RAI, a Clinic for Dialysis Service in the United States

with kidney failure pay for dialysis. More than 40 years later, AKF has become the leading

DaVita, Italian for "giving life," was originally known as Total Renal Care (TRC). Employees who also voted on the company’s core values chose the name. In 1999, on the brink of bankruptcy, Kent Thirty became the Chairman and CEO of DaVita. He lead the company on an ambitious restructuring plans that ten years later has transformed the company into a Fortune 500 company with over $ 6.1 billion in annual revenues. DaVita has grown to a population of over 34,000 teammates and serves approximately 118,000 dialysis patients weekly. DaVita provided services at over 1,500 outpatient dialysis centers and at 720 hospitals in 2009. Kent Thiry has led the company since 1999. DaVita has achieved over 11 straight years of improved clinical outcomes and financial results. In 2004, Gambro 's U.S.- based clinics was acquired by Da Vita doubling DaVita 's outpatient clinics. As of 2011, DaVita employs over 41,000 and provides services at more than 1,800 dialysis centers. In 2009, DaVita moved it 's corporate headquarters to Denver from El Segundo, California. Denver was chosen due to its central location, mass transit, talent pool, cost of living, and quality of life. CEO Kent Thiry states that "DaVita was looking for two equally important things in a new home. Number one, that we find an environment that was good for the company to pursue its business. Number two, that we find an environment where our people could live great lives". DaVita is the second largest provider of dialysis in

Congress mandated QIP, as part of the dialysis bundle reform, which will result in payment decrease to providers who do not meet certain quality metrics. These quality measurements could avert the possibilities of harmful incentive effects (Gupta, C., Chertow, Linthicum, Van Nuys, Belozeroff, Quarles, & Lakdawalla, 2014). The CMS is working to develop a comprehensive quality monitoring initiatives to avoid problems associated with incentives to stint on care. This type of approach could be a significant tool for avoiding and solving the issues of incentives versus quality care (United States Government Accountability Office, 2011). This SE MI clinic is currently struggling to meet Dialysis Quality Indicators (DQI) doing poorly in bone demineralization and access managements, and could mean potential reductions on their bundled payments. The company would have to be more efficient in other budget measures including labor productivity and trimming of supply cost. Cost-containment measures such as staffing shortages can significantly affect quality care (Thomas-Hawkins, Denno, Currier, & Wick,

My practicum is occurring at the University District (UD) Hospital, which is a 104-bed facility with an inpatient behavioral health unit, acute care of the elderly, rehabilitation, in addition to a regional infusion center. During my discussion with the marketing director, secondary to the issues with capacity in all of the units at UD, there is no plan to market new services or seek additional volume there. However, there are plans to recruit pediatric specialists at the large Oregon hospital at RiverBend (RB). The RB Hospital is recruiting an additional pediatric surgeon, a pediatric endocrinologist, in addition to a pediatric neurologist. Given that the nearest pediatric services are 100-miles North in Portland, Oregon, and 600-miles South

Cabral was part of the hemodialysis team who received an award in October for having the highest AVF rate (a quality indicator) among 186 dialysis units in the Southeast. Her skill in cannulation and her attention to detail in identifying any problems with access has helped to exceed our unit benchmark. Ms. Bardsley and her colleagues were also recognized by the VA for being 2nd in the country for excellence in AVF rates, adequacy of hemodialysis and anemia management. Ms. Cabral actively participates in quality improvement activities that result in improved outcomes. Ms. Cabral helps to guide evidenced based practice in the dialysis unit. She participates in monthly quality improvement meetings with the interdisciplinary hemodialysis team in order to discuss and improve quality outcomes. She has revised the Epogen protocol to improve the anemia

It’s often said that if a company grows too fast, both employees and customers will experience growing pains. But preparation, along with the help and support from ARA leadership, ensured that the Regional Dialysis Center of Mesquite, located just outside of Dallas, Texas, experienced only success.

Kidney failure has spread immensely throughout the United States for the past decade. There are many causes for kidney failure, but the top two in the U.S. are Diabetes and Hypertension. Before this research project, I was not aware of how common Chronic Kidney Disease is amongst us, especially since it ranges from birth to old age. One in 10 adults within the age of 20 or older has been diagnosed with kidney disease in the U.S., (Davita.com). This disease causes a complete lifestyle change and with the right educational tools, diet, compliance, and support from family and friends, the patient should be able to keep living without any complications.

