S&C QCOR ESRD 2567s
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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
▼ 342567 Burlington Dialysis 873 Heather Road Burlington NC 4 (Atlanta) 08/08/2019 XT2K11 Complaint
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0122 Ic - Clean, Disinfect Surfaces & Equipment/Written Protocols Standard
V0715 Md Resp - Ensure All Adhere To P&P Standard
V0767 Involuntary Discharge Process Requirements Standard
▼ 342567 Burlington Dialysis 873 Heather Road Burlington NC 4 (Atlanta) 05/19/2022 XC7N11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0117 Ic - Clean/Dirty Areas, Med Prep Area, No Common Med Carts Standard
V0407 Pe - Hemodialysis Patients In View During Treatments Standard
V0552 Psychosocial Counseling/Referrals/Assessment Tool Standard
▼ 342568 Fmc Lincolnton 1090 South Grove Street Extension Lincolnton NC 4 (Atlanta) 09/05/2019 HKU911 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
▼ 342568 Fmc Lincolnton 1090 South Grove Street Extension Lincolnton NC 4 (Atlanta) 02/25/2021 N0YD11 Complaint
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0101 Compliance With Fed/State/Local Laws Standard
▼ 342568 Fmc Lincolnton 1090 South Grove Street Extension Lincolnton NC 4 (Atlanta) 07/20/2021 37V311 Complaint
Deficiency Tag Deficiency Description Tag Type
V0715 Md Resp - Ensure All Adhere To P&P Standard
▼ 342568 Fmc Lincolnton 1090 South Grove Street Extension Lincolnton NC 4 (Atlanta) 09/08/2022 1O5111 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
V0147 Ic - Staff Education Re Catheters/Catheter Care Standard
V0519 Frequency Reassessment - Stable - Annual Standard
V0557 Initial Poc Implemented - 30 Days/13 Tx Standard
V0558 Implement Updates Of Poc - 15 Days P Pt Assessment Standard
▼ 342569 Salem Kidney Center 2705 Boulder Court Road Winston Salem NC 4 (Atlanta) 03/05/2020 QBDJ11 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
V0110 Cfc - Infection Control Condition
V0111 Ic - Sanitary Environment Standard
V0113 Ic - Wear Gloves/Hand Hygiene Standard
V0147 Ic - Staff Education Re Catheters/Catheter Care Standard
V0196 Carbon Adsorption - Monitoring, Testing Frequency Standard
V0750 Cfc - Governance Condition
V0771 Electronic Data Submission Required For Program Adm Standard
▼ 342569 Salem Kidney Center 2705 Boulder Court Road Winston Salem NC 4 (Atlanta) 07/28/2023 HVOF11 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
V0143 Ic - Aseptic Techniques For Iv Meds Standard
V0250 Dialysate Proportioning - Monitor Ph/Conductivity Standard
V0715 Md Resp - Ensure All Adhere To P&P Standard
▼ 342570 Ahoskie Dialysis 129 Hertford County High Rd Ahoskie NC 4 (Atlanta) 05/16/2019 UIBN11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
E0033 Methods For Sharing Information Standard
V0000 Initial Comments - Not A Deficiency Citation Memo
V0122 Ic - Clean, Disinfect Surfaces & Equipment/Written Protocols Standard
V0403 Pe - Equipment Maintenance - Manufacturer'S Dfu Standard
V0638 Continuously Monitor/Take Action/Track/Sustain Improve Standard
▼ 342570 Ahoskie Dialysis 129 Hertford County High Rd Ahoskie NC 4 (Atlanta) 04/27/2022 1SN311 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0452 Respect & Dignity Standard
V0558 Implement Updates Of Poc - 15 Days P Pt Assessment Standard
V0715 Md Resp - Ensure All Adhere To P&P Standard