Dialysis Facility Reports - how does your unit stack up?

[jbeany]

MM, I think it lets you draw some inferences.  If the number of patients with controlled anemia is close to 100%, then there's a good chance that the place is doing more than shuffling the patients in and out the door as fast as they can without caring about quality of life, because they are working to deal with side effects.  The adequate dialysis category is good for that, too.  If the number of patients on the transplant list and the number of transplants is high, they are doing what they can to encourage that option.  Good numbers aren't a guarantee of a good, caring staff, but they sure raise the odds.

[MooseMom]

Jbeany, yes, you're right.  I have been paying particular attention to those numbers, along with the numbers indicating how many patients do home hemo (only 4 out of 80 some-odd at my clinic) as this is how I plan to proceed.

How can we make sure all of our IHD members see this thread and the propublica link?  I know the moderators have a way of "stickying" important threads, right?  I just think this is really important..giving people as much information as possible.

[Bill Peckham]

Jbeany, yes, you're right.  I have been paying particular attention to those numbers, along with the numbers indicating how many patients do home hemo (only 4 out of 80 some-odd at my clinic) as this is how I plan to proceed.

How can we make sure all of our IHD members see this thread and the propublica link?  I know the moderators have a way of "stickying" important threads, right?  I just think this is really important..giving people as much information as possible.

I think this data base will be a part of the dialysis world from here on so whether it is at the top or not (it probably should be) won't take away from being able to direct people here and explain how it can be used. I think the Pro Publica data base is open source so it shouldn't be long before we see sites remixing it or combining it with dialysis facility compare data, for instance on facilities offering shifts starting after 5 or Home Dialysis Central's data. Put all three together would be very interesting.

This internet thingy is pretty cool, I think it is going to catch on.

[Bill Peckham]

http://projects.propublica.org/dialysis/categories


There is another cool feature. Click the above link to read the summary description of each statistical category. Then click the "show me details" button to see the Guide to the 2010 Dialysis Facility Reports, which goes through the DFR line by line.

[plugger]

How can we make sure all of our IHD members see this thread and the propublica link?  I know the moderators have a way of "stickying" important threads, right?  I just think this is really important..giving people as much information as possible.

I did put it on the front page of the DialysisEthics website, but it gets pretty lonely there: http://www.dialysisethics2.org/

[okarol]

  Topic stickied!

[Bill Peckham]

Topic stickied!

 

[MooseMom]

Great!  I think a lot of IHD members will find the link very useful, but over the holidays, it could easily be missed by members who haven't had the time to visit IHD for a while.

[carol1987]

Thank you bill!  I do wash but do not self cannulate I am scheduled for transplant...but know that in the future I will try to do more for myself when /if I get back on,dialysis

[onestronglittlelady]

Very good information, thank you for sharing. I found there were several other centers within 30 minutes of mine, if I ever decided to switch.

[Stacy Without An E]

I want to thank you so much for posting this linik.  The information about my clinic (especially the mortality rates) is fascinating material.  I'm going to be going through some of the major points and posting them on my blog later this week.

Thanks again.

[dialysisadvocate]

Hello All;  I am wondering, as a patient safety advocate if anyone has seen a change in the delivery of care in their unit since the media exposure of care. In California, we have finished posting the surveys for 2010 so that if you are in California, you can see if your facility has been inspected, as well as seeing what deficiencies were cited. In the first six months of 2010,, 23 of 25 facilities had deficiencies cited for lack of implementing correct infection control practices. This is UNACCEPTABLE when the most basic of basic practices are not implemented. Yes, we are talking about the facility's own policies and procedures, as well as federal level regulations.

I am also wondering, but had trouble starting a new thread --- have any of you experienced bullying from staff, retaliation from staff, etc... and, if so, why? This seems to be a more recognized problem now by the feds


www.qualitysafepatientcare.com
Roberta Mikles
Dialysis Patient Safety Advocate
uncompensated with NO ties/connections to the industry

[JasonEb]

I am wondering if there is anywhere where you can find the financial information for dialysis units.  Costs, earnings, profits, and whatnot.

[Bill Peckham]

I am wondering if there is anywhere where you can find the financial information for dialysis units.  Costs, earnings, profits, and whatnot.

If the provider is a public company they have to file quarterly/annual reports to the SEC, for instance DaVita's are here http://investing.businessweek.com/research/stocks/financials/secfilings.asp?ticker=DVA:US
look for the links to the 10-K Annual report released in February or the 10-Q quarterly reports.

Lots of fine print but lots of information too.

If your interested in a non-profit company then you can pull their 1090 via Guidestar.

