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
052600 Satellite Dialysis 393 Blossom Hill Road Suite 110 San Jose CA 9 (San Francisco) 11/08/2019 DWWP11 Standard
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0110 Cfc - Infection Control Condition
V0116 Ic - Items Taken To Station Disposed/Dedicated Or Disinfected Standard
V0124 Ic - Hbv - Test All Pts, Review Results/Pt Status Known Preadmit Standard
V0126 Ic - Hbv - Vaccinate Patients & Staff Standard
V0127 Ic - Hbv - Test Pts/Staff Post Last Dose Standard
V0130 Ic - Hbv - Isolation Of Machines/Equipment/Supplies Standard
V0131 Ic - Hbv - Isolation - Staffing Standard
V0196 Carbon Adsorption - Monitoring, Testing Frequency Standard
V0625 Cfc - Quality Assessment & Performance Improvement Condition
V0628 Measure, Analyze And Track Quality Indicators Standard
V0637 Qapi Indicator - Infection Control - Trend/Plan/Act Standard
V0713 Md Resp - Staff Ed, Training & Performance Standard
V0715 Md Resp - Ensure All Adhere To P&P Standard
052602 Salinas Valley Dialysis Center 955 Blanco Circle Ste C Salinas CA 9 (San Francisco) 01/09/2019 OKI111 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
V0124 Ic - Hbv - Test All Pts, Review Results/Pt Status Known Preadmit Standard
V0127 Ic - Hbv - Test Pts/Staff Post Last Dose Standard
V0190 Softeners - Automatically Regenerated/Timers/Salt/Salt Level Standard
V0195 Carbon Adsorption - 10 Minutes Ebct Standard
V0196 Carbon Adsorption - Monitoring, Testing Frequency Standard
V0253 Microbial Monitoring - Mo Dialysate Sample/Collection/Freq Standard
V0401 Pe - Safe, Functional, Comfortable Environment Standard
V0403 Pe - Equipment Maintenance - Manufacturer'S Dfu Standard
V0407 Pe - Hemodialysis Patients In View During Treatments Standard
V0552 Psychosocial Counseling/Referrals/Assessment Tool Standard
V0628 Measure, Analyze And Track Quality Indicators Standard
V0713 Md Resp - Staff Ed, Training & Performance Standard
V0715 Md Resp - Ensure All Adhere To P&P Standard
V0726 Medical Records - Complete, Accurate, Accessible Standard
052602 Salinas Valley Dialysis Center 955 Blanco Circle Ste C Salinas CA 9 (San Francisco) 08/13/2019 BJ2N11 Complaint
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0452 Respect & Dignity Standard
052604 Manzanita Dialysis Center 4005 Manzanita Ave Suite 17 Carmichael CA 9 (San Francisco) 03/19/2018 PQEU11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0128 Ic - Hbv - Isolation (Existing Facility) Standard
V0142 Ic - Oversight: Monitor Activities & Implement Policies Standard
V0503 Appropriateness Of Dialysis Rx Standard
V0519 Frequency Reassessment - Stable - Annual Standard
V0713 Md Resp - Staff Ed, Training & Performance Standard
V0726 Medical Records - Complete, Accurate, Accessible Standard
052606 Santa Barbara Artificial Kidney Center 1704 State St Santa Barbara CA 9 (San Francisco) 01/12/2018 CFNN11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
E0028 Dialysis Emergency Equipment Standard
E0040 Esrd Patient Orientation Training Standard
V0000 Initial Comments - Not A Deficiency Citation Memo
V0111 Ic - Sanitary Environment Standard
V0113 Ic - Wear Gloves/Hand Hygiene 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
V0121 Ic - Handling Infectious Waste Standard
V0122 Ic - Clean, Disinfect Surfaces & Equipment/Written Protocols Standard
V0142 Ic - Oversight: Monitor Activities & Implement Policies Standard
V0143 Ic - Aseptic Techniques For Iv Meds Standard
V0147 Ic - Staff Education Re Catheters/Catheter Care Standard
