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
152599 Duneland Dialysis Laporte 103 West 18th Street La Porte IN 5 (Chicago) 12/21/2021 746211 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
V0504 Assess B/P & Fluid Management Needs Standard
V0543 Manage Volume Status Standard
V0544 Achieve Adequate Clearance Standard
152599 Duneland Dialysis Laporte 103 West 18th Street La Porte IN 5 (Chicago) 03/05/2025 RINU11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0511 Dialysis Access Type & Maintenance Standard
152601 Liberty Dialysis Lafayette Ii 1020 N 18th St Lafayette IN 5 (Chicago) 06/29/2018 Z7MH11 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
V0115 Ic - Wear Gowns, Shields/Masks; Staff Not Eat/Drink In Tx Area Standard
V0147 Ic - Staff Education Re Catheters/Catheter Care Standard
V0402 Pe - Building - Constructed/Maintained To Ensure Safety Standard
V0504 Assess B/P & Fluid Management Needs Standard
V0715 Md Resp - Ensure All Adhere To P&P Standard
V0726 Medical Records - Complete, Accurate, Accessible Standard
152601 Liberty Dialysis Lafayette Ii 1020 N 18th St Lafayette IN 5 (Chicago) 03/14/2023 GTO311 Complaint
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0112 Ic - Cdc Mmwr 2001 Standard
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
V0558 Implement Updates Of Poc - 15 Days P Pt Assessment Standard
V0580 Cfc: Care At Home Condition
V0582 Idt Oversees Home Training Standard
V0586 Pt/Caregiver Demonstrated Comprehension Of Training Standard
V0587 Fac Receive/Review Self Monitoring Data Every 2 Months Standard
V0590 Coordination Of Care By Member Of Idt Standard
V0716 Md Resp - Ensure Involuntary Discharge P&P Followed Standard
152601 Liberty Dialysis Lafayette Ii 1020 N 18th St Lafayette IN 5 (Chicago) 12/28/2023 D1DK11 Complaint
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
V0111 Ic - Sanitary Environment Standard
V0113 Ic - Wear Gloves/Hand Hygiene Standard
V0114 Ic - Sinks Available Standard
V0122 Ic - Clean, Disinfect Surfaces & Equipment/Written Protocols Standard
V0142 Ic - Oversight: Monitor Activities & Implement Policies Standard
V0143 Ic - Aseptic Techniques For Iv Meds Standard
V0175 Cfc - Water And Dialysate Quality Condition
V0196 Carbon Adsorption - Monitoring, Testing Frequency Standard
V0401 Pe - Safe, Functional, Comfortable Environment Standard
V0407 Pe - Hemodialysis Patients In View During Treatments Standard
V0540 Cfc: Patient Plan Of Care Condition
V0543 Manage Volume Status Standard
V0547 Manage Anemia/H/H Measured Monthly Standard
V0556 Poc Completed/Signed By Idt & Patient Standard
V0559 Outcome Not Achieved - Adjust Poc Standard
V0587 Fac Receive/Review Self Monitoring Data Every 2 Months Standard
V0593 Monitor Water/Dialysate Inc On Site Evaluation Standard
V0715 Md Resp - Ensure All Adhere To P&P Standard
152601 Liberty Dialysis Lafayette Ii 1020 N 18th St Lafayette IN 5 (Chicago) 02/07/2024 D1DK12 Complaint
Deficiency Tag Deficiency Description Tag Type
V0116 Ic - Items Taken To Station Disposed/Dedicated Or Disinfected Standard
V0250 Dialysate Proportioning - Monitor Ph/Conductivity Standard
V0465 Informed - Internal Grievance Process Standard
V0560 Patients Seen By Med Staff Member Monthly Standard
152601 Liberty Dialysis Lafayette Ii 1020 N 18th St Lafayette IN 5 (Chicago) 06/27/2025 L5DR11 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
V0520 Frequency Reassessment - Unstable - Monthly Standard
V0580 Cfc: Care At Home Condition
V0582 Idt Oversees Home Training Standard
V0587 Fac Receive/Review Self Monitoring Data Every 2 Months Standard
V0589 Monitor Home Adaptation,Home Visits - Poc Standard
V0681 Staff Licensed As Req/Qualified/Demonstrate Competencies Standard
V0715 Md Resp - Ensure All Adhere To P&P Standard
V0726 Medical Records - Complete, Accurate, Accessible Standard
152603 Franklin Dialysis 1140 W Jefferson St Ste A Franklin IN 5 (Chicago) 11/08/2018 15O911 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
V0250 Dialysate Proportioning - Monitor Ph/Conductivity Standard
V0402 Pe - Building - Constructed/Maintained To Ensure Safety Standard
152603 Franklin Dialysis 1140 W Jefferson St Ste A Franklin IN 5 (Chicago) 07/09/2021 TU3V11 Special, 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
V0401 Pe - Safe, Functional, Comfortable Environment Standard
V0402 Pe - Building - Constructed/Maintained To Ensure Safety Standard
V0404 Pe - Patient Care Environment - Sufficient Space Standard
V0455 Privacy & Confidentiality In Records Standard
152603 Franklin Dialysis 1140 W Jefferson St Ste A Franklin IN 5 (Chicago) 07/24/2024 2LT511 Complaint, 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
V0190 Softeners - Automatically Regenerated/Timers/Salt/Salt Level Standard
V0402 Pe - Building - Constructed/Maintained To Ensure Safety Standard