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
052770 Selma Dialysis 2711 Cinema Way, Suite 111 Selma CA 9 (San Francisco) 07/25/2019 F5H411 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
E0039 Ep Testing Requirements Standard
V0000 Initial Comments - Not A Deficiency Citation Memo
V0111 Ic - Sanitary Environment Standard
V0116 Ic - Items Taken To Station Disposed/Dedicated Or Disinfected Standard
V0503 Appropriateness Of Dialysis Rx Standard
V0543 Manage Volume Status Standard
V0544 Achieve Adequate Clearance Standard
V0557 Initial Poc Implemented - 30 Days/13 Tx Standard
V0558 Implement Updates Of Poc - 15 Days P Pt Assessment Standard
V0628 Measure, Analyze And Track Quality Indicators Standard
052771 Visalia At Home 1120 N Chinowth St Visalia CA 9 (San Francisco) 09/17/2021 JUXU11 Special, Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0547 Manage Anemia/H/H Measured Monthly Standard
052772 Rai - Hospital Circle - Westminster 290 Hospital Circle Westminster CA 9 (San Francisco) 05/09/2019 95WZ11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0111 Ic - Sanitary Environment Standard
V0113 Ic - Wear Gloves/Hand Hygiene Standard
V0117 Ic - Clean/Dirty Areas, Med Prep Area, No Common Med Carts Standard
V0122 Ic - Clean, Disinfect Surfaces & Equipment/Written Protocols Standard
V0543 Manage Volume Status Standard
V0544 Achieve Adequate Clearance Standard
V0550 Vascular Access - Monitor/Referrals Standard
V0715 Md Resp - Ensure All Adhere To P&P Standard
052773 Westminster South Dialysis 14014 Magnolia St Westminster CA 9 (San Francisco) 03/13/2019 FZ1L11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
E0028 Dialysis Emergency Equipment Standard
E0038 Esrd Ep Training Program Standard
V0000 Initial Comments - Not A Deficiency Citation Memo
V0111 Ic - Sanitary Environment 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
V0117 Ic - Clean/Dirty Areas, Med Prep Area, No Common Med Carts Standard
V0407 Pe - Hemodialysis Patients In View During Treatments Standard
V0543 Manage Volume Status Standard
V0544 Achieve Adequate Clearance Standard
V0715 Md Resp - Ensure All Adhere To P&P Standard
052776 Hi Desert Dialysis 56845 Twentynine Palms Highway Yucca Valley CA 9 (San Francisco) 11/22/2019 06U611 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
V0143 Ic - Aseptic Techniques For Iv Meds Standard
V0147 Ic - Staff Education Re Catheters/Catheter Care Standard
V0323 Inventory Control Standard
V0407 Pe - Hemodialysis Patients In View During Treatments Standard
V0505 Assess Lab Profile Standard
V0546 Manage Mineral Metabolism Standard
V0675 Cfc - Laboratory Services Condition
V0676 Clia Labs/Meet Needs Of Patients Standard
V0750 Cfc - Governance Condition
052778 Santa Clarita Kidney Center 23861 Mcbean Parkway Suite 11 Valencia CA 9 (San Francisco) 09/11/2018 ITCX11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
E0028 Dialysis Emergency Equipment Standard
V0110 Cfc - Infection Control Condition
V0111 Ic - Sanitary Environment Standard
V0113 Ic - Wear Gloves/Hand Hygiene Standard
V0114 Ic - Sinks Available Standard
V0116 Ic - Items Taken To Station Disposed/Dedicated Or Disinfected Standard
V0117 Ic - Clean/Dirty Areas, Med Prep Area, No Common Med Carts Standard
V0118 Ic - Single Use Vials Standard
V0121 Ic - Handling Infectious Waste Standard
V0122 Ic - Clean, Disinfect Surfaces & Equipment/Written Protocols Standard
V0142 Ic - Oversight: Monitor Activities & Implement Policies Standard
V0147 Ic - Staff Education Re Catheters/Catheter Care Standard
V0196 Carbon Adsorption - Monitoring, Testing Frequency Standard
V0231 Acid Conc Mixing Sys - Empty Completely//Prevent Corrosion Standard
V0234 Bicarb Mixing Sys - Not Overmixed Standard
V0403 Pe - Equipment Maintenance - Manufacturer'S Dfu Standard
V0407 Pe - Hemodialysis Patients In View During Treatments Standard
V0453 Receive Information In An Understandable Way Standard
V0503 Appropriateness Of Dialysis Rx Standard
V0504 Assess B/P & Fluid Management Needs Standard
V0516 Frequency - Initial: 30 Days/13 Tx Standard
V0520 Frequency Reassessment - Unstable - Monthly Standard
V0541 Patient Plan Of Care - Goals - Community-Based Standards Standard
V0543 Manage Volume Status Standard
V0544 Achieve Adequate Clearance Standard
V0547 Manage Anemia/H/H Measured Monthly Standard
V0726 Medical Records - Complete, Accurate, Accessible Standard
052778 Santa Clarita Kidney Center 23861 Mcbean Parkway Suite 11 Valencia CA 9 (San Francisco) 10/26/2018 ITCX12 Standard
Deficiency Tag Deficiency Description Tag Type
V0115 Ic - Wear Gowns, Shields/Masks; Staff Not Eat/Drink In Tx Area Standard
V0550 Vascular Access - Monitor/Referrals Standard
052781 North Hollywood Dialysis 12126 Victory Boulevard N Hollywood CA 9 (San Francisco) 06/01/2020 JL7M11 Complaint
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0502 Assess Current Health Status Inc Comorbids Standard
052781 North Hollywood Dialysis 12126 Victory Boulevard N Hollywood CA 9 (San Francisco) 02/24/2022 PE7Z11 Standard
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0117 Ic - Clean/Dirty Areas, Med Prep Area, No Common Med Carts Standard
V0401 Pe - Safe, Functional, Comfortable Environment Standard
V0544 Achieve Adequate Clearance Standard
052782 Duarte Monrovia Dialysis 900 South Mountain Avenue Monrovia CA 9 (San Francisco) 02/06/2020 5JLJ11 Standard
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0113 Ic - Wear Gloves/Hand Hygiene Standard
V0229 Mixing Systems - Permanent Record/Verification Testing Standard
V0250 Dialysate Proportioning - Monitor Ph/Conductivity Standard
V0401 Pe - Safe, Functional, Comfortable Environment Standard
V0403 Pe - Equipment Maintenance - Manufacturer'S Dfu Standard
V0501 Patient Assessment - Interdisciplinary Team Mbrs/Resp. Standard
V0503 Appropriateness Of Dialysis Rx Standard
V0506 Immunization/Medication History Standard
V0516 Frequency - Initial: 30 Days/13 Tx Standard
V0520 Frequency Reassessment - Unstable - Monthly Standard
V0556 Poc Completed/Signed By Idt & Patient Standard
V0557 Initial Poc Implemented - 30 Days/13 Tx Standard
V0714 Md Resp - Develop, Review& Approve P&P Standard
V0715 Md Resp - Ensure All Adhere To P&P Standard