HealthInsight ESRD Network 18 · ESRD Network 18 and 16 in 2015. In 2016, the HealthInsight ESRD...

HealthInsight ESRD Network 18 Serving Southern California

2016 Annual Report

Submitted to: Department of Health and Human Services Centers for Medicare & Medicaid Services For: Contract Number HHSM-500-2016-00018C Submitted to CMS Project Officer June 12, 2017

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ESRD Network 18 2016 Annual Report Table of Contents

Table of Contents

Report Highlights ............................................................................................................................ 3

Introduction ..................................................................................................................................... 4

CMS’ End Stage Renal Disease Network Organization Program .............................................. 4

Medicare Coverage for Individuals with ESRD ......................................................................... 4

History of CMS’ ESRD Network Organization Program........................................................... 4

ESRD Network 18 ...................................................................................................................... 5

Network Goals ............................................................................................................................ 6

Profile of Patients in the Network’s Service Area .......................................................................... 7

Improving Care for ESRD Patients................................................................................................. 8

Patient Safety .............................................................................................................................. 8

Facilities that Consistently Failed to Cooperate with Network Goals ...................................... 13

Recommendations for Sanctions............................................................................................... 14

Recommendations to CMS for Additional Services or Facilities ............................................. 14

Grievances and Access to Care ..................................................................................................... 14

Cases Referred to State Survey Agencies ................................................................................. 14

Emergency Preparedness and Response ....................................................................................... 15

List of Tables ................................................................................................................................ 17

Appendix. Data Tables.................................................................................................................. 18

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Report Highlights

HealthInsight, a private not-for-profit, is dedicated to serving as a primary agent in focusing

community energy to achieve the quality and effectiveness of healthcare. Providing services in

healthcare improvement since 1984, HealthInsight realized the opportunities possible in

expanding their reach into end stage renal disease (ESRD) as they acquired the contracts for

ESRD Network 18 and 16 in 2015.

In 2016, the HealthInsight ESRD Alliance comprised of Network 18 and Network 16, began a

unique collaboration in sharing an Executive Director and Quality Improvement Director in an

effort to realize efficiencies while being responsive to local needs. This resulted in unique

synergies that included sharing and implementing best practices throughout both Networks.

Network 18 engaged the leadership of the only ESRD Seamless Care Organization (ESCO) in

California to align efforts of the Network with emerging priorities of the Center of Medicare &

Medicaid Services (CMS) in alternative payment initiatives. This engagement included a

presentation of ESCOs and their impact in the dialysis population at the regional HealthInsight

corporate board retreat attended by more than 100 leaders in the healthcare community that

HealthInsight represents.

Population Health Innovation Project – Hospitalization Reduction

Network 18 identified hospitalization reduction as the innovation project to work on. This effort

resulted in new community collaborations with area hospital systems and regional quality

organizations to encourage Electronic Medical Records (eMR) exchanges between the hospital

and the dialysis facility upon the hospitalization discharge of a dialysis patient. The Network

worked with San Diego Health Connect to identify information in the Health Information

Exchange that will be necessary to improve dialysis patients’ quality of care. Additionally, the

Network worked closely with participating facilities to identify the top three discharge

diagnoses: gastrointestinal, cardiovascular and fluid control; and applied appropriate targeted

interventions.

Patient and Family Engagement/Patient Services

Network 18’s 2016 Consumer Assessment of Healthcare Providers and Systems In-Center

Hemodialysis Survey (ICH CAHPS) project focused on the question: ‘In the past 12 months, did

either your kidney doctors or dialysis center staff talk to you about peritoneal dialysis?’

70% indicated they made changes in their facility’s activities to increase the education

and awareness of peritoneal dialysis as a viable treatment modality.

90% indicated plans to continue to use one or more of the change package materials

developed by the patient advisory committee.

Patient Safety: Reducing Rates of Healthcare-Acquired Infections

The target facilities reduced their positive blood cultures by 19% in 2016.

Due to BSI prevention interventions, 90 hospitalizations were averted.

