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
162500 Tri-State Dialysis 1515 Delhi Dubuque IA 7 (Kansas City) 01/26/2022 JDIS11 Complaint
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0767 Involuntary Discharge Process Requirements Standard
162500 Tri-State Dialysis 1515 Delhi Dubuque IA 7 (Kansas City) 03/11/2025 JTNM11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0503 Appropriateness Of Dialysis Rx Standard
V0543 Manage Volume Status Standard
162501 Central Des Moines Dialysis 1215 Pleasant Street, Suite 106 Des Moines IA 7 (Kansas City) 08/06/2018 MMBJ11 Complaint
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0502 Assess Current Health Status Inc Comorbids Standard
V0510 Msw - Psychosocial Needs Standard
V0511 Dialysis Access Type & Maintenance Standard
162501 Central Des Moines Dialysis 1215 Pleasant Street, Suite 106 Des Moines IA 7 (Kansas City) 10/04/2021 AIK411 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
V0117 Ic - Clean/Dirty Areas, Med Prep Area, No Common Med Carts Standard
V0122 Ic - Clean, Disinfect Surfaces & Equipment/Written Protocols Standard
V0142 Ic - Oversight: Monitor Activities & Implement Policies Standard
V0250 Dialysate Proportioning - Monitor Ph/Conductivity Standard
V0503 Appropriateness Of Dialysis Rx Standard
162501 Central Des Moines Dialysis 1215 Pleasant Street, Suite 106 Des Moines IA 7 (Kansas City) 01/06/2025 I2VZ11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0196 Carbon Adsorption - Monitoring, Testing Frequency Standard
162506 West Des Moines Dialysis 6800 Lake Drive West Des Moines IA 7 (Kansas City) 12/18/2018 ODZF11 Complaint
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0765 Internal Grievance Process Components & Implemented Standard
162506 West Des Moines Dialysis 6800 Lake Drive West Des Moines IA 7 (Kansas City) 05/21/2019 CGL711 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
V0200 Ro - Monitor/Alarm/Prevent Use Of Unsafe Water Standard
V0500 Cfc - Patient Assessment Condition
V0503 Appropriateness Of Dialysis Rx Standard
V0504 Assess B/P & Fluid Management Needs Standard
V0516 Frequency - Initial: 30 Days/13 Tx Standard
V0517 F/U Reassessment - Within 3 Months Of Initial Standard
V0519 Frequency Reassessment - Stable - Annual Standard
V0520 Frequency Reassessment - Unstable - Monthly Standard
V0540 Cfc: Patient Plan Of Care Condition
V0557 Initial Poc Implemented - 30 Days/13 Tx Standard
V0558 Implement Updates Of Poc - 15 Days P Pt Assessment Standard
V0580 Cfc: Care At Home Condition
V0586 Pt/Caregiver Demonstrated Comprehension Of Training Standard
V0587 Fac Receive/Review Self Monitoring Data Every 2 Months Standard
V0591 Home Patient Plan Of Care Dev/Updated Standard
V0625 Cfc - Quality Assessment & Performance Improvement Condition
V0626 Covers Scope Of Services/Effective/Idt Involved Standard
V0628 Measure, Analyze And Track Quality Indicators Standard
V0632 Qapi Indicator - Anemia Management Standard
V0634 Qapi Indicator - Medical Injuries/Errors Standard
V0637 Qapi Indicator - Infection Control - Trend/Plan/Act Standard
162506 West Des Moines Dialysis 6800 Lake Drive West Des Moines IA 7 (Kansas City) 07/22/2020 T1M711 Complaint
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0112 Ic - Cdc Mmwr 2001 Standard
V0115 Ic - Wear Gowns, Shields/Masks; Staff Not Eat/Drink In Tx Area Standard
162506 West Des Moines Dialysis 6800 Lake Drive West Des Moines IA 7 (Kansas City) 09/29/2022 HUJ611 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0401 Pe - Safe, Functional, Comfortable Environment Standard
V0503 Appropriateness Of Dialysis Rx Standard
V0543 Manage Volume Status Standard
V0628 Measure, Analyze And Track Quality Indicators Standard
V0630 Qapi Indicator - Nutritional Status Standard
V0633 Qapi Indicator - Vascular Access Standard
V0636 Qapi Indicator - Pt Satisfaction & Grievances Standard
V0731 Mr - Maintain Home Patient Records Standard
162507 Fresenius Medical Care Davenport 120 West Locust Street Davenport IA 7 (Kansas City) 10/24/2019 SKTI11 Complaint
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0116 Ic - Items Taken To Station Disposed/Dedicated Or Disinfected Standard
V0120 Ic - Transducer Protectors: Not Wetted/Changed Standard
V0142 Ic - Oversight: Monitor Activities & Implement Policies Standard
V0147 Ic - Staff Education Re Catheters/Catheter Care Standard
V0196 Carbon Adsorption - Monitoring, Testing Frequency Standard
V0450 Cfc - Patients' Rights Condition
V0452 Respect & Dignity Standard
V0463 Receive Services Outlined In Poc Standard
V0503 Appropriateness Of Dialysis Rx Standard
V0625 Cfc - Quality Assessment & Performance Improvement Condition
V0626 Covers Scope Of Services/Effective/Idt Involved Standard
V0636 Qapi Indicator - Pt Satisfaction & Grievances Standard
V0750 Cfc - Governance Condition
V0757 Staff # & Ratio Meet Patient Needs Standard
V0765 Internal Grievance Process Components & Implemented Standard