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
342623 Fmc Dialysis Services Of Robes 704 S Walnut Street Fairmont NC 4 (Atlanta) 01/16/2025 B1NF11 Complaint, Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0520 Frequency Reassessment - Unstable - Monthly Standard
V0543 Manage Volume Status Standard
V0681 Staff Licensed As Req/Qualified/Demonstrate Competencies Standard
V0715 Md Resp - Ensure All Adhere To P&P Standard
342625 Fmc Dialysis Service Of Jones County 110 Industrial Park Drive Trenton NC 4 (Atlanta) 07/02/2019 BDZ411 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
V0543 Manage Volume Status Standard
V0550 Vascular Access - Monitor/Referrals Standard
342625 Fmc Dialysis Service Of Jones County 110 Industrial Park Drive Trenton NC 4 (Atlanta) 06/29/2022 FH7W11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0715 Md Resp - Ensure All Adhere To P&P Standard
342627 Charlotte East Dialysis 5627 Albemarle Road Charlotte NC 4 (Atlanta) 04/27/2018 WCJ911 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
V0116 Ic - Items Taken To Station Disposed/Dedicated Or Disinfected Standard
V0122 Ic - Clean, Disinfect Surfaces & Equipment/Written Protocols Standard
V0130 Ic - Hbv - Isolation Of Machines/Equipment/Supplies Standard
V0143 Ic - Aseptic Techniques For Iv Meds Standard
V0147 Ic - Staff Education Re Catheters/Catheter Care Standard
V0401 Pe - Safe, Functional, Comfortable Environment Standard
V0544 Achieve Adequate Clearance Standard
342627 Charlotte East Dialysis 5627 Albemarle Road Charlotte NC 4 (Atlanta) 04/30/2021 PUVV11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0407 Pe - Hemodialysis Patients In View During Treatments Standard
V0504 Assess B/P & Fluid Management Needs Standard
V0544 Achieve Adequate Clearance Standard
V0587 Fac Receive/Review Self Monitoring Data Every 2 Months Standard
V0715 Md Resp - Ensure All Adhere To P&P Standard
342627 Charlotte East Dialysis 5627 Albemarle Road Charlotte NC 4 (Atlanta) 04/25/2025 HWGY11 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
V0229 Mixing Systems - Permanent Record/Verification Testing Standard
V0715 Md Resp - Ensure All Adhere To P&P Standard
342629 Waynesville Dialysis Center 11 Park Terrace Drive Clyde NC 4 (Atlanta) 05/09/2019 UTNJ11 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
V0500 Cfc - Patient Assessment Condition
V0503 Appropriateness Of Dialysis Rx Standard
V0710 Cfc - Responsibilities Of The Medical Director Condition
V0750 Cfc - Governance Condition
342631 Copperfield Dialysis 1030 Vinehaven Drive Concord NC 4 (Atlanta) 05/22/2019 N5KT11 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
V0147 Ic - Staff Education Re Catheters/Catheter Care Standard
V0551 Va Monitor To Prevent Failure/Stenosis Standard
V0726 Medical Records - Complete, Accurate, Accessible Standard
342631 Copperfield Dialysis 1030 Vinehaven Drive Concord NC 4 (Atlanta) 05/19/2022 GSGT11 Standard
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0229 Mixing Systems - Permanent Record/Verification Testing Standard
342632 Fmc Care Of Ayden 3793 Lee Street Ayden NC 4 (Atlanta) 05/04/2022 RMMG11 Complaint
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0543 Manage Volume Status Standard