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Introduction

CMS’ End Stage Renal Disease Network Organization Program The End Stage Renal Disease Network Organization Program (ESRD Network Program) is a

national quality improvement program funded by the Centers for Medicare & Medicaid Services

(CMS). CMS is a federal agency, part of the U.S. Department of Health and Human Services.

CMS defines end stage renal disease (ESRD) as permanent kidney failure in an individual who

requires dialysis or kidney transplantation to sustain life.

Under contract with CMS, 18 ESRD Network Organizations, or ESRD Networks, carry out a

range of activities to improve the quality of care for individuals with ESRD. The 18 ESRD

Networks serve the 50 states, the District of Columbia, Puerto Rico, the Virgin Islands,

American Samoa, Guam, and the Northern Mariana Islands.

Medicare Coverage for Individuals with ESRD Medicare coverage was extended to most ESRD patients in the U.S. under the Social Security

Act Amendments of 1972 (Public Law 92-603). Individuals with irreversible kidney failure are

eligible for Medicare if they need regular dialysis or have had a kidney transplant and they meet

(or their spouse or parent meets) certain work history requirements under the Social Security

program, the railroad retirement system, or federal employment.

History of CMS’ ESRD Network Organization Program Following passage of the 1972 Amendments to the Social Security Act, in response to the need

for effective coordination of ESRD care, hospitals and other health care facilities were organized

into networks to enhance the delivery of services to people with ESRD.

In 1978, Public Law 95-292 modified the Social Security Act to allow for the coordination of

dialysis and transplant services by linking dialysis facilities, transplant centers, hospitals,

patients, physicians, nurses, social workers, and dietitians into Network Coordinating Councils,

one for each of 32 administrative areas.

In 1988, CMS consolidated the 32 jurisdictions into 18 geographic areas and awarded contracts

to 18 ESRD Network Organizations, now commonly known as ESRD Networks. The ESRD

Networks, under the terms of their contracts with CMS, are responsible for: supporting use of the

most appropriate treatment modalities to maximize quality of care and quality of life;

encouraging treatment providers to support patients’ vocational rehabilitation and employment;

collecting, validating, and analyzing patient registry data; identifying providers that do not

contribute to the achievement of Network goals; and conducting onsite reviews of ESRD

providers as necessary.

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ESRD Network 18 In 2016, Network 18 served the End Stage Renal Disease (ESRD) community in the 13 central

and southern counties of California including: Inyo, Imperial, Kern, Kings, Los Angeles, Orange,

Riverside, San Bernardino, San Diego, San Luis Obispo, Santa Barbara, Tulare and Ventura. The

number of new (incident) patients receiving dialysis increased by 86, while the number of

prevalent patients grew by 1,738. With the increase in dialysis patients, there was also an

addition of 14 new Medicare certified dialysis facilities. The total number of dialysis facilities in

Network 18 totaled 401 at the end of 2016. As noted below, 47% of the dialysis population

identifies their ethnicity as Hispanic. This has increased efforts of the Network to ensure that

appropriate resources are provided for this population. There is an average of 117.3 dialysis

patients per CMS-certified facility, more than any other Network, signifying an urgent need to

accelerate initial certifications for new facilities.

Table A. Dialysis Facilities and Transplant Centers in the Network’s Service Area, as of

December 31, 2016

Category Number

Number of Dialysis Facilities in the Network’s Service Area 386

Number of Transplant Centers in the Network’s Service Area 15

Source of data: CROWNWeb.

Table B. Number of Medicare-Certified Dialysis Facilities in the Network’s Service Area

and Number and Percent of Dialysis Facilities Offering Dialysis Shifts Starting after 5 PM,

as of December 31, 2016

Category Number Percent

Number of Dialysis Facilities in the Network’s Service Area 386

Dialysis Facilities in the Network’s Service Area Offering Dialysis Shifts

Starting after 5 PM

386 100%


Of the Network’s 386 dialysis facilities, 20 or 5% offer Nocturnal Hemodialysis as a service.

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Network Goals

CMS establishes priorities for the ESRD Network contractors annually in the Statement of Work

section of each Network’s contract with the agency. These priorities support CMS and

Department of Health and Human Services (HHS) national quality improvement goals and

priorities.

