S&C QCOR ESRD 2567s
d QCOR:  Quality, Certification and Oversight Reports.
ESRDs 2567s
Selection Criteria

Time Interval

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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
042553 Jacksonville Central Dialysis Center 400 T P White Drive Jacksonville AR 6 (Dallas) 04/16/2021 UOZU11 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
V0117 Ic - Clean/Dirty Areas, Med Prep Area, No Common Med Carts Standard
V0122 Ic - Clean, Disinfect Surfaces & Equipment/Written Protocols Standard
V0132 Ic - Training And Education Standard
V0143 Ic - Aseptic Techniques For Iv Meds Standard
V0402 Pe - Building - Constructed/Maintained To Ensure Safety Standard
V0403 Pe - Equipment Maintenance - Manufacturer'S Dfu Standard
V0407 Pe - Hemodialysis Patients In View During Treatments Standard
V0503 Appropriateness Of Dialysis Rx Standard
V0520 Frequency Reassessment - Unstable - Monthly Standard
V0543 Manage Volume Status Standard
V0544 Achieve Adequate Clearance Standard
V0547 Manage Anemia/H/H Measured Monthly Standard
V0558 Implement Updates Of Poc - 15 Days P Pt Assessment Standard
V0632 Qapi Indicator - Anemia Management Standard
V0638 Continuously Monitor/Take Action/Track/Sustain Improve Standard
V0684 Nurse Manager - 12 Mo Rn + 6 Mo Dialysis Standard
V0715 Md Resp - Ensure All Adhere To P&P Standard
V0726 Medical Records - Complete, Accurate, Accessible Standard
042554 Jackson County Dialysis 1912 Mclain Pratt Square Newport AR 6 (Dallas) 06/08/2018 XK3511 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
E0024 Policies/Procedures-Volunteers And Staffing Standard
E0026 Roles Under A Waiver Declared By Secretary Standard
E0039 Ep Testing Requirements Standard
V0000 Initial Comments - Not A Deficiency Citation Memo
V0113 Ic - Wear Gloves/Hand Hygiene Standard
V0122 Ic - Clean, Disinfect Surfaces & Equipment/Written Protocols Standard
V0128 Ic - Hbv - Isolation (Existing Facility) Standard
V0143 Ic - Aseptic Techniques For Iv Meds Standard
V0184 Environment: Secure And Restricted Standard
V0193 Carbon Adsorption - Banks Of Tanks Standard
V0196 Carbon Adsorption - Monitoring, Testing Frequency Standard
V0228 Mixing Systems - Labeling Standard
V0403 Pe - Equipment Maintenance - Manufacturer'S Dfu Standard
V0557 Initial Poc Implemented - 30 Days/13 Tx Standard
V0681 Staff Licensed As Req/Qualified/Demonstrate Competencies Standard
V0772 Responds To Nw Requests/Works Toward Goals Standard
042556 Benton Dialysis 2101 Congo Road Benton AR 6 (Dallas) 01/24/2019 3NZ011 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
V0113 Ic - Wear Gloves/Hand Hygiene Standard
V0115 Ic - Wear Gowns, Shields/Masks; Staff Not Eat/Drink In Tx Area Standard
V0117 Ic - Clean/Dirty Areas, Med Prep Area, No Common Med Carts Standard
V0122 Ic - Clean, Disinfect Surfaces & Equipment/Written Protocols Standard
V0147 Ic - Staff Education Re Catheters/Catheter Care Standard
V0189 Cartridge Filters - Config And Monitoring Standard
V0207 Ultrafiltration - Effective/Opaque Housing/Monitoring Standard
V0403 Pe - Equipment Maintenance - Manufacturer'S Dfu Standard
V0504 Assess B/P & Fluid Management Needs Standard
V0509 Rd - Nutritional Status Standard
V0513 Transplantation Referral Standard
V0520 Frequency Reassessment - Unstable - Monthly Standard
V0543 Manage Volume Status Standard
V0545 Effective Nutritional Status Standard
V0554 Transplantation Status Plan Or Why Not Standard
V0638 Continuously Monitor/Take Action/Track/Sustain Improve Standard
042556 Benton Dialysis 2101 Congo Road Benton AR 6 (Dallas) 07/28/2021 Z9DH11 Complaint
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
V0504 Assess B/P & Fluid Management Needs Standard
V0543 Manage Volume Status Standard
042556 Benton Dialysis 2101 Congo Road Benton AR 6 (Dallas) 07/08/2022 T7SF11 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
