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
232574 Southeastern Michigan Kidney Center 1695 12 Mile Rd, Suite 250 Berkley MI 5 (Chicago) 06/12/2020 COQV11 Special
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0132 Ic - Training And Education Standard
232574 Southeastern Michigan Kidney Center 1695 12 Mile Rd, Suite 250 Berkley MI 5 (Chicago) 11/20/2023 8YLJ11 Standard
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0400 Cfc - Physical Environment Condition
V0417 Pe-Fire Safety-Life Safety Code Standard
V0580 Cfc: Care At Home Condition
V0587 Fac Receive/Review Self Monitoring Data Every 2 Months Standard
232574 Southeastern Michigan Kidney Center 1695 12 Mile Rd, Suite 250 Berkley MI 5 (Chicago) 11/20/2023 8YLJ21 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
K0000 Initial Comments - Not A Deficiency Citation Memo
K0345 Fire Alarm System - Testing And Maintenance Standard
K0346 Fire Alarm System - Out Of Service Standard
K0353 Sprinkler System - Maintenance And Testing Standard
K0354 Sprinkler System - Out Of Service Standard
K0761 Maintenance, Inspection And Testing - Doors Standard
K0781 Portable Space Heaters Standard
232575 Clarkston Dialysis Center 6770 Dixie Highway Clarkston MI 5 (Chicago) 04/05/2018 OC9L11 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
V0407 Pe - Hemodialysis Patients In View During Treatments Standard
V0455 Privacy & Confidentiality In Records Standard
232575 Clarkston Dialysis Center 6770 Dixie Highway Clarkston MI 5 (Chicago) 03/21/2024 2PKK11 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
V0115 Ic - Wear Gowns, Shields/Masks; Staff Not Eat/Drink In Tx Area Standard
V0122 Ic - Clean, Disinfect Surfaces & Equipment/Written Protocols Standard
232576 Michigan Dialysis Services Of Ann Arbor 2850 South Industrial Highway, Ste 100 Ann Arbor MI 5 (Chicago) 08/02/2018 BM4711 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
V0115 Ic - Wear Gowns, Shields/Masks; Staff Not Eat/Drink In Tx Area Standard
V0117 Ic - Clean/Dirty Areas, Med Prep Area, No Common Med Carts Standard
V0122 Ic - Clean, Disinfect Surfaces & Equipment/Written Protocols Standard
V0625 Cfc - Quality Assessment & Performance Improvement Condition
V0628 Measure, Analyze And Track Quality Indicators Standard
V0634 Qapi Indicator - Medical Injuries/Errors Standard
V0636 Qapi Indicator - Pt Satisfaction & Grievances Standard
V0726 Medical Records - Complete, Accurate, Accessible Standard
232578 State Fair Dialysis Center 19800 Woodward Avenue Detroit MI 5 (Chicago) 07/19/2018 EV0M11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0233 Bicarb Mixing Sys - Storage/Use Time Limits/Min Combine Standard
V0401 Pe - Safe, Functional, Comfortable Environment Standard
V0403 Pe - Equipment Maintenance - Manufacturer'S Dfu Standard
232578 State Fair Dialysis Center 19800 Woodward Avenue Detroit MI 5 (Chicago) 05/15/2019 GV5111 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
E0028 Dialysis Emergency Equipment Standard
E0039 Ep Testing Requirements Standard
V0000 Initial Comments - Not A Deficiency Citation Memo
V0111 Ic - Sanitary Environment Standard
V0122 Ic - Clean, Disinfect Surfaces & Equipment/Written Protocols Standard
V0260 Personnel - Training Program/Periodic Audits Standard
V0512 Eval For Self Care, Modality & Setting Standard
V0715 Md Resp - Ensure All Adhere To P&P Standard
V0726 Medical Records - Complete, Accurate, Accessible Standard
232578 State Fair Dialysis Center 19800 Woodward Avenue Detroit MI 5 (Chicago) 02/03/2021 R9TF11 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
V0126 Ic - Hbv - Vaccinate Patients & Staff Standard
V0403 Pe - Equipment Maintenance - Manufacturer'S Dfu Standard
V0750 Cfc - Governance Condition
V0765 Internal Grievance Process Components & Implemented Standard
232578 State Fair Dialysis Center 19800 Woodward Avenue Detroit MI 5 (Chicago) 08/18/2022 DD6Q11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
E0006 Plan Based On All Hazards Risk Assessment Standard
E0013 Development Of Ep Policies And Procedures Standard
V0000 Initial Comments - Not A Deficiency Citation Memo
V0715 Md Resp - Ensure All Adhere To P&P Standard