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
052305 Santa Clara Valley Medical Center - Esrd 2220 Moorpark Avenue San Jose CA 9 (San Francisco) 06/29/2018 PL0111 Standard
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0122 Ic - Clean, Disinfect Surfaces & Equipment/Written Protocols Standard
V0126 Ic - Hbv - Vaccinate Patients & Staff Standard
V0127 Ic - Hbv - Test Pts/Staff Post Last Dose Standard
V0128 Ic - Hbv - Isolation (Existing Facility) Standard
V0130 Ic - Hbv - Isolation Of Machines/Equipment/Supplies Standard
V0142 Ic - Oversight: Monitor Activities & Implement Policies Standard
V0213 Dist Sys - Culture/Lal/Sample Sites/Frequency(New)/Log Standard
V0552 Psychosocial Counseling/Referrals/Assessment Tool Standard
V0587 Fac Receive/Review Self Monitoring Data Every 2 Months Standard
V0628 Measure, Analyze And Track Quality Indicators Standard
V0715 Md Resp - Ensure All Adhere To P&P Standard
052305 Santa Clara Valley Medical Center - Esrd 2220 Moorpark Avenue San Jose CA 9 (San Francisco) 12/19/2023 12MV11 Complaint
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0715 Md Resp - Ensure All Adhere To P&P Standard
052305 Santa Clara Valley Medical Center - Esrd 2220 Moorpark Avenue San Jose CA 9 (San Francisco) 07/24/2025 YHPF11 Complaint
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0715 Md Resp - Ensure All Adhere To P&P Standard
052323 Kaiser Permanente-L A Dialysis 4700 Sunset Blvd, 2nd Floor Los Angeles CA 9 (San Francisco) 09/13/2018 NUQ311 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
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
V0130 Ic - Hbv - Isolation Of Machines/Equipment/Supplies Standard
V0142 Ic - Oversight: Monitor Activities & Implement Policies Standard
V0175 Cfc - Water And Dialysate Quality Condition
V0196 Carbon Adsorption - Monitoring, Testing Frequency Standard
V0250 Dialysate Proportioning - Monitor Ph/Conductivity Standard
V0260 Personnel - Training Program/Periodic Audits Standard
V0403 Pe - Equipment Maintenance - Manufacturer'S Dfu Standard
V0540 Cfc: Patient Plan Of Care Condition
V0543 Manage Volume Status Standard
V0550 Vascular Access - Monitor/Referrals Standard
V0625 Cfc - Quality Assessment & Performance Improvement Condition
V0627 Ongoing, Uses Indicators - Improved Health Outcomes Standard
V0633 Qapi Indicator - Vascular Access Standard
V0637 Qapi Indicator - Infection Control - Trend/Plan/Act Standard
V0710 Cfc - Responsibilities Of The Medical Director Condition
V0715 Md Resp - Ensure All Adhere To P&P Standard
052323 Kaiser Permanente-L A Dialysis 4700 Sunset Blvd, 2nd Floor Los Angeles CA 9 (San Francisco) 11/26/2018 NUQ321 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
E0029 Development Of Communication Plan Standard
K0000 Initial Comments - Not A Deficiency Citation Memo
K0912 Electrical Systems - Receptacles Standard
K0918 Electrical Systems - Essential Electric Syste Standard
052323 Kaiser Permanente-L A Dialysis 4700 Sunset Blvd, 2nd Floor Los Angeles CA 9 (San Francisco) 07/10/2019 1QKO11 Standard
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
V0199 Ro - Meets Aami/Monitored, Recorded On Log Standard
V0502 Assess Current Health Status Inc Comorbids Standard
V0503 Appropriateness Of Dialysis Rx Standard
V0587 Fac Receive/Review Self Monitoring Data Every 2 Months Standard
V0714 Md Resp - Develop, Review& Approve P&P Standard
052323 Kaiser Permanente-L A Dialysis 4700 Sunset Blvd, 2nd Floor Los Angeles CA 9 (San Francisco) 08/12/2020 S93X11 Complaint
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0142 Ic - Oversight: Monitor Activities & Implement Policies Standard
V0681 Staff Licensed As Req/Qualified/Demonstrate Competencies Standard
052334 Arrowhead Regional Medical Center 400 North Pepper Avenue Colton CA 9 (San Francisco) 04/12/2019 STQ611 Standard
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0143 Ic - Aseptic Techniques For Iv Meds Standard
V0337 Blood Path Integrity Test After Q Use Standard
V0403 Pe - Equipment Maintenance - Manufacturer'S Dfu Standard
V0730 Mr - Centralize All Info, Each Member Of Idt Has Access Standard
052368 St Joseph Hospital Renal Center 1100 West Stewart Dr Orange CA 9 (San Francisco) 07/12/2018 785611 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
V0111 Ic - Sanitary Environment Standard
V0113 Ic - Wear Gloves/Hand Hygiene Standard
V0122 Ic - Clean, Disinfect Surfaces & Equipment/Written Protocols Standard
V0250 Dialysate Proportioning - Monitor Ph/Conductivity Standard
V0543 Manage Volume Status Standard
V0544 Achieve Adequate Clearance Standard
V0594 Preconfig Hd Sys -Testing Water/Dialysate Follow Dfu/Fda Standard
V0714 Md Resp - Develop, Review& Approve P&P Standard
V0715 Md Resp - Ensure All Adhere To P&P Standard
V0726 Medical Records - Complete, Accurate, Accessible Standard
052381 Kaiser Hosp Woodland Hills Pd 5601 De Soto Ave Woodland Hills CA 9 (San Francisco) 01/18/2019 OUHE11 Standard
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0516 Frequency - Initial: 30 Days/13 Tx Standard
V0517 F/U Reassessment - Within 3 Months Of Initial Standard
V0558 Implement Updates Of Poc - 15 Days P Pt Assessment Standard
V0715 Md Resp - Ensure All Adhere To P&P Standard
V0726 Medical Records - Complete, Accurate, Accessible Standard