Dialysis is a life-saving treatment for adults and children with acute and chronic kidney failure. While it is a life-saving treatment, it can also be life threatening. There are steps and precautions that a healthcare professional must take when assisting a patient with the initiation of dialysis treatment. Patients must also take personal precautions. Training is provided to patient care technicians, nurses and other direct patient care staff. This is to ensure the safety of the patients by having knowledgeable and educated staff. Patients are also trained on certain aspects of the treatment to ensure they receive proper care.

Acceptance of treatment is influenced by the impact a treatment model has on a patient’s quality of life 24 25. Thus a patient’s preference for a model of care can affect treatment uptake and adherence and impact on health outcomes 26. As requirements for dialysis extends over many years, models of dialysis care must be sustainable, cost-effective and appropriate for the patient group and setting. Our aim is to investigate the costs and outcomes relevant to each of five selected dialysis models of care in the NT.

I work at Fresenius Kidney Care, one of the largest dialysis companies in the United States and the world. Our competitors are DaVita, DCI, and American Renal Associates. We all offer dialysis services to include hemodialysis, peritoneal dialysis, and home hemodialysis to the community. Although our strategies and methods of execution are primarily the same, there are some differences. One difference is that my company, Fresenius Kidney Care, diversifies into other dialysis services that the other three competitors aren’t involved in. Fresenius Kidney Care has its own pharmacy, it’s own pharmaceutical services, and it makes and distributes dialysis machines and disposable products. Fresenius Kidney Care has also formed strategic alliances

Dialysis clinics like DaVita and Fresenius, being the two largest for-profit corporations are fighting against a proposed Senate Bill No.349 (SB 349, 2017) that would necessitate dialysis clinics in California to have a mandated minimum staffing requirement. Furthermore, SB 349 (2017), as authored by Senator Ricardo Lara, would also require that dialysis clinics to provide patients with forty-five (45) minute transition time, and frequent inspection be done yearly instead of every five to six years (SB 349, 2017). With this regulation in place, patients will be provided with a higher level of care. The mandated staffing ratios would also help promote patient safety. Furthermore, with greater than 66,000 dialysis patients in

This method is a change in how emergency medical care is provided. In this technique is a design to get the patients with high severe health problem seen faster by the physician and trying to make the care of less injured patients easy, as well. The most important factor of this method is to triage early and priorities the severity of patient disease and to find out what specific care does the patient need.

DaVita dialysis center on Memphis St delivers dialysis care to patients with end-stage kidney failure, and chronic kidney disease, which makes them one of the busiest dialysis centers, in Northeast Philadelphia. On a daily basis, their patient load usually consists of 42 to 36 patients. The Dialysis course of treatment usually lasts from three to four hours, it very crucial that these patients be weighed before and after the treatment. Blood pressure screening before, during and after the procedure is also important because during dialysis excess fluid and waste is removed that a person retains due to their kidney failure which can cause the patient’s blood pressure to bottom out if too much is removed to quickly and the patient’s body cannot handle the loss so adjustments have to be made throughout the treatment. Also, most of the patients who are on dialysis, often are advised to hold their morning medications until after their treatment. According to Evelyn Rhoads (DaVita dialysis facility administrator) at this facility about fifty percent of the patients are diabetic therefore, there is a high chance that their blood glucose levels can plummet

Unfortunately, if given the duty to select patients for dialysis on hourly basis, I would give preference to young children and individuals who require less time. In that case selecting patients A, C, E and F would be given priority which account to consumption of 23 hours. Lastly, I would give preference to the patient J who requires 6 hours of dialysis and is waiting kidney donation from his brother.

According to the Centers for Disease Control and Prevention (CDC) 2010, 10% of adults in the United States have chronic kidney disease (CKD). That is estimated at about 20 million people. People with CKD may not feel any symptoms in the early stages, so treatment most likely has not been started. When a person often finds out they are in need of treatment, they may already be in kidney failure or end stage renal disease (ESRD). This paper will discuss the reimbursement mechanisms presented in the Sullivan article, the economics of providing ESRD treatment from the organization's point of view, patients options and potential trade-offs related to cost, quality, and access to