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
342726 Glen Raven Dialysis 2210 W Webb Avenue Burlington NC 4 (Atlanta) 04/09/2025 SFTG11 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
V0197 Carbon Adsorption - Action If First Test Positive Standard
V0199 Ro - Meets Aami/Monitored, Recorded On Log Standard
V0229 Mixing Systems - Permanent Record/Verification Testing Standard
V0543 Manage Volume Status Standard
342727 Fayetteville Road Dialysis 285 Paraclete Drive Raeford NC 4 (Atlanta) 05/27/2021 Q5FF11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
V0116 Ic - Items Taken To Station Disposed/Dedicated Or Disinfected Standard
V0199 Ro - Meets Aami/Monitored, Recorded On Log Standard
V0407 Pe - Hemodialysis Patients In View During Treatments Standard
V0543 Manage Volume Status Standard
V0550 Vascular Access - Monitor/Referrals Standard
342727 Fayetteville Road Dialysis 285 Paraclete Drive Raeford NC 4 (Atlanta) 06/06/2024 O19B11 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
V0407 Pe - Hemodialysis Patients In View During Treatments Standard
V0543 Manage Volume Status Standard
V0715 Md Resp - Ensure All Adhere To P&P Standard
342728 Nash County Dialysis 110 Enterprise Drive Rocky Mount NC 4 (Atlanta) 07/08/2021 NP9C11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0147 Ic - Staff Education Re Catheters/Catheter Care Standard
V0403 Pe - Equipment Maintenance - Manufacturer'S Dfu Standard
V0407 Pe - Hemodialysis Patients In View During Treatments Standard
V0543 Manage Volume Status Standard
V0544 Achieve Adequate Clearance Standard
V0587 Fac Receive/Review Self Monitoring Data Every 2 Months Standard
342729 Catawba County Dialysis 1900 3rd Avenue Lane Se Hickory NC 4 (Atlanta) 02/16/2024 MTTG11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0502 Assess Current Health Status Inc Comorbids Standard
V0543 Manage Volume Status Standard
V0544 Achieve Adequate Clearance Standard
V0715 Md Resp - Ensure All Adhere To P&P Standard
342730 Spencer Dialysis 1287 N Salisbury Avenue Spencer NC 4 (Atlanta) 01/16/2025 4PUE11 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
V0510 Msw - Psychosocial Needs Standard
V0516 Frequency - Initial: 30 Days/13 Tx Standard
V0517 F/U Reassessment - Within 3 Months Of Initial Standard
V0519 Frequency Reassessment - Stable - Annual Standard
V0557 Initial Poc Implemented - 30 Days/13 Tx Standard
V0628 Measure, Analyze And Track Quality Indicators Standard
342731 Brookshire Dialysis 5601 Tuckaseegee Road Charlotte NC 4 (Atlanta) 06/17/2021 I2S611 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0247 Conc Outlets - Separate/Labeled/Connection Safety Standard
V0550 Vascular Access - Monitor/Referrals Standard
342731 Brookshire Dialysis 5601 Tuckaseegee Road Charlotte NC 4 (Atlanta) 07/11/2024 KLKI11 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
V0403 Pe - Equipment Maintenance - Manufacturer'S Dfu Standard
V0715 Md Resp - Ensure All Adhere To P&P Standard
342732 Bull City Dialysis 3607 Witherspoon Blvd Durham NC 4 (Atlanta) 03/12/2020 M8SF11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0143 Ic - Aseptic Techniques For Iv Meds Standard
V0503 Appropriateness Of Dialysis Rx Standard
V0771 Electronic Data Submission Required For Program Adm Standard
342732 Bull City Dialysis 3607 Witherspoon Blvd Durham NC 4 (Atlanta) 03/02/2023 6KEQ11 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
V0715 Md Resp - Ensure All Adhere To P&P Standard