In 2016, the ESRD Network contractors were tasked with meeting the following goals:

Improving care for ESRD patients in the Network’s service area by:

o Promoting patient- and family-centered care,

o Responding to grievances about ESRD-related services filed by, or on behalf of,

ESRD patients,

o Supporting improvement in patients’ experience of care,

o Working with dialysis facilities to ensure that all dialysis patients have access to

appropriate care,

o Promoting best practices in vascular access management; and,

o Helping dialysis facilities reduce the incidence of healthcare-associated

infections.

Improving the health of the ESRD patient population in the Network’s service area

through activities designed to reduce disparities in ESRD care; and,

Reducing the costs of ESRD care in the Network’s service area by supporting

performance improvement at the dialysis facility level and supporting facilities’

submission of data to CMS-designated data collection systems.

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Profile of Patients in the Network’s Service Area

Network 18 collects data on incident (new) ESRD patients, prevalent (currently treated) dialysis

patients, and renal transplant recipients.

The Network uses data on patients’ clinical characteristics—including primary cause of ESRD,

treatment modality, and vascular access type—to focus its outreach and quality improvement

activities.

Table C. Clinical Characteristics of the ESRD Population in the Network’s Service Area,

Calendar Year 2016

Category Number Percent

Incident (New) ESRD Patients

Number of Incident ESRD Patients, Calendar Year 2016 10,310

Prevalent Dialysis Patients

Number of Prevalent Dialysis Patients as of December 31, 2016 45,663

Treatment Modality of Prevalent Dialysis Patients as of December 31, 2016

In-Center Hemodialysis or Peritoneal Dialysis 40,506 89%

In-Home Hemodialysis or Peritoneal Dialysis 5,174 11%

Total 45,680 100%

Vascular Access Type at Latest Treatment among Prevalent In-Center

and In-Home Hemodialysis Patients as of December 31, 2016

Arteriovenous Fistula in Use 27,186 67.98%

Arteriovenous Graft in Use 5,876 14.69%

Catheter in Use for 90 Days or Longer 4,024 10.07%

Other** 2,903 7.26%

Total 39,992 100%

Renal Transplants

Number of Renal Transplant Recipients,* Calendar Year 2016

1,262

Total 1,262 100%


*Count of unduplicated individuals receiving renal transplantation during the calendar year.

**Does not include 406 NA or Missing Counts.

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Improving Care for ESRD Patients

Network 18 works closely with ESRD patients, patients’ family members and friends,

nephrologists, dialysis facilities, healthcare organizations, ESRD advocacy organizations, and

other ESRD stakeholders to improve the care for ESRD patients in Southern California.

Under its contract with CMS, the Network is responsible for:

Identifying opportunities for quality improvement and developing interventions to

improve care for ESRD patients in Southern California,

Identifying opportunities for improvement at the facility level and providing technical

assistance to facilities as needed,

Promoting the use of best practices in clinical care for ESRD patients,

Encouraging use of all modalities of care, including home modalities and transplantation,

as appropriate, to promote patient independence and improve clinical outcomes,

Promoting the coordination of care across treatment settings; and

Ensuring accurate and timely data collection, analysis, and reporting by facilities in

accordance with national standards.

Patient Safety

Patient Safety: Improve Vaccination Rates

Network 18 was able to greatly improve vaccination rates for pneumococcal pneumonia for

target facilities. At the end of the project 918 patients received a Pneumococcal polysaccharides

vaccine (PPV) shot.

Patient Safety: Reducing Rates of Healthcare-Acquired Infections Network 18 compared facility ranks on eight measures of mortality and morbidity taken from the

2015 Dialysis Facility Reports (DFR) and National Healthcare Safety Network (NHSN), in order

to select candidate facilities for quality improvement of infection control. The measures were:

Percentage of deaths due to infection, 2011-2014 (DFR)

Percentage of Medicare patients hospitalized for septicemia, 2011-2014 (DFR)

Access-related infection rate for hemodialysis patients, 2014 (DFR)

Access-related infection rate for peritoneal dialysis patients, 2014 (DFR)

Standardized Mortality Ratio (SMR) greater than overall Network SMR, 2011-2014

(DFR)

Positive blood culture rate, 2015 (NHSN)

Access-related bloodstream infection rate, 2015 (NHSN)

Local Access Site Infection Rate, 2015 (NHSN)

The 20 lowest-scoring facilities for each measure were selected and ranked. The ranks were then

equally weighted to create a combined score that was used to compare and select facilities that

demonstrated relatively greater opportunities for improvement across multiple measures.

