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
152690 Freedom Dialysis 800 N Main Street Evansville IN 5 (Chicago) 08/15/2024 9FE011 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0715 Md Resp - Ensure All Adhere To P&P Standard
152691 Fresenius Kidney Care Southport 6826 Madison Avenue Indianapolis IN 5 (Chicago) 05/10/2023 YHWA11 Complaint
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0115 Ic - Wear Gowns, Shields/Masks; Staff Not Eat/Drink In Tx Area Standard
V0122 Ic - Clean, Disinfect Surfaces & Equipment/Written Protocols Standard
152691 Fresenius Kidney Care Southport 6826 Madison Avenue Indianapolis IN 5 (Chicago) 12/20/2023 Z0VM11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
E0018 Procedures For Tracking Of Staff And Patients Standard
E0028 Dialysis Emergency Equipment Standard
V0000 Initial Comments - Not A Deficiency Citation Memo
V0401 Pe - Safe, Functional, Comfortable Environment Standard
V0543 Manage Volume Status Standard
152692 Munster Dialysis Center 10120 Calumet Avenue, Suite 102 Munster IN 5 (Chicago) 05/16/2018 8DJJ11 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
152692 Munster Dialysis Center 10120 Calumet Avenue, Suite 102 Munster IN 5 (Chicago) 02/14/2022 275B11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
E0009 Local, State, Tribal Collaboration Process Standard
E0028 Dialysis Emergency Equipment Standard
E0033 Methods For Sharing Information Standard
E0034 Information On Occupancy/Needs Standard
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
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
V0142 Ic - Oversight: Monitor Activities & Implement Policies Standard
V0143 Ic - Aseptic Techniques For Iv Meds Standard
V0407 Pe - Hemodialysis Patients In View During Treatments Standard
V0452 Respect & Dignity Standard
V0504 Assess B/P & Fluid Management Needs Standard
V0543 Manage Volume Status Standard
V0544 Achieve Adequate Clearance Standard
V0675 Cfc - Laboratory Services Condition
V0681 Staff Licensed As Req/Qualified/Demonstrate Competencies Standard
V0726 Medical Records - Complete, Accurate, Accessible Standard
V0765 Internal Grievance Process Components & Implemented Standard
152692 Munster Dialysis Center 10120 Calumet Avenue, Suite 102 Munster IN 5 (Chicago) 09/01/2022 D7QH11 Complaint
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0504 Assess B/P & Fluid Management Needs Standard
V0543 Manage Volume Status Standard
V0544 Achieve Adequate Clearance Standard
V0715 Md Resp - Ensure All Adhere To P&P Standard
152692 Munster Dialysis Center 10120 Calumet Avenue, Suite 102 Munster IN 5 (Chicago) 04/07/2025 NJBK11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
E0009 Local, State, Tribal Collaboration Process Standard
E0023 Policies/Procedures For Medical Documentation Standard
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
V0116 Ic - Items Taken To Station Disposed/Dedicated Or Disinfected Standard
V0143 Ic - Aseptic Techniques For Iv Meds Standard
V0146 Ic - Catheters; General Standard
V0148 Ic - Monitor Cath Related Bsi Rates/Surveillance Standard
V0190 Softeners - Automatically Regenerated/Timers/Salt/Salt Level Standard
V0199 Ro - Meets Aami/Monitored, Recorded On Log Standard
V0401 Pe - Safe, Functional, Comfortable Environment Standard
V0407 Pe - Hemodialysis Patients In View During Treatments Standard
V0452 Respect & Dignity Standard
V0503 Appropriateness Of Dialysis Rx Standard
V0543 Manage Volume Status Standard
V0550 Vascular Access - Monitor/Referrals Standard
V0551 Va Monitor To Prevent Failure/Stenosis Standard
V0625 Cfc - Quality Assessment & Performance Improvement Condition
V0628 Measure, Analyze And Track Quality Indicators Standard
V0634 Qapi Indicator - Medical Injuries/Errors Standard
V0637 Qapi Indicator - Infection Control - Trend/Plan/Act Standard
V0638 Continuously Monitor/Take Action/Track/Sustain Improve Standard
V0726 Medical Records - Complete, Accurate, Accessible Standard
152693 American Kidney Center Of Madison Llc 419 Clifty Dr Madison IN 5 (Chicago) 12/01/2021 F6NI11 Special, 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
V0122 Ic - Clean, Disinfect Surfaces & Equipment/Written Protocols Standard
V0178 Bacteriology Of Water-Maximum And Action Levels Standard
V0260 Personnel - Training Program/Periodic Audits Standard
V0402 Pe - Building - Constructed/Maintained To Ensure Safety Standard
V0403 Pe - Equipment Maintenance - Manufacturer'S Dfu Standard
V0503 Appropriateness Of Dialysis Rx Standard
V0543 Manage Volume Status Standard
V0544 Achieve Adequate Clearance Standard
V0587 Fac Receive/Review Self Monitoring Data Every 2 Months Standard
V0589 Monitor Home Adaptation,Home Visits - Poc Standard
V0715 Md Resp - Ensure All Adhere To P&P Standard
152693 American Kidney Center Of Madison Llc 419 Clifty Dr Madison IN 5 (Chicago) 01/29/2025 GUIF11 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
V0124 Ic - Hbv - Test All Pts, Review Results/Pt Status Known Preadmit Standard
V0147 Ic - Staff Education Re Catheters/Catheter Care Standard
V0519 Frequency Reassessment - Stable - Annual Standard
V0580 Cfc: Care At Home Condition
V0584 Training Conducted By Qualified Rn Standard
V0587 Fac Receive/Review Self Monitoring Data Every 2 Months Standard
V0590 Coordination Of Care By Member Of Idt Standard
V0595 Meet Rd 52 2004 Standard
152694 Fall Creek Dialysis 3820 N College Ave Indianapolis IN 5 (Chicago) 02/02/2022 L9I611 Special, 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
V0117 Ic - Clean/Dirty Areas, Med Prep Area, No Common Med Carts Standard
V0142 Ic - Oversight: Monitor Activities & Implement Policies Standard
V0147 Ic - Staff Education Re Catheters/Catheter Care Standard
V0407 Pe - Hemodialysis Patients In View During Treatments Standard
V0726 Medical Records - Complete, Accurate, Accessible Standard