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
162507 Fresenius Medical Care Davenport 120 West Locust Street Davenport IA 7 (Kansas City) 05/05/2021 FIQT11 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
V0122 Ic - Clean, Disinfect Surfaces & Equipment/Written Protocols Standard
V0503 Appropriateness Of Dialysis Rx Standard
162507 Fresenius Medical Care Davenport 120 West Locust Street Davenport IA 7 (Kansas City) 10/10/2024 QZOW11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0502 Assess Current Health Status Inc Comorbids Standard
V0503 Appropriateness Of Dialysis Rx Standard
162509 Southeastern Renal Dialysis Lc 507 South White Street Mount Pleasant IA 7 (Kansas City) 12/10/2020 HZG011 Special, Standard
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
V0503 Appropriateness Of Dialysis Rx Standard
V0543 Manage Volume Status Standard
V0628 Measure, Analyze And Track Quality Indicators Standard
162509 Southeastern Renal Dialysis Lc 507 South White Street Mount Pleasant IA 7 (Kansas City) 12/28/2022 8UGD11 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
V0503 Appropriateness Of Dialysis Rx Standard
162511 Tri-State Dialysis 107 11th Street Suite 2 Manchester IA 7 (Kansas City) 05/19/2021 C64W11 Special, Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0142 Ic - Oversight: Monitor Activities & Implement Policies Standard
V0403 Pe - Equipment Maintenance - Manufacturer'S Dfu Standard
V0404 Pe - Patient Care Environment - Sufficient Space Standard
V0502 Assess Current Health Status Inc Comorbids Standard
V0503 Appropriateness Of Dialysis Rx Standard
V0511 Dialysis Access Type & Maintenance Standard
V0550 Vascular Access - Monitor/Referrals Standard
V0551 Va Monitor To Prevent Failure/Stenosis Standard
V0714 Md Resp - Develop, Review& Approve P&P Standard
162511 Tri-State Dialysis 107 11th Street Suite 2 Manchester IA 7 (Kansas City) 10/30/2024 6MTS11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0250 Dialysate Proportioning - Monitor Ph/Conductivity Standard
162512 Southeastern Renal Dialysis Lc 1213 South Gear Avenue West Burlington IA 7 (Kansas City) 11/19/2020 KDFP11 Special, 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
V0118 Ic - Single Use Vials Standard
V0196 Carbon Adsorption - Monitoring, Testing Frequency Standard
V0202 Di - Continuous Monitoring Resistivity/Logged 2 X Day Standard
V0407 Pe - Hemodialysis Patients In View During Treatments Standard
V0506 Immunization/Medication History Standard
V0544 Achieve Adequate Clearance Standard
V0550 Vascular Access - Monitor/Referrals Standard
V0628 Measure, Analyze And Track Quality Indicators Standard
162512 Southeastern Renal Dialysis Lc 1213 South Gear Avenue West Burlington IA 7 (Kansas City) 08/15/2024 EKN011 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
V0407 Pe - Hemodialysis Patients In View During Treatments Standard
V0504 Assess B/P & Fluid Management Needs Standard
162512 Southeastern Renal Dialysis Lc 1213 South Gear Avenue West Burlington IA 7 (Kansas City) 12/03/2025 QKQ611 Complaint
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0684 Nurse Manager - 12 Mo Rn + 6 Mo Dialysis Standard
162514 Creston Dialysis 1700 West Townline Road Suite 2 B Creston IA 7 (Kansas City) 08/06/2020 BINP11 Special
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0113 Ic - Wear Gloves/Hand Hygiene Standard
V0143 Ic - Aseptic Techniques For Iv Meds Standard