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
152568 Daviess County Dialysis 310 Ne 14th St Washington IN 5 (Chicago) 05/26/2022 W11511 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
E0033 Methods For Sharing Information Standard
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
V0506 Immunization/Medication History Standard
V0544 Achieve Adequate Clearance Standard
V0715 Md Resp - Ensure All Adhere To P&P Standard
V0800 Covid-19 Vaccination Of Facility Staff Standard
152569 East Evansville Dialysis 1312 Professional Blvd Evansville IN 5 (Chicago) 05/17/2018 SIKD11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0143 Ic - Aseptic Techniques For Iv Meds Standard
V0407 Pe - Hemodialysis Patients In View During Treatments Standard
V0470 Rights Posted With State/Nw Contact #S And Addresses Standard
152569 East Evansville Dialysis 1312 Professional Blvd Evansville IN 5 (Chicago) 06/30/2020 SZ8H11 Complaint, Special
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
V0405 Pe - Comfortable Temperature Standard
V0765 Internal Grievance Process Components & Implemented Standard
152569 East Evansville Dialysis 1312 Professional Blvd Evansville IN 5 (Chicago) 12/03/2021 DYQ111 Special, Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0222 Acid Bulk Storage Tanks - Safety Controls Standard
V0250 Dialysate Proportioning - Monitor Ph/Conductivity Standard
V0506 Immunization/Medication History Standard
V0543 Manage Volume Status Standard
V0544 Achieve Adequate Clearance Standard
V0628 Measure, Analyze And Track Quality Indicators Standard
V0632 Qapi Indicator - Anemia Management Standard
V0715 Md Resp - Ensure All Adhere To P&P Standard
152569 East Evansville Dialysis 1312 Professional Blvd Evansville IN 5 (Chicago) 02/28/2025 TNQ511 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
V0113 Ic - Wear Gloves/Hand Hygiene Standard
V0119 Ic - Supply Cart Distant/No Supplies In Pockets Standard
V0122 Ic - Clean, Disinfect Surfaces & Equipment/Written Protocols Standard
V0143 Ic - Aseptic Techniques For Iv Meds Standard
V0250 Dialysate Proportioning - Monitor Ph/Conductivity Standard
V0715 Md Resp - Ensure All Adhere To P&P Standard
152571 Fresenius Medical Care Terre Haute North 351 Maiden Ln Terre Haute IN 5 (Chicago) 08/11/2020 7T6611 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
V0121 Ic - Handling Infectious Waste Standard
V0461 Informed - Own Medical Status Standard
152571 Fresenius Medical Care Terre Haute North 351 Maiden Ln Terre Haute IN 5 (Chicago) 07/01/2021 G33Y11 Special, 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
V0115 Ic - Wear Gowns, Shields/Masks; Staff Not Eat/Drink In Tx Area Standard
V0143 Ic - Aseptic Techniques For Iv Meds Standard
V0403 Pe - Equipment Maintenance - Manufacturer'S Dfu Standard
V0543 Manage Volume Status Standard
V0715 Md Resp - Ensure All Adhere To P&P Standard
152571 Fresenius Medical Care Terre Haute North 351 Maiden Ln Terre Haute IN 5 (Chicago) 08/29/2024 22RG11 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
V0113 Ic - Wear Gloves/Hand Hygiene Standard
V0122 Ic - Clean, Disinfect Surfaces & Equipment/Written Protocols 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
152571 Fresenius Medical Care Terre Haute North 351 Maiden Ln Terre Haute IN 5 (Chicago) 10/30/2024 JPPG11 Complaint
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0715 Md Resp - Ensure All Adhere To P&P Standard
V0750 Cfc - Governance Condition
V0757 Staff # & Ratio Meet Patient Needs Standard
V0760 Gb - Responsible For Staff Oriented To Facility & Resp Standard
152572 Us Renal Care Greenwood Dialysis 973 Emerson Parkway, Suite C Greenwood IN 5 (Chicago) 10/18/2022 18ZE11 Complaint
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0113 Ic - Wear Gloves/Hand Hygiene Standard
V0122 Ic - Clean, Disinfect Surfaces & Equipment/Written Protocols Standard