V0130 Ic - Hbv - Isolation Of Machines/Equipment/Supplies Standard
V0403 Pe - Equipment Maintenance - Manufacturer'S Dfu Standard
V0503 Appropriateness Of Dialysis Rx Standard
042556 Benton Dialysis 2101 Congo Road Benton AR 6 (Dallas) 03/26/2025 MGMP11 Standard
Deficiency Tag Deficiency Description Tag Type
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
V0187 Environment - Schematic Diagrams/Labels Standard
V0190 Softeners - Automatically Regenerated/Timers/Salt/Salt Level Standard
V0402 Pe - Building - Constructed/Maintained To Ensure Safety Standard
V0403 Pe - Equipment Maintenance - Manufacturer'S Dfu Standard
V0407 Pe - Hemodialysis Patients In View During Treatments Standard
V0454 Privacy & Confidentiality In Treatment Standard
V0502 Assess Current Health Status Inc Comorbids Standard
042557 Independence County Dialysis 1700 Harrison Street, Suite F Batesville AR 6 (Dallas) 07/18/2018 X4RD11 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
V0115 Ic - Wear Gowns, Shields/Masks; Staff Not Eat/Drink In Tx Area Standard
V0122 Ic - Clean, Disinfect Surfaces & Equipment/Written Protocols Standard
V0403 Pe - Equipment Maintenance - Manufacturer'S Dfu Standard
V0506 Immunization/Medication History Standard
V0547 Manage Anemia/H/H Measured Monthly Standard
V0628 Measure, Analyze And Track Quality Indicators Standard
V0772 Responds To Nw Requests/Works Toward Goals Standard
042557 Independence County Dialysis 1700 Harrison Street, Suite F Batesville AR 6 (Dallas) 10/09/2024 DJNL11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0184 Environment: Secure And Restricted Standard
V0402 Pe - Building - Constructed/Maintained To Ensure Safety Standard
V0403 Pe - Equipment Maintenance - Manufacturer'S Dfu Standard
V0502 Assess Current Health Status Inc Comorbids Standard
V0504 Assess B/P & Fluid Management Needs Standard
V0543 Manage Volume Status Standard
042558 Saline County Dialysis 1200 North Main, Suite 2 Benton AR 6 (Dallas) 07/13/2018 3N8411 Complaint, Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
E0018 Procedures For Tracking Of Staff And Patients Standard
E0028 Dialysis Emergency Equipment Standard
E0033 Methods For Sharing Information Standard
E0038 Esrd Ep Training Program Standard
E0039 Ep Testing Requirements Standard
E0040 Esrd Patient Orientation Training Standard
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
V0117 Ic - Clean/Dirty Areas, Med Prep Area, No Common Med Carts Standard
V0122 Ic - Clean, Disinfect Surfaces & Equipment/Written Protocols Standard
V0132 Ic - Training And Education Standard
V0143 Ic - Aseptic Techniques For Iv Meds Standard
V0402 Pe - Building - Constructed/Maintained To Ensure Safety Standard
V0403 Pe - Equipment Maintenance - Manufacturer'S Dfu Standard
V0407 Pe - Hemodialysis Patients In View During Treatments Standard
V0507 Assess Anemia Standard
V0520 Frequency Reassessment - Unstable - Monthly Standard
V0543 Manage Volume Status Standard
V0547 Manage Anemia/H/H Measured Monthly Standard
V0550 Vascular Access - Monitor/Referrals Standard
V0558 Implement Updates Of Poc - 15 Days P Pt Assessment Standard
V0638 Continuously Monitor/Take Action/Track/Sustain Improve Standard
V0681 Staff Licensed As Req/Qualified/Demonstrate Competencies Standard
V0715 Md Resp - Ensure All Adhere To P&P Standard
V0726 Medical Records - Complete, Accurate, Accessible Standard
V0765 Internal Grievance Process Components & Implemented Standard
V0772 Responds To Nw Requests/Works Toward Goals Standard
042558 Saline County Dialysis 1200 North Main, Suite 2 Benton AR 6 (Dallas) 01/29/2019 55YU11 Complaint
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0401 Pe - Safe, Functional, Comfortable Environment Standard
V0751 Identifiable Governing Body W/Full Authority/Responsibility Standard