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
052631 Wilshire Dialysis Center 1212 Wilshire Blvd Los Angeles CA 9 (San Francisco) 01/12/2018 DOR311 Standard
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
V0121 Ic - Handling Infectious Waste Standard
V0122 Ic - Clean, Disinfect Surfaces & Equipment/Written Protocols Standard
V0143 Ic - Aseptic Techniques For Iv Meds Standard
V0199 Ro - Meets Aami/Monitored, Recorded On Log Standard
V0260 Personnel - Training Program/Periodic Audits Standard
V0401 Pe - Safe, Functional, Comfortable Environment Standard
V0403 Pe - Equipment Maintenance - Manufacturer'S Dfu Standard
V0452 Respect & Dignity Standard
V0501 Patient Assessment - Interdisciplinary Team Mbrs/Resp. Standard
V0503 Appropriateness Of Dialysis Rx Standard
V0516 Frequency - Initial: 30 Days/13 Tx Standard
V0517 F/U Reassessment - Within 3 Months Of Initial Standard
V0519 Frequency Reassessment - Stable - Annual Standard
V0520 Frequency Reassessment - Unstable - Monthly Standard
V0542 Idt Develops Plan Of Care Standard
V0558 Implement Updates Of Poc - 15 Days P Pt Assessment Standard
V0587 Fac Receive/Review Self Monitoring Data Every 2 Months Standard
V0597 Provide Ordered Supplies/Equipment Standard
052632 Glendale Dialysis 1000 E Palmer Avenue Glendale CA 9 (San Francisco) 09/18/2019 08Z611 Standard
Deficiency Tag Deficiency Description Tag Type
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
V0120 Ic - Transducer Protectors: Not Wetted/Changed Standard
V0191 Softeners - Testing Hardness/Log Standard
V0231 Acid Conc Mixing Sys - Empty Completely//Prevent Corrosion Standard
V0236 Additives - Labeling Spiked Jugs/Labeling If For Specific Pt 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
V0501 Patient Assessment - Interdisciplinary Team Mbrs/Resp. Standard
V0503 Appropriateness Of Dialysis Rx Standard
V0516 Frequency - Initial: 30 Days/13 Tx Standard
V0517 F/U Reassessment - Within 3 Months Of Initial Standard
V0519 Frequency Reassessment - Stable - Annual Standard
V0520 Frequency Reassessment - Unstable - Monthly Standard
V0557 Initial Poc Implemented - 30 Days/13 Tx Standard
V0587 Fac Receive/Review Self Monitoring Data Every 2 Months Standard
V0589 Monitor Home Adaptation,Home Visits - Poc Standard
V0715 Md Resp - Ensure All Adhere To P&P Standard
052633 Mission Hills Dialysis, Llc 11550 Indian Hills Rd, Ste 100 Mission Hills CA 9 (San Francisco) 01/24/2018 ME8Q12 Standard
Deficiency Tag Deficiency Description Tag Type
V0110 Cfc - Infection Control null
V0111 Ic - Sanitary Environment Standard
V0115 Ic - Wear Gowns, Shields/Masks; Staff Not Eat/Drink In Tx Area null
V0143 Ic - Aseptic Techniques For Iv Meds null
V0147 Ic - Staff Education Re Catheters/Catheter Care null
V0260 Personnel - Training Program/Periodic Audits null
V0401 Pe - Safe, Functional, Comfortable Environment null
V0407 Pe - Hemodialysis Patients In View During Treatments null
V0408 Emergency Preparedness - Procedures null
V0411 Nursing Staff Trained In Emergency Equip And Meds null
V0500 Cfc - Patient Assessment null
V0502 Assess Current Health Status Inc Comorbids null
V0503 Appropriateness Of Dialysis Rx null
V0504 Assess B/P & Fluid Management Needs null
V0516 Frequency - Initial: 30 Days/13 Tx null
V0517 F/U Reassessment - Within 3 Months Of Initial null
V0519 Frequency Reassessment - Stable - Annual null
V0520 Frequency Reassessment - Unstable - Monthly null
V0550 Vascular Access - Monitor/Referrals null
V0581 Idt Resp - Services Equivalent To In-Center Patients null
V0587 Fac Receive/Review Self Monitoring Data Every 2 Months null
V0675 Cfc - Laboratory Services null
V0676 Clia Labs/Meet Needs Of Patients null
V0684 Nurse Manager - 12 Mo Rn + 6 Mo Dialysis null
