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
162540 Southeastern Renal Dialysis Lc 2000a South Main Street Fairfield IA 7 (Kansas City) 09/27/2021 YY5M11 Special, 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
V0122 Ic - Clean, Disinfect Surfaces & Equipment/Written Protocols Standard
V0250 Dialysate Proportioning - Monitor Ph/Conductivity Standard
V0403 Pe - Equipment Maintenance - Manufacturer'S Dfu Standard
162541 Black Hawk Dialysis 3421 West Ninth Street Waterloo IA 7 (Kansas City) 09/11/2018 XMDX11 Complaint
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0401 Pe - Safe, Functional, Comfortable Environment Standard
162541 Black Hawk Dialysis 3421 West Ninth Street Waterloo IA 7 (Kansas City) 09/16/2021 LIYS11 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
V0122 Ic - Clean, Disinfect Surfaces & Equipment/Written Protocols Standard
V0250 Dialysate Proportioning - Monitor Ph/Conductivity Standard
162542 Cedar Valley Waverly Dialysis 220 10th Street Sw Waverly IA 7 (Kansas City) 04/29/2021 XU1J11 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
V0142 Ic - Oversight: Monitor Activities & Implement Policies Standard
V0196 Carbon Adsorption - Monitoring, Testing Frequency Standard
V0199 Ro - Meets Aami/Monitored, Recorded On Log Standard
V0226 Mixing Sys - Follow Dfu/Monitor/Pm/Log/Sanitization Standard
V0250 Dialysate Proportioning - Monitor Ph/Conductivity Standard
V0403 Pe - Equipment Maintenance - Manufacturer'S Dfu Standard
V0503 Appropriateness Of Dialysis Rx Standard
V0626 Covers Scope Of Services/Effective/Idt Involved Standard
162542 Cedar Valley Waverly Dialysis 220 10th Street Sw Waverly IA 7 (Kansas City) 10/02/2024 8BQZ11 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
V0117 Ic - Clean/Dirty Areas, Med Prep Area, No Common Med Carts Standard
V0122 Ic - Clean, Disinfect Surfaces & Equipment/Written Protocols Standard
V0503 Appropriateness Of Dialysis Rx Standard
V0543 Manage Volume Status Standard
V0547 Manage Anemia/H/H Measured Monthly Standard
162543 Fresenius Medical Care Maquoketa 700 West Grove Street Maquoketa IA 7 (Kansas City) 07/11/2018 671911 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
V0122 Ic - Clean, Disinfect Surfaces & Equipment/Written Protocols Standard
V0147 Ic - Staff Education Re Catheters/Catheter Care Standard
V0504 Assess B/P & Fluid Management Needs Standard
V0550 Vascular Access - Monitor/Referrals Standard
162543 Fresenius Medical Care Maquoketa 700 West Grove Street Maquoketa IA 7 (Kansas City) 01/16/2019 CG8Q11 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
V0504 Assess B/P & Fluid Management Needs Standard
V0511 Dialysis Access Type & Maintenance Standard
162544 Buchanan County Dialysis 1600 1st St East Independence IA 7 (Kansas City) 07/18/2018 N8MC11 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
V0407 Pe - Hemodialysis Patients In View During Treatments Standard
V0502 Assess Current Health Status Inc Comorbids Standard
V0504 Assess B/P & Fluid Management Needs Standard
V0511 Dialysis Access Type & Maintenance Standard
V0543 Manage Volume Status Standard
V0550 Vascular Access - Monitor/Referrals Standard
V0551 Va Monitor To Prevent Failure/Stenosis Standard
162544 Buchanan County Dialysis 1600 1st St East Independence IA 7 (Kansas City) 03/09/2022 NZP511 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
V0213 Dist Sys - Culture/Lal/Sample Sites/Frequency(New)/Log Standard
V0250 Dialysate Proportioning - Monitor Ph/Conductivity Standard
V0254 Microbial Monitoring - Sample Before Disinfect Standard
V0401 Pe - Safe, Functional, Comfortable Environment Standard
V0403 Pe - Equipment Maintenance - Manufacturer'S Dfu Standard
V0504 Assess B/P & Fluid Management Needs Standard
V0628 Measure, Analyze And Track Quality Indicators Standard
162546 Lemars Area Dialysis Services 1-1st Street Southwest Le Mars IA 7 (Kansas City) 07/08/2021 W4T511 Special, Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0276 I-C Use Of Preconfigured Hd Systems - Follow Fda Labeling Standard
V0543 Manage Volume Status Standard
V0545 Effective Nutritional Status Standard