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
342523 South Charlotte Dialysis 10504 Park Road Charlotte NC 4 (Atlanta) 11/01/2018 MOKU11 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
V0127 Ic - Hbv - Test Pts/Staff Post Last Dose Standard
V0147 Ic - Staff Education Re Catheters/Catheter Care Standard
V0401 Pe - Safe, Functional, Comfortable Environment Standard
V0403 Pe - Equipment Maintenance - Manufacturer'S Dfu Standard
V0454 Privacy & Confidentiality In Treatment Standard
V0543 Manage Volume Status Standard
V0544 Achieve Adequate Clearance Standard
342523 South Charlotte Dialysis 10504 Park Road Charlotte NC 4 (Atlanta) 10/24/2024 H7X711 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0543 Manage Volume Status Standard
V0544 Achieve Adequate Clearance Standard
342524 Bma Of Asheboro 187 Browers Chapel Road Asheboro NC 4 (Atlanta) 01/20/2023 5ZW111 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
V0544 Achieve Adequate Clearance Standard
V0771 Electronic Data Submission Required For Program Adm Standard
V0800 Covid-19 Vaccination Of Facility Staff Standard
342524 Bma Of Asheboro 187 Browers Chapel Road Asheboro NC 4 (Atlanta) 10/31/2025 Q2X111 Complaint, 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
V0544 Achieve Adequate Clearance Standard
V0715 Md Resp - Ensure All Adhere To P&P Standard
342525 Metrolina Kidney Center 1338 E Sunset Drive Monroe NC 4 (Atlanta) 11/06/2019 TH2J11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0116 Ic - Items Taken To Station Disposed/Dedicated Or Disinfected Standard
V0401 Pe - Safe, Functional, Comfortable Environment Standard
V0715 Md Resp - Ensure All Adhere To P&P Standard
342526 Union County Dialysis 615 Comfort Lane Monroe NC 4 (Atlanta) 05/09/2019 VLYO11 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
V0147 Ic - Staff Education Re Catheters/Catheter Care Standard
V0544 Achieve Adequate Clearance Standard
342527 Statesville Dialysis Center 627 Signal Hill Drive Ext Statesville NC 4 (Atlanta) 04/04/2019 MHV011 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
V0122 Ic - Clean, Disinfect Surfaces & Equipment/Written Protocols Standard
V0401 Pe - Safe, Functional, Comfortable Environment Standard
342527 Statesville Dialysis Center 627 Signal Hill Drive Ext Statesville NC 4 (Atlanta) 04/28/2023 PSWR11 Complaint
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0101 Compliance With Fed/State/Local Laws Standard
V0510 Msw - Psychosocial Needs Standard
V0761 Staff Have Access To Continuing Education Standard
342527 Statesville Dialysis Center 627 Signal Hill Drive Ext Statesville NC 4 (Atlanta) 08/28/2025 I1BK11 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
342528 Bma Lumberton 720 Wesley Pines Road Lumberton NC 4 (Atlanta) 02/14/2019 KKKZ11 Complaint
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0715 Md Resp - Ensure All Adhere To P&P Standard