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
152538 Fresenius Medical Care Tri Counties 817 S 13th St Decatur IN 5 (Chicago) 12/17/2024 TVO811 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
E0003 Establishment Of The Ep Program Dialysis Condition
E0007 Ep Program Patient Population Standard
E0018 Procedures For Tracking Of Staff And Patients Standard
E0023 Policies/Procedures For Medical Documentation Standard
E0028 Dialysis Emergency Equipment Standard
E0033 Methods For Sharing Information Standard
E0034 Information On Occupancy/Needs Standard
E0039 Ep Testing Requirements Standard
V0000 Initial Comments - Not A Deficiency Citation Memo
V0111 Ic - Sanitary Environment Standard
V0113 Ic - Wear Gloves/Hand Hygiene Standard
V0128 Ic - Hbv - Isolation (Existing Facility) Standard
V0543 Manage Volume Status Standard
V0544 Achieve Adequate Clearance Standard
V0556 Poc Completed/Signed By Idt & Patient Standard
V0715 Md Resp - Ensure All Adhere To P&P Standard
152539 Quad Counties Dialysis 528 N Grandstaff Dr Auburn IN 5 (Chicago) 02/27/2019 5G0I11 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
152539 Quad Counties Dialysis 528 N Grandstaff Dr Auburn IN 5 (Chicago) 06/15/2022 9JTX11 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
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
V0715 Md Resp - Ensure All Adhere To P&P Standard
152539 Quad Counties Dialysis 528 N Grandstaff Dr Auburn IN 5 (Chicago) 12/31/2025 SKPY11 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
V0114 Ic - Sinks Available Standard
V0115 Ic - Wear Gowns, Shields/Masks; Staff Not Eat/Drink In Tx Area Standard
V0190 Softeners - Automatically Regenerated/Timers/Salt/Salt Level Standard
V0403 Pe - Equipment Maintenance - Manufacturer'S Dfu Standard
V0551 Va Monitor To Prevent Failure/Stenosis Standard
152541 Merrillville Dialysis Center 550 W 84th Drive Merrillville IN 5 (Chicago) 01/08/2020 DZ8P11 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
V0401 Pe - Safe, Functional, Comfortable Environment Standard
152541 Merrillville Dialysis Center 550 W 84th Drive Merrillville IN 5 (Chicago) 06/12/2020 S9WX11 Complaint, Special
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
V0116 Ic - Items Taken To Station Disposed/Dedicated Or Disinfected Standard
V0143 Ic - Aseptic Techniques For Iv Meds Standard
152541 Merrillville Dialysis Center 550 W 84th Drive Merrillville IN 5 (Chicago) 08/02/2023 K95U11 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
V0143 Ic - Aseptic Techniques For Iv Meds Standard
152541 Merrillville Dialysis Center 550 W 84th Drive Merrillville IN 5 (Chicago) 05/06/2024 7ZFC11 Complaint
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0544 Achieve Adequate Clearance Standard
152542 Fresenius Medical Care Nephrology Blackthorn 6201 Nimtz Pkwy South Bend IN 5 (Chicago) 06/26/2018 RM4011 Complaint, Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
E0040 Esrd Patient Orientation Training Standard
V0000 Initial Comments - Not A Deficiency Citation Memo
V0111 Ic - Sanitary Environment Standard
V0113 Ic - Wear Gloves/Hand Hygiene Standard
V0122 Ic - Clean, Disinfect Surfaces & Equipment/Written Protocols Standard
V0407 Pe - Hemodialysis Patients In View During Treatments Standard
V0451 Patients Informed Of Rights When Begin Treatment Standard
V0455 Privacy & Confidentiality In Records Standard
V0501 Patient Assessment - Interdisciplinary Team Mbrs/Resp. Standard
V0509 Rd - Nutritional Status Standard
V0543 Manage Volume Status Standard
V0544 Achieve Adequate Clearance Standard
V0559 Outcome Not Achieved - Adjust Poc Standard
152542 Fresenius Medical Care Nephrology Blackthorn 6201 Nimtz Pkwy South Bend IN 5 (Chicago) 09/03/2020 ORSX11 Special
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0113 Ic - Wear Gloves/Hand Hygiene Standard
V0116 Ic - Items Taken To Station Disposed/Dedicated Or Disinfected Standard
V0122 Ic - Clean, Disinfect Surfaces & Equipment/Written Protocols Standard