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
672763 Dialyspa Vintage Park 102 Vintage Park Blvd, Bldg L, Ste A Houston TX 6 (Dallas) 07/18/2019 LIPY11 Complaint, 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
V0120 Ic - Transducer Protectors: Not Wetted/Changed Standard
V0122 Ic - Clean, Disinfect Surfaces & Equipment/Written Protocols Standard
V0147 Ic - Staff Education Re Catheters/Catheter Care Standard
V0184 Environment: Secure And Restricted Standard
V0400 Cfc - Physical Environment Condition
V0403 Pe - Equipment Maintenance - Manufacturer'S Dfu Standard
V0463 Receive Services Outlined In Poc Standard
V0626 Covers Scope Of Services/Effective/Idt Involved Standard
V0750 Cfc - Governance Condition
V0754 Adm Resp For Fiscal Operations Standard
672763 Dialyspa Vintage Park 102 Vintage Park Blvd, Bldg L, Ste A Houston TX 6 (Dallas) 10/15/2019 LIPY12 Standard
Deficiency Tag Deficiency Description Tag Type
V0519 Frequency Reassessment - Stable - Annual Standard
V0520 Frequency Reassessment - Unstable - Monthly Standard
V0558 Implement Updates Of Poc - 15 Days P Pt Assessment Standard
672764 Green Oak Dialysis 1426 Kingwood Dr Kingwood TX 6 (Dallas) 08/09/2019 4KLE11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0727 Mr - Protect Patient Records From Loss/Keep Confidential Standard
672766 Fresenius Medical Care Harker Heights 625 W Central Texas Expressway Harker Heights TX 6 (Dallas) 06/04/2024 PBOF11 Complaint
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0101 Compliance With Fed/State/Local Laws Standard
V0111 Ic - Sanitary Environment Standard
672767 Pine Park Dialysis 3333 Bayshore Blvd Pasadena TX 6 (Dallas) 09/06/2019 M42F11 Complaint, 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
V0715 Md Resp - Ensure All Adhere To P&P Standard
V0758 Rn, Msw, & Rd Available To Meet Patient Needs Standard
672767 Pine Park Dialysis 3333 Bayshore Blvd Pasadena TX 6 (Dallas) 03/28/2025 P7YB11 Complaint
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0101 Compliance With Fed/State/Local Laws Standard
V0117 Ic - Clean/Dirty Areas, Med Prep Area, No Common Med Carts Standard
V0122 Ic - Clean, Disinfect Surfaces & Equipment/Written Protocols Standard
V0403 Pe - Equipment Maintenance - Manufacturer'S Dfu Standard
672767 Pine Park Dialysis 3333 Bayshore Blvd Pasadena TX 6 (Dallas) 09/10/2025 F0V111 Complaint
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0111 Ic - Sanitary Environment Standard
V0113 Ic - Wear Gloves/Hand Hygiene Standard
V0122 Ic - Clean, Disinfect Surfaces & Equipment/Written Protocols Standard
V0407 Pe - Hemodialysis Patients In View During Treatments Standard
V0463 Receive Services Outlined In Poc Standard
V0508 Assess Renal Bone Disease Standard
V0516 Frequency - Initial: 30 Days/13 Tx Standard
V0557 Initial Poc Implemented - 30 Days/13 Tx Standard
V0715 Md Resp - Ensure All Adhere To P&P Standard
672769 Riverstone Dialysis 5672 Highway 6 Missouri City TX 6 (Dallas) 02/21/2019 PU5411 Complaint
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0113 Ic - Wear Gloves/Hand Hygiene Standard
V0122 Ic - Clean, Disinfect Surfaces & Equipment/Written Protocols Standard
V0502 Assess Current Health Status Inc Comorbids Standard
672769 Riverstone Dialysis 5672 Highway 6 Missouri City TX 6 (Dallas) 03/12/2020 RNM611 Complaint, 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
V0122 Ic - Clean, Disinfect Surfaces & Equipment/Written Protocols Standard
V0126 Ic - Hbv - Vaccinate Patients & Staff Standard
V0274 Water Test Results - Deviations Require Corrective Action Plan Standard
V0403 Pe - Equipment Maintenance - Manufacturer'S Dfu Standard
V0750 Cfc - Governance Condition
V0757 Staff # & Ratio Meet Patient Needs Standard
V0760 Gb - Responsible For Staff Oriented To Facility & Resp Standard
672769 Riverstone Dialysis 5672 Highway 6 Missouri City TX 6 (Dallas) 03/14/2023 QJ0Q11 Complaint
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0407 Pe - Hemodialysis Patients In View During Treatments Standard
V0715 Md Resp - Ensure All Adhere To P&P Standard