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
152687 Home Dialysis Of Indianapolis 8803 N Meridian St Ste 150 Indianapolis IN 5 (Chicago) 11/22/2023 N9XN11 Complaint
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
E0006 Plan Based On All Hazards Risk Assessment Standard
E0018 Procedures For Tracking Of Staff And Patients Standard
E0036 Ep Training And Testing 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
V0147 Ic - Staff Education Re Catheters/Catheter Care Standard
V0201 Ro - Chemical Analysis - Frequency Standard
V0401 Pe - Safe, Functional, Comfortable Environment Standard
V0450 Cfc - Patients' Rights Condition
V0455 Privacy & Confidentiality In Records Standard
V0463 Receive Services Outlined In Poc Standard
V0500 Cfc - Patient Assessment Condition
V0501 Patient Assessment - Interdisciplinary Team Mbrs/Resp. Standard
V0504 Assess B/P & Fluid Management Needs Standard
V0540 Cfc: Patient Plan Of Care Condition
V0542 Idt Develops Plan Of Care Standard
V0543 Manage Volume Status Standard
V0557 Initial Poc Implemented - 30 Days/13 Tx Standard
V0634 Qapi Indicator - Medical Injuries/Errors Standard
V0636 Qapi Indicator - Pt Satisfaction & Grievances Standard
V0637 Qapi Indicator - Infection Control - Trend/Plan/Act Standard
V0681 Staff Licensed As Req/Qualified/Demonstrate Competencies Standard
152688 Metro Point Dialysis 1218 N Pennsylvania St Indianapolis IN 5 (Chicago) 09/27/2021 9LMC11 Standard
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
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
V0407 Pe - Hemodialysis Patients In View During Treatments Standard
V0450 Cfc - Patients' Rights Condition
V0463 Receive Services Outlined In Poc Standard
V0544 Achieve Adequate Clearance Standard
V0726 Medical Records - Complete, Accurate, Accessible Standard
152688 Metro Point Dialysis 1218 N Pennsylvania St Indianapolis IN 5 (Chicago) 07/06/2022 4QN111 Complaint
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0113 Ic - Wear Gloves/Hand Hygiene Standard
V0401 Pe - Safe, Functional, Comfortable Environment Standard
152688 Metro Point Dialysis 1218 N Pennsylvania St Indianapolis IN 5 (Chicago) 03/22/2023 VHZ211 Complaint
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0543 Manage Volume Status Standard
152689 Terre Haute Dialysis 504 6th Street Terre Haute IN 5 (Chicago) 01/30/2018 JOLD11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0551 Va Monitor To Prevent Failure/Stenosis Standard
152689 Terre Haute Dialysis 504 6th Street Terre Haute IN 5 (Chicago) 07/16/2021 UDHY11 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
V0113 Ic - Wear Gloves/Hand Hygiene Standard
V0114 Ic - Sinks Available Standard
V0122 Ic - Clean, Disinfect Surfaces & Equipment/Written Protocols Standard
V0143 Ic - Aseptic Techniques For Iv Meds Standard
V0147 Ic - Staff Education Re Catheters/Catheter Care Standard
V0543 Manage Volume Status Standard
152689 Terre Haute Dialysis 504 6th Street Terre Haute IN 5 (Chicago) 02/21/2023 4NZ111 Complaint
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
V0117 Ic - Clean/Dirty Areas, Med Prep Area, No Common Med Carts Standard
V0403 Pe - Equipment Maintenance - Manufacturer'S Dfu Standard
V0715 Md Resp - Ensure All Adhere To P&P Standard
V0800 Covid-19 Vaccination Of Facility Staff Standard
152689 Terre Haute Dialysis 504 6th Street Terre Haute IN 5 (Chicago) 09/17/2024 OLQR11 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
V0122 Ic - Clean, Disinfect Surfaces & Equipment/Written Protocols Standard
V0143 Ic - Aseptic Techniques For Iv Meds Standard
V0147 Ic - Staff Education Re Catheters/Catheter Care Standard
V0715 Md Resp - Ensure All Adhere To P&P Standard
152690 Freedom Dialysis 800 N Main Street Evansville IN 5 (Chicago) 07/20/2021 PYBT11 Special, Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0101 Compliance With Fed/State/Local Laws Standard
V0113 Ic - Wear Gloves/Hand Hygiene Standard
V0122 Ic - Clean, Disinfect Surfaces & Equipment/Written Protocols Standard
V0143 Ic - Aseptic Techniques For Iv Meds Standard
V0401 Pe - Safe, Functional, Comfortable Environment Standard
V0407 Pe - Hemodialysis Patients In View During Treatments Standard
V0543 Manage Volume Status Standard
V0715 Md Resp - Ensure All Adhere To P&P Standard
V0726 Medical Records - Complete, Accurate, Accessible Standard
152690 Freedom Dialysis 800 N Main Street Evansville IN 5 (Chicago) 08/24/2021 RC0S11 Complaint
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0547 Manage Anemia/H/H Measured Monthly Standard
V0715 Md Resp - Ensure All Adhere To P&P Standard