052633 Mission Hills Dialysis, Llc 11550 Indian Hills Rd, Ste 100 Mission Hills CA 9 (San Francisco) 05/05/2023 9ER211 Standard
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0113 Ic - Wear Gloves/Hand Hygiene Standard
V0196 Carbon Adsorption - Monitoring, Testing Frequency Standard
V0403 Pe - Equipment Maintenance - Manufacturer'S Dfu Standard
V0453 Receive Information In An Understandable Way Standard
052634 Rai - Centinela - Inglewood 1416 Centinella Avenue Inglewood CA 9 (San Francisco) 04/12/2023 ETHR11 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
V0228 Mixing Systems - Labeling Standard
V0401 Pe - Safe, Functional, Comfortable Environment Standard
V0403 Pe - Equipment Maintenance - Manufacturer'S Dfu Standard
V0503 Appropriateness Of Dialysis Rx Standard
V0543 Manage Volume Status Standard
052634 Rai - Centinela - Inglewood 1416 Centinella Avenue Inglewood CA 9 (San Francisco) 06/17/2025 DQDH11 Complaint
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0757 Staff # & Ratio Meet Patient Needs Standard
052635 Bakersfield Brimhall Dialysis 8501 Brimhall Road, Bld 500 Bakersfield CA 9 (San Francisco) 03/15/2018 YIGI11 Standard
Deficiency Tag Deficiency Description Tag Type
E0000 Initial Comments - Not A Deficiency Citation Memo
E0036 Ep Training And Testing Standard
V0000 Initial Comments - Not A Deficiency Citation Memo
V0111 Ic - Sanitary Environment Standard
V0112 Ic - Cdc Mmwr 2001 Standard
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
V0124 Ic - Hbv - Test All Pts, Review Results/Pt Status Known Preadmit Standard
V0142 Ic - Oversight: Monitor Activities & Implement Policies Standard
V0260 Personnel - Training Program/Periodic Audits Standard
V0456 Participate In Care, Discontinue/Refuse Treatment Standard
V0463 Receive Services Outlined In Poc Standard
V0503 Appropriateness Of Dialysis Rx Standard
V0511 Dialysis Access Type & Maintenance Standard
V0544 Achieve Adequate Clearance Standard
V0628 Measure, Analyze And Track Quality Indicators Standard
V0726 Medical Records - Complete, Accurate, Accessible Standard
052635 Bakersfield Brimhall Dialysis 8501 Brimhall Road, Bld 500 Bakersfield CA 9 (San Francisco) 06/10/2020 2P4911 Special
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0113 Ic - Wear Gloves/Hand Hygiene Standard
052637 Burbank Dialysis 1211 North San Fernando Blvd Burbank CA 9 (San Francisco) 08/06/2019 980Z11 Standard
Deficiency Tag Deficiency Description Tag Type
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
V0196 Carbon Adsorption - Monitoring, Testing Frequency Standard
V0199 Ro - Meets Aami/Monitored, Recorded On Log Standard
V0245 Acid Conc Distribution - Conc Labeled & Color-Coded Red Standard
V0403 Pe - Equipment Maintenance - Manufacturer'S Dfu Standard
V0407 Pe - Hemodialysis Patients In View During Treatments Standard
V0501 Patient Assessment - Interdisciplinary Team Mbrs/Resp. Standard
V0502 Assess Current Health Status Inc Comorbids Standard
V0503 Appropriateness Of Dialysis Rx Standard
V0504 Assess B/P & Fluid Management Needs Standard
V0506 Immunization/Medication History Standard
V0516 Frequency - Initial: 30 Days/13 Tx Standard
V0519 Frequency Reassessment - Stable - Annual Standard
V0520 Frequency Reassessment - Unstable - Monthly Standard
V0715 Md Resp - Ensure All Adhere To P&P Standard
V0726 Medical Records - Complete, Accurate, Accessible Standard
052637 Burbank Dialysis 1211 North San Fernando Blvd Burbank CA 9 (San Francisco) 05/14/2021 JP7T11 Standard
Deficiency Tag Deficiency Description Tag Type
V0000 Initial Comments - Not A Deficiency Citation Memo
V0122 Ic - Clean, Disinfect Surfaces & Equipment/Written Protocols Standard
V0127 Ic - Hbv - Test Pts/Staff Post Last Dose Standard
V0232 Bicarb Mixing Sys - Empty/Disinfect/Prevent Corrosion Standard
V0403 Pe - Equipment Maintenance - Manufacturer'S Dfu Standard