Weighting measures equally ignores correlations between measures; however, contrary to

expectations, the measures were not highly correlated empirically on the facility level.

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The lowest-performing 20% of the facilities were required to be on the healthcare-acquired

infection Learning and Action Network (HAI LAN) and CDC audit project. Besides the required

CDC audits, facilities were required to attend monthly webinars and present on at least one

webinar. Facilities also were required to: complete facility-specific goal statements derived from

their CDC audit tool results, use a Plan-Do-Study-Act (PDSA) cycle and discuss improvements

and challenges on the webinar. The targeted facilities reduced their positive blood cultures by

19% in 2016 preventing 176 blood stream infections. Reducing Blood Stream Infections (BSI)

contributed to preventing 90 hospitalizations.

Network 18

# Target Facilities 76

Year 2015 2016 Projections* 2016 Actual

Total Patients 7,538 7,840 7,818

BSI Rate 95% 95% 74%

# BSI Events 756 786 610

# BSI Prevented 0 -30 176

% BSI Improvement 0% 0% 19%

# Hospitalizations 868 903 813

# Hosp. Prevented 0 -35 90

Innovation Project For 2016, Network 18 selected Project A2: Network Workgroup-Focus on Reducing Hospital

Utilization. The goals of the project were to reduce hospital utilization by 2% overall, and to

improve access to eMR for dialysis providers at their primary admitting hospitals.

The Network selected 20 dialysis units along with their primary hospitals to participate in the

project. The facilities had a census of 2,409 patients. The Network excluded the tracking of

patients with planned admissions, pediatric patients, and any patient with active cancer

comorbidity.

Interventions included post-hospitalization assessments, infection prevention of the dialysis

access site, and gaining access to the primary admitting hospital’s eMR. Other interventions

were based on facility-specific discharge diagnoses and patient comorbidities.

Discharge diagnoses were not as expected. Analysis of the facility reported baseline data (April

through September 2015) showed the most common discharge diagnoses were cardiovascular

16%, infection (not airborne) 12%, gastrointestinal 6%, and then the fourth position was a four

way tie that included fluid overload. Analysis of the 2016 facility reported data showed the top

discharge diagnoses changed to: gastrointestinal 13%, cardiovascular 12%, and fluid overload at

10%.

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Provider Education

Network 18 and Network16 partnered to present a live webinar on Refueling and Reconnecting

as Compassionate Caregivers in Nephrology Care. Free CEs were provided to over 90 attendees.

Evaluation results were excellent, and comments indicated that the webinar content was highly

relevant for their setting. Some comments:

“Very important information for healthcare professionals.”

“This event was the highlight of my day.”

“This session was incredibly helpful and came at a time in my career when I needed it the

most. I will refer back to these slides often as refreshers are needed with the difficult

work load. Thank you for acknowledging the difficult life our patients live and how this

can impact us as clinicians.”

In response to patient grievances, access to care concerns, reported facility concerns and/or by

request, the Network conducted on site training to staff related to conflict management,

improving communication skills and increasing professionalism at two dialysis facilities and at

three regional meetings in 2016. These activities provide an opportunity for staff to learn new

skills, and for the Network to better understand staff member perspective and struggles in their

work with patients. Presentations at regional meetings allow us an opportunity to engage social

workers and facility administrators from dozens of units at one time proving us a better

opportunity to reach more members of the community.

The Network issues a quarterly provider newsletter to all facilities via constant contact. Though

this online web based service we are able to view the open rate as well as the rate at which

people click on the links embedded within the newsletter. In 2016, the last reported open rate

was at 27% with a click rate of 11%. This is a newsletter is sent out to a distribution list of over

1,600 community partners in the Network 18 service area.