V0187 Environment - Schematic Diagrams/Labels Standard
V0200 Ro - Monitor/Alarm/Prevent Use Of Unsafe Water Standard
V0231 Acid Conc Mixing Sys - Empty Completely//Prevent Corrosion Standard
V0234 Bicarb Mixing Sys - Not Overmixed Standard
V0407 Pe - Hemodialysis Patients In View During Treatments Standard
V0543 Manage Volume Status Standard
V0544 Achieve Adequate Clearance Standard
V0550 Vascular Access - Monitor/Referrals Standard
V0552 Psychosocial Counseling/Referrals/Assessment Tool Standard
V0587 Fac Receive/Review Self Monitoring Data Every 2 Months Standard
V0637 Qapi Indicator - Infection Control - Trend/Plan/Act Standard
V0758 Rn, Msw, & Rd Available To Meet Patient Needs Standard
052606 Santa Barbara Artificial Kidney Center 1704 State St Santa Barbara CA 9 (San Francisco) 05/27/2021 DUCU11 Complaint
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
V0143 Ic - Aseptic Techniques For Iv Meds Standard
V0550 Vascular Access - Monitor/Referrals Standard
V0751 Identifiable Governing Body W/Full Authority/Responsibility Standard
052608 Fresno Dialysis 4308 W Shaw Ave Suite 101 Fresno CA 9 (San Francisco) 08/02/2018 F8CK11 Standard
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0110 Cfc - Infection Control Condition
V0111 Ic - Sanitary Environment Standard
V0113 Ic - Wear Gloves/Hand Hygiene 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
V0130 Ic - Hbv - Isolation Of Machines/Equipment/Supplies Standard
V0143 Ic - Aseptic Techniques For Iv Meds Standard
V0147 Ic - Staff Education Re Catheters/Catheter Care Standard
V0500 Cfc - Patient Assessment Condition
V0520 Frequency Reassessment - Unstable - Monthly Standard
V0540 Cfc: Patient Plan Of Care Condition
V0543 Manage Volume Status Standard
V0544 Achieve Adequate Clearance Standard
V0557 Initial Poc Implemented - 30 Days/13 Tx Standard
V0560 Patients Seen By Med Staff Member Monthly Standard
V0715 Md Resp - Ensure All Adhere To P&P Standard
052610 Rai - Telegraph - Piedmont 2710 Telegraph Avenue Oakland CA 9 (San Francisco) 06/28/2018 XSJ211 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
052612 Bma - Central Valley Rural Dialysis 810 E Manning Avenue Reedley CA 9 (San Francisco) 05/09/2018 DQ7Z11 Complaint
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0403 Pe - Equipment Maintenance - Manufacturer'S Dfu Standard
V0681 Staff Licensed As Req/Qualified/Demonstrate Competencies Standard
052613 Eaton Canyon Dialysis Center 2551 E Washington Blvd Pasadena CA 9 (San Francisco) 07/13/2018 J75H11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
V0000 Initial Comments - Not A Deficiency Citation Memo
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
V0177 Max Level Of Chemical Contaminants In Water/Chem Analysis Standard
V0191 Softeners - Testing Hardness/Log Standard
V0196 Carbon Adsorption - Monitoring, Testing Frequency Standard
V0401 Pe - Safe, Functional, Comfortable Environment Standard
V0453 Receive Information In An Understandable Way Standard
V0500 Cfc - Patient Assessment Condition
V0502 Assess Current Health Status Inc Comorbids Standard
V0503 Appropriateness Of Dialysis Rx Standard
V0504 Assess B/P & Fluid Management Needs Standard
V0625 Cfc - Quality Assessment & Performance Improvement Condition
V0627 Ongoing, Uses Indicators - Improved Health Outcomes Standard
V0727 Mr - Protect Patient Records From Loss/Keep Confidential Standard
V0750 Cfc - Governance Condition
V0751 Identifiable Governing Body W/Full Authority/Responsibility Standard