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
262564 Dsi Kansas City Renal Center 4601 Madison Avenue Kansas City MO 7 (Kansas City) 01/30/2024 BXFR21 Standard
Deficiency Tag Deficiency Description Tag Type
K0000 Initial Comments - Not A Deficiency Citation Memo
K0211 Means Of Egress - General Standard
K0353 Sprinkler System - Maintenance And Testing Standard
262564 Dsi Kansas City Renal Center 4601 Madison Avenue Kansas City MO 7 (Kansas City) 01/31/2024 BXFR11 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
V0544 Achieve Adequate Clearance Standard
V0715 Md Resp - Ensure All Adhere To P&P Standard
262564 Dsi Kansas City Renal Center 4601 Madison Avenue Kansas City MO 7 (Kansas City) 03/10/2025 MTH911 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
V0407 Pe - Hemodialysis Patients In View During Treatments Standard
V0544 Achieve Adequate Clearance Standard
262565 Forest Park Dialysis Center 4205 Forest Park Avenue Saint Louis MO 7 (Kansas City) 10/01/2019 ZO7T11 Complaint
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0468 Informed - D/C & Transfer Policies Inc Involuntary Dc Standard
V0767 Involuntary Discharge Process Requirements Standard
262565 Forest Park Dialysis Center 4205 Forest Park Avenue Saint Louis MO 7 (Kansas City) 07/14/2021 L47K11 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
V0122 Ic - Clean, Disinfect Surfaces & Equipment/Written Protocols Standard
V0503 Appropriateness Of Dialysis Rx Standard
V0544 Achieve Adequate Clearance Standard
V0726 Medical Records - Complete, Accurate, Accessible Standard
262569 Jefferson County Dialysis Center 1301 Ymca Dr Suite 200 Festus MO 7 (Kansas City) 04/24/2018 LTYM11 Complaint
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0765 Internal Grievance Process Components & Implemented Standard
262569 Jefferson County Dialysis Center 1301 Ymca Dr Suite 200 Festus MO 7 (Kansas City) 01/22/2020 JZYG11 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
V0196 Carbon Adsorption - Monitoring, Testing Frequency Standard
V0715 Md Resp - Ensure All Adhere To P&P Standard
262569 Jefferson County Dialysis Center 1301 Ymca Dr Suite 200 Festus MO 7 (Kansas City) 01/19/2023 R6OL11 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
V0113 Ic - Wear Gloves/Hand Hygiene Standard
V0115 Ic - Wear Gowns, Shields/Masks; Staff Not Eat/Drink In Tx Area Standard
V0401 Pe - Safe, Functional, Comfortable Environment Standard
V0542 Idt Develops Plan Of Care Standard
V0550 Vascular Access - Monitor/Referrals Standard
262570 Dialysis Clinic Inc 604 Rankin Mill Lane Boonville MO 7 (Kansas City) 10/02/2018 2QE711 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0196 Carbon Adsorption - Monitoring, Testing Frequency Standard
V0542 Idt Develops Plan Of Care Standard
V0715 Md Resp - Ensure All Adhere To P&P Standard
262570 Dialysis Clinic Inc 604 Rankin Mill Lane Boonville MO 7 (Kansas City) 07/20/2022 JFQW11 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
V0121 Ic - Handling Infectious Waste Standard
V0122 Ic - Clean, Disinfect Surfaces & Equipment/Written Protocols Standard
V0520 Frequency Reassessment - Unstable - Monthly Standard