Patient and Family Engagement

Network 18 is committed to incorporating the perspective of patients, family members, and other

caregivers into its quality improvement activities. In 2016, the Network collaborated closely with

Patient Advisory Council (PAC) Subject Matter Experts (SMEs). Network 18’s PAC is

comprised of 19 culturally diverse patients, representing all ESRD modalities in 5 of the 13

counties located in Network 18. PAC members participated in all 2016 Network Quality

Improvement Activities, in Network Board and Medical Review Board in-person meetings, and

in development of all Network patient education activities and materials. The majority of the

Network’s PAC members are active in the renal community as national presenters and authors,

board members, and patient advocates, including: Renal Support Network, Living Donor

Outreach, NxStage, Standardized Outcomes in Nephrology (SONG) Initiative, local and national

peer mentoring initiatives, National Coordinating Center, and Forum of ESRD Networks.

The Network and its patient SMEs participated in the following educational activities in 2016:

Blogs – short posts sent out by email to promote new educational materials, resources,

alerts, and events of interest to consumers; there were 552 blog prescribers in 2016.

Emergency Readiness fliers specific to Southern California with wildfires and power

outages due to extreme heat.

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Patient Newsletter- under the new contract holder of HealthInsight, the PAC provided

extensive feedback in revising the newsletter template to ensure that it is patient centered.

Patient Newsletter Postcard- a new post card was created with the PAC that will be

initially sent to all existing patients in 2017, and then to all new patients thereafter in June

of 2017. This effort began in 2016 with PAC involvement in every step. This project will

allow patients to choose how they wish to receive the Network Patient Newsletter; hard

copy by mail, or by email.

Grievance Poster- the PAC was very involved in the creation, layout and wording used

on the new grievance poster created in 2016 as an English and a Spanish version.

Website – there were 6,689 ‘hits’ on the Patients & Family webpage from February to

December 2016.

Projects to Promote Home Therapies

Network 18’s 2016 ICH CAHPS project focused on Question 39: “In the past 12 months did

either your kidney doctors or dialysis center staff talk to you about peritoneal dialysis?” Twenty

facilities were selected for participation based on scoring on the lower end of all units analyzed.

Of these 20 facilities, only 30.46 percent of patients surveyed responded ‘yes’ to this question

(baseline). At the completion of this project, the project facilities achieved considerable

improvement in the number of patient’s responding “yes,” obtaining 90.4 percent positive (yes)

responses (nearly a 60 percentage point improvement). The Network utilized existing materials

on PD Education from MEI, NCC, and the Forum of ESRD Networks. Additionally, the

Network’s PAC developed Modality Referral Tracking Sheets, Home Unit Referral Appointment

Cards, Best Practices Checklists and Myth & Fact Sheets. The Network conducted an evaluation

with project facilities and found:

70% indicated they made changes in their facility’s activities as a result of the

90% indicated plans to continue to use one or more of the change package materials

One aspect to consider in planning future activities around ICH CAHPS is facility reluctance to

ask patients to fill out monthly one-question surveys (survey burden), as requests for the survey

question to be provided in more languages that English and Spanish. Additionally the request

was made to make educational resources available in multiple languages as well.

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In addition to its responsibilities under its contract with CMS, the Network achieved

participation in health care related events that extend beyond the dialysis and kidney transplant

population. Network staff participated in the Ethics of Caring Annual Conference held in Los

Angeles California and the California Coalition for Compassionate Care. Network 18 staff was

able to connect with other care providers in this area of health care and gain insight on other how

other organizations address similar topics of ethics including end of life decisions that often arise

when dealing with a fragile population such as people with kidney disease. The Patient Services

Department has ensured that this is included in all presentations, all site visits, and when

conducting any case consultation on the phone.

Network 18 has been making efforts for several years to ensure that end of life is included in care

planning and that our dialysis staff have access to education and resources that are available.

Through the Coalition for Compassionate Care, the Network has been able to share valuable

webinars and educational materials that are available to our community in regards to advanced

directives, end of life planning, palliative care and hospice. This is an area that we will continue

to bring light to in our work with our population and will continue to grow the relationship with

Coalition and encourage our dialysis units to do the same.

