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
162524 Dialysis Clinic Inc 1620 Diamond Street Place Onawa IA 7 (Kansas City) 07/20/2022 J16011 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
V0503 Appropriateness Of Dialysis Rx Standard
V0628 Measure, Analyze And Track Quality Indicators Standard
V0714 Md Resp - Develop, Review& Approve P&P Standard
162525 F M C Dialysis Services Midwest 4000 Indian Hills Drive Sioux City IA 7 (Kansas City) 04/08/2021 T7F311 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
V0121 Ic - Handling Infectious Waste Standard
V0122 Ic - Clean, Disinfect Surfaces & Equipment/Written Protocols Standard
V0142 Ic - Oversight: Monitor Activities & Implement Policies Standard
V0147 Ic - Staff Education Re Catheters/Catheter Care Standard
V0276 I-C Use Of Preconfigured Hd Systems - Follow Fda Labeling Standard
V0403 Pe - Equipment Maintenance - Manufacturer'S Dfu Standard
V0407 Pe - Hemodialysis Patients In View During Treatments Standard
V0503 Appropriateness Of Dialysis Rx Standard
V0550 Vascular Access - Monitor/Referrals Standard
V0634 Qapi Indicator - Medical Injuries/Errors Standard
162525 F M C Dialysis Services Midwest 4000 Indian Hills Drive Sioux City IA 7 (Kansas City) 10/16/2024 VGFQ11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
E0018 Procedures For Tracking Of Staff And Patients Standard
V0000 Initial Comments - Not A Deficiency Citation Memo
V0111 Ic - Sanitary Environment Standard
V0113 Ic - Wear Gloves/Hand Hygiene Standard
V0143 Ic - Aseptic Techniques For Iv Meds Standard
V0634 Qapi Indicator - Medical Injuries/Errors Standard
162526 West Union Dialysis Center 405 Highway 150 North West Union IA 7 (Kansas City) 05/17/2023 B2EN11 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
V0550 Vascular Access - Monitor/Referrals Standard
162527 Shenandoah Dialysis 300 Pershing Avenue Shenandoah IA 7 (Kansas City) 09/27/2018 AROV11 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
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
V0402 Pe - Building - Constructed/Maintained To Ensure Safety Standard
V0504 Assess B/P & Fluid Management Needs Standard
V0511 Dialysis Access Type & Maintenance Standard
V0547 Manage Anemia/H/H Measured Monthly Standard
V0550 Vascular Access - Monitor/Referrals Standard
V0636 Qapi Indicator - Pt Satisfaction & Grievances Standard
162527 Shenandoah Dialysis 300 Pershing Avenue Shenandoah IA 7 (Kansas City) 04/14/2022 8BH011 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
V0503 Appropriateness Of Dialysis Rx Standard
V0550 Vascular Access - Monitor/Referrals Standard
V0551 Va Monitor To Prevent Failure/Stenosis Standard
V0626 Covers Scope Of Services/Effective/Idt Involved Standard
V0628 Measure, Analyze And Track Quality Indicators Standard
V0727 Mr - Protect Patient Records From Loss/Keep Confidential Standard
162527 Shenandoah Dialysis 300 Pershing Avenue Shenandoah IA 7 (Kansas City) 05/14/2025 DRIH11 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
V0503 Appropriateness Of Dialysis Rx Standard
162528 Harlan Dialysis 2802 12th Street Harlan IA 7 (Kansas City) 03/30/2021 I7Z011 Special, Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0175 Cfc - Water And Dialysate Quality Condition
V0196 Carbon Adsorption - Monitoring, Testing Frequency Standard
V0219 Bacterial Control - Disinfect Monthly/Disinfection Dwell Standard
V0276 I-C Use Of Preconfigured Hd Systems - Follow Fda Labeling Standard
V0504 Assess B/P & Fluid Management Needs Standard
V0544 Achieve Adequate Clearance Standard
V0772 Responds To Nw Requests/Works Toward Goals Standard
162529 Riverpoint Dialysis Unit 501 Sw Seventh Street Des Moines IA 7 (Kansas City) 08/20/2020 SLXN11 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
V0111 Ic - Sanitary Environment Standard
V0113 Ic - Wear Gloves/Hand Hygiene Standard
V0122 Ic - Clean, Disinfect Surfaces & Equipment/Written Protocols Standard
V0143 Ic - Aseptic Techniques For Iv Meds Standard
V0250 Dialysate Proportioning - Monitor Ph/Conductivity Standard
V0628 Measure, Analyze And Track Quality Indicators Standard
162529 Riverpoint Dialysis Unit 501 Sw Seventh Street Des Moines IA 7 (Kansas City) 11/30/2023 E2Y311 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
V0116 Ic - Items Taken To Station Disposed/Dedicated Or Disinfected Standard
V0142 Ic - Oversight: Monitor Activities & Implement Policies Standard
V0143 Ic - Aseptic Techniques For Iv Meds Standard
V0503 Appropriateness Of Dialysis Rx Standard
V0550 Vascular Access - Monitor/Referrals Standard
V0626 Covers Scope Of Services/Effective/Idt Involved Standard