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
242569 East River Road Dialysis 5301 East River Road Northeast Suite 117 Fridley MN 5 (Chicago) 09/25/2019 KQP611 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
V0407 Pe - Hemodialysis Patients In View During Treatments Standard
V0520 Frequency Reassessment - Unstable - Monthly Standard
242570 Fmc Maplewood Heights 1725 Legacy Parkway, Suite 200 Maplewood MN 5 (Chicago) 06/27/2018 CFDP11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0503 Appropriateness Of Dialysis Rx Standard
242571 Maple Grove Dialysis Unit 15655 Grove Circle North Maple Grove MN 5 (Chicago) 07/19/2018 O94K11 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
242571 Maple Grove Dialysis Unit 15655 Grove Circle North Maple Grove MN 5 (Chicago) 03/12/2024 L2J911 Complaint
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0110 Cfc - Infection Control Condition
V0765 Internal Grievance Process Components & Implemented Standard
242572 Fresenius Medical Care Coon Rapids 3465 Northdale Boulevard Coon Rapids MN 5 (Chicago) 09/06/2018 19YT11 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
V0407 Pe - Hemodialysis Patients In View During Treatments Standard
242573 Highland Park Dialysis 1559 West Seventh Street Saint Paul MN 5 (Chicago) 05/10/2018 SMGQ11 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
V0132 Ic - Training And Education Standard
V0693 Pct - Complete Training Program Standard
242574 Sun Ray Dialysis Unit 1744 Old Hudson Road Saint Paul MN 5 (Chicago) 09/26/2018 NBIW11 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
242576 Westwood Hills Dialysis 7525 Wayzata Boulevard Saint Louis Park MN 5 (Chicago) 10/18/2018 8N4A11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0147 Ic - Staff Education Re Catheters/Catheter Care Standard
V0228 Mixing Systems - Labeling Standard
V0503 Appropriateness Of Dialysis Rx Standard
V0520 Frequency Reassessment - Unstable - Monthly Standard
V0550 Vascular Access - Monitor/Referrals Standard
V0628 Measure, Analyze And Track Quality Indicators Standard
V0634 Qapi Indicator - Medical Injuries/Errors Standard
242577 Fmc West St Paul Dialysis 1590 South Robert Street #103 West Saint Paul MN 5 (Chicago) 04/25/2018 NL8S11 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
V0117 Ic - Clean/Dirty Areas, Med Prep Area, No Common Med Carts Standard
242579 Fresenius Medical Care Maple Grove 7365 Krikwood Court Suite 135 Maple Grove MN 5 (Chicago) 03/09/2018 GEYB11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0122 Ic - Clean, Disinfect Surfaces & Equipment/Written Protocols Standard
V0143 Ic - Aseptic Techniques For Iv Meds Standard