Network 18 continues to engage with the ESCO based in San Diego to follow outcomes related

to this alternative payment model tracking facility participation in contract projects including

dialogue on the Board of Directors to consider innovative directions to accomplish assigned

metrics. This is an on-going discussion.

Network 18 partnered with the California Department of Health on their EBOLA grant with a

focus on improving infection control. To also improve infection control the Network provided

presentations to Association of Professionals in Infection Control (APIC) chapters locally in

Southern California.

The Quality Improvement Director provided education to providers at local American

Nephrology Nurses Association (ANNA) chapter meetings and at the Annual Dialysis

Conference as well as regional provider trainings. The Executive Director presented at the

National Renal Administrators Association (NRAA) Spring Meeting in Washington D.C.

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Facilities that Consistently Failed to Cooperate with Network Goals Network 18 used the following non-compliance policy in dealing with facilities who consistently

failed to cooperate with Network goals. While facilities were identified and started through the

process outlined below, none made it to stage three. These facilities demonstrated improvement

and cooperation with the Network by the end of the year.

Network 18 has a policy regarding non-compliance with Network projects. In addressing non-

compliant facilities the following steps are taken:

Stage One: Network staff shall call the Facility Administrator and discuss the

activity/information request and attempt to overcome any barriers.

Documentation will be maintained including notes on the discussion and the

parties involved in the discussion.

Stage Two: If there is no response, or an inadequate response to the call, Network staff

shall email the facility's Administrator and regional personnel describing the

area(s) of noncooperation, specifying a reasonable time frame for submitting

late material and/or a plan of corrective action and offering the assistance of

appropriate Network staff or committee members in resolving the problem.

Stage Three: If the facility continues in the uncooperative pattern, the Network will send

a letter to the facility and regional/corporate management describing the

goal/information/project required and set a 5 to 15 workday timeframe to

resolve the issues. The letter will let the facility know that being

uncooperative may be reported to CMS and/or state survey agencies and can

lead to the sanction process.

At this time Network staff will notify the Medical Review Board of the

uncooperative facility and attempts to rectify the situation.

Stage Four: If the facility still has not met the requirements of the goal/project or

information request, Network staff will meet with the Executive Director

and Medical Review Board to discuss starting the Sanction Policy for this

facility.

If it is agreed that the Network should progress to the Sanction policy, a

letter will be sent to the Facility Administrator, corporate office and

Chairman of the Network board of directors, notifying them of the decision

that the facility is uncooperative, and may be reported as uncooperative in

Network reporting, i.e., Network Annual Report which may be made public

and that the Network may begin the sanction process. CMS and state

surveyors may be notified of the facilities that are uncooperative.

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Recommendations for Sanctions Network 18 did not recommend any facilities for sanctions in 2016. No providers were identified

as consistently failing to cooperate with Network projects or to have serious quality of care

issues. State Surveyors did place facilities on the slow track for decertification, but all of these

cases were resolved with the Network’s assistance or offer of assistance.

Recommendations to CMS for Additional Services or Facilities Network 18 shared available aggregate data with State Survey Offices, CMS Region IX (San

Francisco) and Region X (Seattle) for use in conjunction with other factors in determining

prioritization of certification surveys, but made no specific recommendation for the addition of

dialysis facilities.

Grievances and Access to Care

Network 18 responds to grievances filed by or on behalf of ESRD patients in its service area. In

2016, the Network responded to 192 grievances. Of these, three (1.5%) involved issues related to

access to care.

Table D. Grievance Data for Calendar Year 2016

Source of data: Patient Contact Utility.

Cases Referred to State Survey Agencies In addition to routine notification to the state of any involuntary discharges for 2016, there were

nine grievance referrals and one referral related to access to care made to State Survey Agencies

for Network 18 in 2016:

Lack of 30 minute intradialytic checks identified during review of a grievance filed by

the wife of her deceased husband regarding the lack of professionalism, compassion, and

monitoring of patients on dialysis.

