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
162516 Cedar Valley Dialysis Center 1661 West Ridgeway Avenue Waterloo IA 7 (Kansas City) 11/06/2024 4O2R11 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
V0219 Bacterial Control - Disinfect Monthly/Disinfection Dwell Standard
V0503 Appropriateness Of Dialysis Rx Standard
V0504 Assess B/P & Fluid Management Needs Standard
162517 Southeastern Renal Dialysis Lc 1419 Morgan Street Keokuk IA 7 (Kansas City) 06/23/2021 4MJO11 Special, 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
V0403 Pe - Equipment Maintenance - Manufacturer'S Dfu Standard
162518 Renal Center Of Storm Lake 1426 N Lake Ave Storm Lake IA 7 (Kansas City) 06/27/2019 R0DO11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
E0020 Policies For Evac. And Primary/Alt. Comm. Standard
V0000 Initial Comments - Not A Deficiency Citation Memo
V0715 Md Resp - Ensure All Adhere To P&P Standard
V0726 Medical Records - Complete, Accurate, Accessible Standard
162518 Renal Center Of Storm Lake 1426 N Lake Ave Storm Lake IA 7 (Kansas City) 08/01/2022 247511 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0199 Ro - Meets Aami/Monitored, Recorded On Log Standard
V0470 Rights Posted With State/Nw Contact #S And Addresses Standard
V0503 Appropriateness Of Dialysis Rx Standard
V0628 Measure, Analyze And Track Quality Indicators Standard
V0715 Md Resp - Ensure All Adhere To P&P Standard
162520 Atlantic Dialysis 1500 East Tenth Street Atlantic IA 7 (Kansas City) 06/23/2021 Z85Y11 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
V0113 Ic - Wear Gloves/Hand Hygiene Standard
V0122 Ic - Clean, Disinfect Surfaces & Equipment/Written Protocols Standard
V0503 Appropriateness Of Dialysis Rx Standard
V0504 Assess B/P & Fluid Management Needs Standard
V0550 Vascular Access - Monitor/Referrals Standard
V0551 Va Monitor To Prevent Failure/Stenosis Standard
162523 Newton Dialysis 204 North Fourth Avenue East Suite 104 Newton IA 7 (Kansas City) 05/02/2019 EIXH11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
E0009 Local, State, Tribal Collaboration Process Standard
E0018 Procedures For Tracking Of Staff And Patients Standard
E0030 Names And Contact Information Standard
E0039 Ep Testing Requirements Standard
V0000 Initial Comments - Not A Deficiency Citation Memo
V0122 Ic - Clean, Disinfect Surfaces & Equipment/Written Protocols Standard
V0219 Bacterial Control - Disinfect Monthly/Disinfection Dwell Standard
V0500 Cfc - Patient Assessment Condition
V0504 Assess B/P & Fluid Management Needs Standard
V0511 Dialysis Access Type & Maintenance Standard
V0516 Frequency - Initial: 30 Days/13 Tx Standard
V0625 Cfc - Quality Assessment & Performance Improvement Condition
V0628 Measure, Analyze And Track Quality Indicators Standard
V0634 Qapi Indicator - Medical Injuries/Errors Standard
V0714 Md Resp - Develop, Review& Approve P&P Standard
V0751 Identifiable Governing Body W/Full Authority/Responsibility Standard
162523 Newton Dialysis 204 North Fourth Avenue East Suite 104 Newton IA 7 (Kansas City) 07/28/2020 U73L11 Special
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0111 Ic - Sanitary Environment Standard
162523 Newton Dialysis 204 North Fourth Avenue East Suite 104 Newton IA 7 (Kansas City) 07/28/2022 Z02611 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0112 Ic - Cdc Mmwr 2001 Standard
V0401 Pe - Safe, Functional, Comfortable Environment Standard
162524 Dialysis Clinic Inc 1620 Diamond Street Place Onawa IA 7 (Kansas City) 02/27/2020 2TFV11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
E0023 Policies/Procedures For Medical Documentation Standard
E0025 Arrangement With Other Facilities Standard
E0028 Dialysis Emergency Equipment Standard
E0038 Esrd Ep Training Program Standard
E0039 Ep Testing Requirements Standard
V0000 Initial Comments - Not A Deficiency Citation Memo
V0111 Ic - Sanitary Environment Standard
V0143 Ic - Aseptic Techniques For Iv Meds Standard
V0147 Ic - Staff Education Re Catheters/Catheter Care Standard
V0175 Cfc - Water And Dialysate Quality Condition
V0187 Environment - Schematic Diagrams/Labels Standard
V0196 Carbon Adsorption - Monitoring, Testing Frequency Standard
V0250 Dialysate Proportioning - Monitor Ph/Conductivity Standard
V0550 Vascular Access - Monitor/Referrals Standard
V0551 Va Monitor To Prevent Failure/Stenosis Standard
V0587 Fac Receive/Review Self Monitoring Data Every 2 Months Standard
V0626 Covers Scope Of Services/Effective/Idt Involved Standard
V0628 Measure, Analyze And Track Quality Indicators Standard
162524 Dialysis Clinic Inc 1620 Diamond Street Place Onawa IA 7 (Kansas City) 06/29/2021 X9CZ11 Complaint, Special
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0182 Equipment-General/Back Up Plan Standard