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
052384 Kaiser Foundation Hospitals, I 6041 Cadillac Ave Los Angeles CA 9 (San Francisco) 03/03/2020 KG5W11 Standard
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0114 Ic - Sinks Available Standard
V0519 Frequency Reassessment - Stable - Annual Standard
V0556 Poc Completed/Signed By Idt & Patient Standard
V0587 Fac Receive/Review Self Monitoring Data Every 2 Months Standard
052389 Kaiser Foundation Hosp-Downey Dialysis 9333 Imperial Highway Downey CA 9 (San Francisco) 12/12/2018 26S011 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0503 Appropriateness Of Dialysis Rx Standard
052389 Kaiser Foundation Hosp-Downey Dialysis 9333 Imperial Highway Downey CA 9 (San Francisco) 06/06/2021 7CJT11 Complaint
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0452 Respect & Dignity Standard
052390 Lucile Salter Packard Children's Hospital Esrd 725 Welch Road Palo Alto CA 9 (San Francisco) 06/20/2019 LCQP11 Standard
Deficiency Tag Deficiency Description Tag Type
E0028 Dialysis Emergency Equipment Standard
V0000 Initial Comments - Not A Deficiency Citation Memo
V0111 Ic - Sanitary Environment Standard
V0124 Ic - Hbv - Test All Pts, Review Results/Pt Status Known Preadmit Standard
V0196 Carbon Adsorption - Monitoring, Testing Frequency Standard
V0628 Measure, Analyze And Track Quality Indicators Standard
V0637 Qapi Indicator - Infection Control - Trend/Plan/Act Standard
V0681 Staff Licensed As Req/Qualified/Demonstrate Competencies Standard
V0726 Medical Records - Complete, Accurate, Accessible Standard
052394 Kaiser Foundation Hospitals, Anaheim 3460 La Palma Ave Anaheim CA 9 (San Francisco) 06/03/2021 NBOD11 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
V0506 Immunization/Medication History Standard
V0726 Medical Records - Complete, Accurate, Accessible Standard
052397 San Francisco General Hospital Renal Center 1001 Potrero Avenue San Francisco CA 9 (San Francisco) 01/30/2018 KZNA12 Complaint
Deficiency Tag Deficiency Description Tag Type
V0110 Cfc - Infection Control null
V0124 Ic - Hbv - Test All Pts, Review Results/Pt Status Known Preadmit null
V0128 Ic - Hbv - Isolation (Existing Facility) null
V0516 Frequency - Initial: 30 Days/13 Tx null
052398 Kaiser Foundation Hospital San Leandro Esrd 27303 Sleepy Hollow Avenue Hayward CA 9 (San Francisco) 06/27/2019 D13V11 Standard
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0715 Md Resp - Ensure All Adhere To P&P Standard
052398 Kaiser Foundation Hospital San Leandro Esrd 27303 Sleepy Hollow Avenue Hayward CA 9 (San Francisco) 07/27/2019 D13V12 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
E0028 Dialysis Emergency Equipment Standard
052399 Kaiser Foundation Hospita Baldwin Park Esrd 1813 North Hacienda Boulevard La Puente CA 9 (San Francisco) 08/01/2019 BD6B11 Standard
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0113 Ic - Wear Gloves/Hand Hygiene Standard
V0114 Ic - Sinks Available Standard
V0517 F/U Reassessment - Within 3 Months Of Initial Standard
V0520 Frequency Reassessment - Unstable - Monthly Standard
V0558 Implement Updates Of Poc - 15 Days P Pt Assessment Standard
V0714 Md Resp - Develop, Review& Approve P&P Standard
V0715 Md Resp - Ensure All Adhere To P&P Standard
052406 Loma Linda Univ Children's Hosp Ped Chronic Dialy 11234 Anderson St Loma Linda CA 9 (San Francisco) 08/09/2019 JTLF11 Standard
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0110 Cfc - Infection Control Condition
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
V0122 Ic - Clean, Disinfect Surfaces & Equipment/Written Protocols Standard
V0147 Ic - Staff Education Re Catheters/Catheter Care Standard
V0403 Pe - Equipment Maintenance - Manufacturer'S Dfu Standard
V0407 Pe - Hemodialysis Patients In View During Treatments Standard
V0504 Assess B/P & Fluid Management Needs Standard
V0625 Cfc - Quality Assessment & Performance Improvement Condition
V0715 Md Resp - Ensure All Adhere To P&P Standard
V0726 Medical Records - Complete, Accurate, Accessible Standard