New Center

To open a PD clinic do you have to be attached to a HD unit .I am a PD nurse living in North Carolina who would like to open my own PD facility.Can you advise me?

There is no requirement that a PD clinic be connected to a hemodialysis clinic. Each can stand alone. In fact, if you search by name and type in “peritoneal dialysis,” there are 17 clinics that have Peritoneal Dialysis in their name in the Find a Center database on Home Dialysis Central.

Off the top of my head, you’d need to:
– have a location where you could do training and all the equipment, supplies, and education materials needed to train patients and eventually to train other staff as your patient population grows;
– meet the personnel qualifications in the ESRD regulations;
– have one or more nephrologists who would refer patients to your PD program and prescribe dialysis for their patients;
– have a dietitian and a social worker to make sure that patients have good nutrition and their psychosocial needs are met;
– have an arrangement with one or more companies to provide supplies and PD machine(s);
– have an arrangement with a hospital where your patients could be admitted;
– have a way for patients to call if they have questions/problems 24/7;
– have procedures and policy manuals under which you’d operate and these would have to reflect state and federal regulations;
– be certified by Medicare to offer PD;
– be a Medicaid provider for your state and possibly other nearby states;
– have contracts with major insurers;
– have startup capital.

I bet there are other things that I neglected to mention. Therefore, you might want to talk with the PD nurse or administrator and one of the PD clinics on Home Dialysis Central.

Beth, I had a doctor tell me he is going to open up a PD only Center in the San Antonio area. The person surveying the building asked for the water treatment system and the items you would need for Hemodialysis facility. Since this is only going to be a PD unit and there are a few in the state. Why would one area approve and another not approve a PD only center? What would you recommend be the next step in getting this facility approved? I think this would be great for this area where PD is greatly under utilized. It seems like the surveyors are not all on the same page here.

I am finding out that the surveyors in one region of the state don’t know what the other surveyors are doing. I am being told that a PD clinic cannot be certified without hemo. They are requiring us to have a water system and hemodialysis machine. Do you have any suggestions to where I should turn to next?

Here’s a website that describes the process of applying for Medicare certification. This page offers links to fiscal intermediaries and state survey agencies:

You may want to seek help from your fiscal intermediary or the supervisor at the state agency. Wanting to open a PD only clinic is much less common than wanting to open a clinic that offers HD or even one with HD and PD. I suspect few surveyors have encountered a PD only clinic. The surveyor could contact the CMS regional office or central office for instruction.

You can also contact a PD only clinic for advice. By typing “peritoneal dialysis” in the clinic name field and searching the Find a Center database, I found several clinics that have a name that implies that the clinic is PD only, such as Bay Area Peritoneal Dialysis LLC (CA) and Dialysis Concepts, Inc. (OH), Peritoneal Dialysis Center of NW OH. I’d suggest that you speak to the administrator.

I have important information on how to establish a home program in NC

If interested, please respond to me privately to disucss.

I have become aware that the Medical Review Board for the Texas Department of State Health Services and the ESRD Network 14 have met to discuss the rules and regulations for a PD only clinic. There is no clear cut regulation for PD only clinics currently in Texas. The unit in San Antonio will have to wait until a new ruling is passed with the “exceptions” implemented in the current rules and regs. This is the most ridiculus thing I have ever heard. License the clinic and get these patients on PD now! The Medicare Program is pushing for home dialysis and Texas is hindering the process!!!
Anyone else out there frustrated?