Corporate Way Indianapolis IN 5 (Chicago) 12/04/2019 YTQL11 Complaint, Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0469 Receive Written Notice 30 Days Before Involuntary Dc Standard
V0543 Manage Volume Status Standard
V0716 Md Resp - Ensure Involuntary Discharge P&P Followed Standard
V0726 Medical Records - Complete, Accurate, Accessible Standard
V0766 Gb & Med Dir Ensure All Staff Follow Disch/Transfer P&P Standard
V0767 Involuntary Discharge Process Requirements Standard
152524 Us Renal Care Northwest Indianapolis Dialysis 6488 Corporate Way Indianapolis IN 5 (Chicago) 06/15/2020 RXVG11 Special
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
E0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0504 Assess B/P & Fluid Management Needs Standard
V0544 Achieve Adequate Clearance Standard
V0556 Poc Completed/Signed By Idt & Patient Standard
152524 Us Renal Care Northwest Indianapolis Dialysis 6488 Corporate Way Indianapolis IN 5 (Chicago) 02/16/2023 WW7K11 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
V0147 Ic - Staff Education Re Catheters/Catheter Care Standard
V0402 Pe - Building - Constructed/Maintained To Ensure Safety Standard
152524 Us Renal Care Northwest Indianapolis Dialysis 6488 Corporate Way Indianapolis IN 5 (Chicago) 05/12/2025 3MV211 Complaint
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
V0402 Pe - Building - Constructed/Maintained To Ensure Safety Standard
V0543 Manage Volume Status Standard
152525 Fresenius Medical Care Indianapolis North 1225 W 86th St Indianapolis IN 5 (Chicago) 09/16/2021 DZ5K11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0119 Ic - Supply Cart Distant/No Supplies In Pockets Standard
V0122 Ic - Clean, Disinfect Surfaces & Equipment/Written Protocols Standard
V0147 Ic - Staff Education Re Catheters/Catheter Care Standard
V0503 Appropriateness Of Dialysis Rx Standard
152525 Fresenius Medical Care Indianapolis North 1225 W 86th St Indianapolis IN 5 (Chicago) 01/09/2025 UQO611 Complaint, 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
V0113 Ic - Wear Gloves/Hand Hygiene Standard
V0117 Ic - Clean/Dirty Areas, Med Prep Area, No Common Med Carts Standard
V0402 Pe - Building - Constructed/Maintained To Ensure Safety Standard
V0543 Manage Volume Status Standard
152526 Fresenius Medical Care Kokomo 2350 S Dixon Rd Ste 450 Kokomo IN 5 (Chicago) 06/20/2018 EZKA11 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
V0121 Ic - Handling Infectious Waste Standard
152526 Fresenius Medical Care Kokomo 2350 S Dixon Rd Ste 450 Kokomo IN 5 (Chicago) 12/09/2021 9O3111 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0240 Bicarb Distribution Systems - Use Of Uv Standard
V0402 Pe - Building - Constructed/Maintained To Ensure Safety Standard
V0407 Pe - Hemodialysis Patients In View During Treatments Standard
V0715 Md Resp - Ensure All Adhere To P&P Standard