[JasonEb]

I am not really sure what the unit is at the moment.  It was an FMC unit until I think some point last year, at which case it became an independent company.  It is definitely for profit, though..of that there is NO mistake!

"Sooner Dialysis, where we say 'keep the change'...and we do!"

[The Lady]

Thanks for the link...the staff at my unit are fabulous and it was comforting to see the numbers are pretty darn good as well!

http://projects.propublica.org/dialysis/facilities/202502

[pagandialysis]

Not really sure how I feel about this data. o.0

http://projects.propublica.org/dialysis/facilities/182592

[Bill Peckham]

Not really sure how I feel about this data. o.0

http://projects.propublica.org/dialysis/facilities/182592

I'd be real interested to hear more - over the years of advocating for this information I heard a lot said about downsides to the information's release ... now that it is out I'd like to hear more about how it is seen. I'd really like to hear about concerns or downsides that are seen.

[MooseMom]

Not really sure how I feel about this data. o.0

http://projects.propublica.org/dialysis/facilities/182592

WOW...86% of patients at your center were NOT seen by a nephrologist before beginning dialysis?  That's outrageous!  Why do you think that is?

[jbeany]

What does that mean, exactly?  They weren't followed by any neph?  They weren't followed by the center's neph?  It seems unlikely that 86% of patients at any center would be acute onset.

[Bill Peckham]

What does that mean, exactly?  They weren't followed by any neph?  They weren't followed by the center's neph?  It seems unlikely that 86% of patients at any center would be acute onset.

There is a question on a form that is filled out on the day of your first treatment ... check it out
https://secure.ssa.gov/apps10/poms/images/Other/G-CMS-2728U3-1.pdf

Think about it: Was patient under care of a nephrologist? Yes or No. 86% of the time it was no. Wow. I was under a nephrologist's care for about 33 months prior to starting ESRD therapy.


EDITED TO ADD: In the business these are called the 2728s, pronounced: the twenty-seven twenty-eights.
You can ask to see your own 2728 ... make sure it is correct.

[MooseMom]

Geez, I've been seeing my neph for almost 7 years now!

jbeany, I'm assuming that 86% of new dialyzors at this particular clinic had CKD but never knew it, so never saw a nephrologist because they didn't think they needed to.  These are probably people who don't have regular checkups in the first place.  But that just seems outrageous.

[Meinuk]

I would question this nephrologist number simply because the facility has a good fistula rate:  Fistula Percent of patients with a fistula, 2009:   67%

Even IF the fistula rate were counted within the first 90 days of treatment, that is a GREAT rate compared to the 58.6% national average (5/2011)*, and I think that a nephrologist would at least be informed by the vascular surgeon who placed the fistula.

I would look for clerical error in the case of this clinic.

*http://fistulafirst.org/

[jbeany]

Or maybe an ESL thing - perhaps a large percentage who didn't know what a neph was?

There is a question on a form that is filled out on the day of your first treatment ... check it out
https://secure.ssa.gov/apps10/poms/images/Other/G-CMS-2728U3-1.pdf

Well, I suppose there was - it was 5 years ago and the center is now 5 hours away!  I don't remember them doing more than shoving a stack of papers at me while I was nervous and half scared out of my wits.  (Thanks to being on here, I did have enough clarity to refuse to let them put epo through my lines so I could stay in control of it and get my usual injections, though.)  Still, if other centers are even less inclined to help patients fill out paperwork, maybe my ESL theory is part of it.

[Bill Peckham]

Or maybe an ESL thing - perhaps a large percentage who didn't know what a neph was?

There is a question on a form that is filled out on the day of your first treatment ... check it out
https://secure.ssa.gov/apps10/poms/images/Other/G-CMS-2728U3-1.pdf

Well, I suppose there was - it was 5 years ago and the center is now 5 hours away!  I don't remember them doing more than shoving a stack of papers at me while I was nervous and half scared out of my wits.  (Thanks to being on here, I did have enough clarity to refuse to let them put epo through my lines so I could stay in control of it and get my usual injections, though.)  Still, if other centers are even less inclined to help patients fill out paperwork, maybe my ESL theory is part of it.

ESL in Bath Maine?    Looks to me the issue is that there is no Nephrologist in Bath Maine. I don't think I have ever seen this discussed but I think I would move if I lived somewhere without a resident nephrology practice. Even if there was a dialysis center (which Bath obviously has).


The form is filled out by staff and physicians. Payment increases with comorbidities. I've always thought if every dialyzor checked their own 2728 many people would be surprised to learn they had a drinking or drug problem.