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
232561 Rcg Kalamazoo 521 E Michigan Avenue Kalamazoo MI 5 (Chicago) 01/18/2018 2M7811 Complaint
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0111 Ic - Sanitary Environment Standard
V0122 Ic - Clean, Disinfect Surfaces & Equipment/Written Protocols Standard
V0143 Ic - Aseptic Techniques For Iv Meds Standard
V0147 Ic - Staff Education Re Catheters/Catheter Care Standard
V0454 Privacy & Confidentiality In Treatment Standard
V0715 Md Resp - Ensure All Adhere To P&P Standard
232561 Rcg Kalamazoo 521 E Michigan Avenue Kalamazoo MI 5 (Chicago) 09/20/2018 QEB911 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0110 Cfc - Infection Control Condition
V0113 Ic - Wear Gloves/Hand Hygiene Standard
V0116 Ic - Items Taken To Station Disposed/Dedicated Or Disinfected Standard
V0122 Ic - Clean, Disinfect Surfaces & Equipment/Written Protocols Standard
V0143 Ic - Aseptic Techniques For Iv Meds Standard
V0147 Ic - Staff Education Re Catheters/Catheter Care Standard
V0402 Pe - Building - Constructed/Maintained To Ensure Safety Standard
V0500 Cfc - Patient Assessment Condition
V0501 Patient Assessment - Interdisciplinary Team Mbrs/Resp. Standard
V0520 Frequency Reassessment - Unstable - Monthly Standard
V0540 Cfc: Patient Plan Of Care Condition
V0556 Poc Completed/Signed By Idt & Patient Standard
V0558 Implement Updates Of Poc - 15 Days P Pt Assessment Standard
V0715 Md Resp - Ensure All Adhere To P&P Standard
232562 Muskegon Dialysis 1250 Mercy Drive, Ste 201 Muskegon MI 5 (Chicago) 02/27/2020 5KNJ11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0110 Cfc - Infection Control Condition
V0111 Ic - Sanitary Environment Standard
V0113 Ic - Wear Gloves/Hand Hygiene Standard
V0122 Ic - Clean, Disinfect Surfaces & Equipment/Written Protocols Standard
V0400 Cfc - Physical Environment Condition
V0402 Pe - Building - Constructed/Maintained To Ensure Safety Standard
V0403 Pe - Equipment Maintenance - Manufacturer'S Dfu Standard
V0407 Pe - Hemodialysis Patients In View During Treatments Standard
V0450 Cfc - Patients' Rights Condition
V0455 Privacy & Confidentiality In Records Standard
V0715 Md Resp - Ensure All Adhere To P&P Standard
232563 Pdi-Grand Haven 16964 Robbins Rd Grand Haven MI 5 (Chicago) 05/28/2021 6WRH11 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
V0143 Ic - Aseptic Techniques For Iv Meds Standard
232564 Rai-Royal Park-Zeeland 2 Royal Park Drive Zeeland MI 5 (Chicago) 01/31/2018 BCLN11 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
V0147 Ic - Staff Education Re Catheters/Catheter Care Standard
V0454 Privacy & Confidentiality In Treatment Standard
V0715 Md Resp - Ensure All Adhere To P&P Standard
232564 Rai-Royal Park-Zeeland 2 Royal Park Drive Zeeland MI 5 (Chicago) 08/03/2023 6ZWD11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0121 Ic - Handling Infectious Waste Standard
V0543 Manage Volume Status Standard
V0715 Md Resp - Ensure All Adhere To P&P Standard
V0726 Medical Records - Complete, Accurate, Accessible Standard
232565 Physicians Dialysis - Grand Rapids 801 Cherry Street Se Grand Rapids MI 5 (Chicago) 12/19/2018 OXZL11 Complaint
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
E0003 Establishment Of The Ep Program Dialysis Condition
E0004 Develop Ep Plan, Review And Update Annually Standard
E0028 Dialysis Emergency Equipment Standard
V0000 Initial Comments - Not A Deficiency Citation Memo
V0726 Medical Records - Complete, Accurate, Accessible Standard
V0729 Mr - Complete Records Promptly Standard
V0750 Cfc - Governance Condition
V0760 Gb - Responsible For Staff Oriented To Facility & Resp Standard
232565 Physicians Dialysis - Grand Rapids 801 Cherry Street Se Grand Rapids MI 5 (Chicago) 03/17/2021 PIMZ11 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
V0175 Cfc - Water And Dialysate Quality Condition
V0184 Environment: Secure And Restricted Standard
V0400 Cfc - Physical Environment Condition
V0401 Pe - Safe, Functional, Comfortable Environment Standard
V0542 Idt Develops Plan Of Care Standard
232566 Rai-Clyde Park-Wyoming 4893 Clyde Park Southwest Wyoming MI 5 (Chicago) 04/17/2018 7HG911 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
V0113 Ic - Wear Gloves/Hand Hygiene Standard
V0122 Ic - Clean, Disinfect Surfaces & Equipment/Written Protocols Standard
V0520 Frequency Reassessment - Unstable - Monthly Standard
V0715 Md Resp - Ensure All Adhere To P&P Standard
232566 Rai-Clyde Park-Wyoming 4893 Clyde Park Southwest Wyoming MI 5 (Chicago) 12/01/2022 LQM211 Complaint, 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
V0456 Participate In Care, Discontinue/Refuse Treatment Standard
V0543 Manage Volume Status Standard
V0556 Poc Completed/Signed By Idt & Patient Standard
V0715 Md Resp - Ensure All Adhere To P&P Standard