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
392792 Grant One Dialysis 9475 Roosevelt Blvd Philadelphia PA 3 (Philadelphia) 01/18/2019 V6R511 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
392792 Grant One Dialysis 9475 Roosevelt Blvd Philadelphia PA 3 (Philadelphia) 01/21/2022 W54U11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
E0038 Esrd Ep Training Program Standard
V0000 Initial Comments - Not A Deficiency Citation Memo
V0113 Ic - Wear Gloves/Hand Hygiene Standard
V0520 Frequency Reassessment - Unstable - Monthly Standard
392792 Grant One Dialysis 9475 Roosevelt Blvd Philadelphia PA 3 (Philadelphia) 01/29/2025 SEBM11 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
V0543 Manage Volume Status Standard
392794 Broomall Dialysis 2835 West Chester Pike Suite 2 Broomall PA 3 (Philadelphia) 12/18/2019 I9RI11 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
V0142 Ic - Oversight: Monitor Activities & Implement Policies Standard
392796 Lake Erie Home Dialysis 2563 West 8th Street Erie PA 3 (Philadelphia) 06/07/2018 NFG011 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0124 Ic - Hbv - Test All Pts, Review Results/Pt Status Known Preadmit Standard
V0520 Frequency Reassessment - Unstable - Monthly Standard
392797 Paxton Dialysis 479 Port View Drive Suite B21 Harrisburg PA 3 (Philadelphia) 08/24/2018 HW1T11 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
V0130 Ic - Hbv - Isolation Of Machines/Equipment/Supplies Standard
V0147 Ic - Staff Education Re Catheters/Catheter Care Standard
V0190 Softeners - Automatically Regenerated/Timers/Salt/Salt Level Standard
V0516 Frequency - Initial: 30 Days/13 Tx Standard
V0519 Frequency Reassessment - Stable - Annual Standard
V0543 Manage Volume Status Standard
V0550 Vascular Access - Monitor/Referrals Standard
V0552 Psychosocial Counseling/Referrals/Assessment Tool Standard
V0587 Fac Receive/Review Self Monitoring Data Every 2 Months Standard
V0714 Md Resp - Develop, Review& Approve P&P Standard
V0715 Md Resp - Ensure All Adhere To P&P Standard
392797 Paxton Dialysis 479 Port View Drive Suite B21 Harrisburg PA 3 (Philadelphia) 01/16/2019 BQNH11 Complaint
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0122 Ic - Clean, Disinfect Surfaces & Equipment/Written Protocols Standard
V0228 Mixing Systems - Labeling Standard
392797 Paxton Dialysis 479 Port View Drive Suite B21 Harrisburg PA 3 (Philadelphia) 10/26/2020 TO4J11 Complaint, Special
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
V0101 Compliance With Fed/State/Local Laws Standard
V0110 Cfc - Infection Control Condition
V0115 Ic - Wear Gowns, Shields/Masks; Staff Not Eat/Drink In Tx Area Standard
V0122 Ic - Clean, Disinfect Surfaces & Equipment/Written Protocols Standard
V0124 Ic - Hbv - Test All Pts, Review Results/Pt Status Known Preadmit Standard
V0130 Ic - Hbv - Isolation Of Machines/Equipment/Supplies Standard
V0402 Pe - Building - Constructed/Maintained To Ensure Safety Standard
V0715 Md Resp - Ensure All Adhere To P&P Standard
392797 Paxton Dialysis 479 Port View Drive Suite B21 Harrisburg PA 3 (Philadelphia) 08/12/2021 65IT11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
E0040 Esrd Patient Orientation Training Standard
V0000 Initial Comments - Not A Deficiency Citation Memo
V0101 Compliance With Fed/State/Local Laws Standard
V0113 Ic - Wear Gloves/Hand Hygiene Standard
V0122 Ic - Clean, Disinfect Surfaces & Equipment/Written Protocols Standard
V0176 Water Purity - Ansi/Aami Rd52-2004 Standard
V0543 Manage Volume Status Standard
392797 Paxton Dialysis 479 Port View Drive Suite B21 Harrisburg PA 3 (Philadelphia) 08/19/2024 LR8L11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0110 Cfc - Infection Control Condition
V0111 Ic - Sanitary Environment Standard
V0122 Ic - Clean, Disinfect Surfaces & Equipment/Written Protocols Standard
V0190 Softeners - Automatically Regenerated/Timers/Salt/Salt Level Standard
V0191 Softeners - Testing Hardness/Log Standard
V0199 Ro - Meets Aami/Monitored, Recorded On Log Standard
V0323 Inventory Control Standard
V0400 Cfc - Physical Environment Condition
V0402 Pe - Building - Constructed/Maintained To Ensure Safety Standard
V0403 Pe - Equipment Maintenance - Manufacturer'S Dfu Standard
V0404 Pe - Patient Care Environment - Sufficient Space Standard