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
152701 Dialyze Direct In, Llc 13295 Illinois Street, Suite 210 Carmel IN 5 (Chicago) 09/05/2024 XSJB11 Complaint
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
V0117 Ic - Clean/Dirty Areas, Med Prep Area, No Common Med Carts Standard
V0122 Ic - Clean, Disinfect Surfaces & Equipment/Written Protocols Standard
V0147 Ic - Staff Education Re Catheters/Catheter Care Standard
V0450 Cfc - Patients' Rights Condition
V0468 Informed - D/C & Transfer Policies Inc Involuntary Dc Standard
V0502 Assess Current Health Status Inc Comorbids Standard
V0504 Assess B/P & Fluid Management Needs Standard
V0542 Idt Develops Plan Of Care Standard
V0543 Manage Volume Status Standard
V0550 Vascular Access - Monitor/Referrals Standard
V0559 Outcome Not Achieved - Adjust Poc Standard
V0590 Coordination Of Care By Member Of Idt Standard
V0714 Md Resp - Develop, Review& Approve P&P Standard
V0715 Md Resp - Ensure All Adhere To P&P Standard
V0751 Identifiable Governing Body W/Full Authority/Responsibility Standard
V0772 Responds To Nw Requests/Works Toward Goals Standard
152703 Fresenius Kidney Care North Elkhart 801 W Bristol Street Elkhart IN 5 (Chicago) 12/09/2022 322111 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
E0003 Establishment Of The Ep Program Dialysis Condition
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
E0036 Ep Training And Testing Standard
E0039 Ep Testing Requirements Standard
E0042 Integrated Ep Program Standard
V0000 Initial Comments - Not A Deficiency Citation Memo
V0114 Ic - Sinks Available Standard
V0401 Pe - Safe, Functional, Comfortable Environment Standard
V0541 Patient Plan Of Care - Goals - Community-Based Standards Standard
V0752 Appoint Ceo/Administrator Standard
152704 Dialysis Care Center Merillville Llc 349 W 80th Place Merrillville IN 5 (Chicago) 10/25/2019 ILSI11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
E0004 Develop Ep Plan, Review And Update Annually 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
V0190 Softeners - Automatically Regenerated/Timers/Salt/Salt Level Standard
V0199 Ro - Meets Aami/Monitored, Recorded On Log Standard
V0520 Frequency Reassessment - Unstable - Monthly Standard
152704 Dialysis Care Center Merillville Llc 349 W 80th Place Merrillville IN 5 (Chicago) 05/16/2023 ZZJE11 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
V0147 Ic - Staff Education Re Catheters/Catheter Care Standard
V0500 Cfc - Patient Assessment Condition
V0503 Appropriateness Of Dialysis Rx Standard
V0504 Assess B/P & Fluid Management Needs Standard
V0543 Manage Volume Status Standard
V0544 Achieve Adequate Clearance Standard
V0640 Immediately Correct Any Ij Issues Standard
V0714 Md Resp - Develop, Review& Approve P&P Standard
V0715 Md Resp - Ensure All Adhere To P&P Standard
V0726 Medical Records - Complete, Accurate, Accessible Standard
152704 Dialysis Care Center Merillville Llc 349 W 80th Place Merrillville IN 5 (Chicago) 06/19/2023 ZZJE14 Standard
Deficiency Tag Deficiency Description Tag Type
V0116 Ic - Items Taken To Station Disposed/Dedicated Or Disinfected Standard
152704 Dialysis Care Center Merillville Llc 349 W 80th Place Merrillville IN 5 (Chicago) 08/08/2024 ZQ5Y11 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
V0146 Ic - Catheters; General Standard
V0403 Pe - Equipment Maintenance - Manufacturer'S Dfu Standard
V0559 Outcome Not Achieved - Adjust Poc Standard
V0628 Measure, Analyze And Track Quality Indicators Standard
V0638 Continuously Monitor/Take Action/Track/Sustain Improve Standard
152704 Dialysis Care Center Merillville Llc 349 W 80th Place Merrillville IN 5 (Chicago) 10/30/2024 E4QS11 Complaint
Deficiency Tag Deficiency Description Tag Type
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
V0500 Cfc - Patient Assessment Condition
V0503 Appropriateness Of Dialysis Rx Standard
V0504 Assess B/P & Fluid Management Needs Standard
V0540 Cfc: Patient Plan Of Care Condition
V0543 Manage Volume Status Standard
V0547 Manage Anemia/H/H Measured Monthly Standard
V0551 Va Monitor To Prevent Failure/Stenosis Standard
V0638 Continuously Monitor/Take Action/Track/Sustain Improve Standard
V0726 Medical Records - Complete, Accurate, Accessible Standard
152709 Optimal Dialysis Llc 8315 E 56th St Suite 120 Indianapolis IN 5 (Chicago) 01/29/2024 XSPN11 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
V0401 Pe - Safe, Functional, Comfortable Environment Standard
152710 Highland Dialysis 5779 S Us Hwy 41 Allendale IN 5 (Chicago) 02/19/2025 M7RI11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
E0023 Policies/Procedures For Medical Documentation Standard
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
V0187 Environment - Schematic Diagrams/Labels Standard
V0715 Md Resp - Ensure All Adhere To P&P Standard
V0726 Medical Records - Complete, Accurate, Accessible Standard
153522 Riley Hospital Renal Services 705 Riley Hospital Drive Roc Ste 1240 Indianapolis IN 5 (Chicago) 01/30/2019 ZK5D11 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
V0132 Ic - Training And Education Standard
V0147 Ic - Staff Education Re Catheters/Catheter Care Standard
V0196 Carbon Adsorption - Monitoring, Testing Frequency Standard
V0201 Ro - Chemical Analysis - Frequency Standard
V0260 Personnel - Training Program/Periodic Audits Standard
V0587 Fac Receive/Review Self Monitoring Data Every 2 Months Standard
V0589 Monitor Home Adaptation,Home Visits - Poc Standard