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
262584 Fmc Mountain Grove Dba Renal Care Group Inc 1200 North Main Street, Suite 2 Mountain Grove MO 7 (Kansas City) 08/21/2019 5RXA11 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
V0402 Pe - Building - Constructed/Maintained To Ensure Safety Standard
V0504 Assess B/P & Fluid Management Needs Standard
V0637 Qapi Indicator - Infection Control - Trend/Plan/Act Standard
262584 Fmc Mountain Grove Dba Renal Care Group Inc 1200 North Main Street, Suite 2 Mountain Grove MO 7 (Kansas City) 12/14/2022 PBYX11 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
V0544 Achieve Adequate Clearance Standard
V0676 Clia Labs/Meet Needs Of Patients Standard
V0715 Md Resp - Ensure All Adhere To P&P Standard
262585 St Louis West Home Training 9632 Olive Blvd Olivette MO 7 (Kansas City) 09/01/2020 5B4P11 Special, Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0403 Pe - Equipment Maintenance - Manufacturer'S Dfu Standard
V0516 Frequency - Initial: 30 Days/13 Tx Standard
262587 Renal Care Group 156 Evergreen Parkway Lebanon MO 7 (Kansas City) 07/28/2021 9IGF11 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
V0544 Achieve Adequate Clearance Standard
262589 Hazelwood Dialysis 637 Dunn Road Hazelwood MO 7 (Kansas City) 08/07/2018 TQE611 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
V0503 Appropriateness Of Dialysis Rx Standard
V0516 Frequency - Initial: 30 Days/13 Tx Standard
V0726 Medical Records - Complete, Accurate, Accessible Standard
262589 Hazelwood Dialysis 637 Dunn Road Hazelwood MO 7 (Kansas City) 03/16/2022 0C3X11 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
V0250 Dialysate Proportioning - Monitor Ph/Conductivity Standard
V0503 Appropriateness Of Dialysis Rx Standard
V0544 Achieve Adequate Clearance Standard
V0800 Covid-19 Vaccination Of Facility Staff Standard
262589 Hazelwood Dialysis 637 Dunn Road Hazelwood MO 7 (Kansas City) 10/02/2023 3X5L11 Complaint
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0503 Appropriateness Of Dialysis Rx Standard
262589 Hazelwood Dialysis 637 Dunn Road Hazelwood MO 7 (Kansas City) 07/09/2025 WT2311 Complaint, 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
V0503 Appropriateness Of Dialysis Rx Standard
V0544 Achieve Adequate Clearance Standard
262590 Fmc Letholt Dialysis Center 910 Stonner Loop Richmond MO 7 (Kansas City) 06/03/2021 IVCR11 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
V0503 Appropriateness Of Dialysis Rx Standard
262591 Rtc - Crestwood Dialysis 9560 Watson Road Suite A Crestwood MO 7 (Kansas City) 02/06/2019 QKTO11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
E0009 Local, State, Tribal Collaboration Process Standard
E0039 Ep Testing Requirements Standard
V0000 Initial Comments - Not A Deficiency Citation Memo
V0586 Pt/Caregiver Demonstrated Comprehension Of Training Standard
V0587 Fac Receive/Review Self Monitoring Data Every 2 Months Standard
V0626 Covers Scope Of Services/Effective/Idt Involved Standard
V0688 Staff Nurse - Meet State Requirements Standard
V0715 Md Resp - Ensure All Adhere To P&P Standard