Grievant reported a lack of patient supervision, inadequate staffing as well as failure to

provide appropriate translation services to non-English speaking patients. Clinical

Category Number

Number of Grievance Cases Opened by the Network in Calendar Year 2016 192

Number of Grievance Cases Involving Access to Care 0

Number of Grievance Cases Involving Involuntary Transfer 0

Number of Grievance Cases Involving Involuntary Discharge 2

Number of Grievance Cases Involving Failure to Place 1

Number of Non-Grievance Cases Involving Access to Care 76

Number of Non-Grievance Cases Involving Involuntary Transfer 0

Number of Non-Grievance Cases Involving Involuntary Discharge 28

Number of Non-Grievance Cases Involving Failure to Place 4

Total Number of Grievance and Non-Grievance Cases Involving Access to Care 79

Number of Grievance Cases Closed by the Network in Calendar Year 2016 178

Number of Non-Grievance Access to Care Cases Closed by the Network in

Calendar Year 2016

66

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implications related to the concerns reported by the grievant had the potential to cause

immediate harm to patients.

Involuntary discharge not reported to the Network or the State prior to the patient being

discharged.

Violation of patient rights for the unit’s ongoing failure to provide a non-English

speaking patient with translation services.

Grievant reported that their blood line had been oozing blood undetected for over an hour

due to staff failure to physically check on the patient and the machine in the required

intervals.

Failure to address hypotensive events, prescription for dialysate flow and blood flow not

being followed per doctors’ orders, and post assessments not completed were identified

during the investigation of a grievance regarding limited staff and long wait times.

Unit lacking staff trained to cannulate a VWING access site, leading to the patient not

receiving dialysis.

Five anonymous letters received by the Network regarding inappropriate transplant

denials or delays in process at one specified transplant center.

Anonymous grievant reported staff is arriving up to four hours after the first patient is

scheduled to start leading to extensive delays in treatment start time.

Anonymous grievance reported the presence of gnats, specifically in the drains on the

treatment floor.

Emergency Preparedness and Response Network 18 works proactively throughout the year to ensure that all units in the Network area are

prepared for the possibility of a disaster. These efforts include the following:

Membership on the Los Angeles and Ventura County Health Care Coalition Emergency

Management groups. This includes phone calls as well in person meetings. Membership

on these groups ensure that the Network has the most recent emergency planning

information as it relates to all health care facilities as well as ensures that the voice and

needs of the dialysis population are heard and incorporated into disaster planning efforts.

Participated in DaVita’s Emergency Planning table top exercise which focused on

responding to a severe drought that limited dialysis unit and patient’s access to water.

Publicized and encouraged all units to participate in the Annual California Shake Out.

Participated in the Kidney Community Emergency Response (KCER) national exercise

drill.

Health alerts and medical recalls are shared with the dialysis community as they are

received.

State Survey Agency is notified each time there is an interruption in service at a dialysis

facility that impacts patient care in any way.

Send out Network wide notification of excessive heat, cold, or wind warnings that are

activated in the Network area. Resources for cooling stations were provided during

summer months when extreme heat was present.

Resources sent out on at least a quarterly basis to assist unit in maintaining their internal

emergency plans as well as ensuring that they keep patients and staff members updated

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on how to respond to an emergency and what resources are available to them (KCER

resources, local Emergency Medical Services, 3 day renal diets, emergency planning the

home, etc.).

The Network monitored all emergencies in its 13 county region throughout 2016 (wildfires,

earthquakes, power outages, flooding/mud slides, and/or minor issues that cause a unit to stop

services for any reason). Several patients were transferred to nearby units, as needed, to ensure

that dialysis was received during evacuations or an interruption in service outside the unit’s

control. The Network was able to assist one patient in getting a quick transfer by helping to

expedite records transfers on the unit’s behalf.

The Network experienced 11 wild fires during California’s fire season in 2016 (Boarder,

Reservoir, Fish, Bogart, Calabasas, Hollywood, Santa Clarity, Pilot, Blue Cut,

Goleta/Santa Barbara, and Kern). Each time a fire was identified; all units in the

surrounding area were contacted either by email or phone. All units provided updated

reports as requested by the Network to ensure that all the patients dialysis were met and

transfers were not required. Transfers for several patients were required as a result of

local evacuations or road closures, but no patients went without care.

A minor earthquake occurred in June of 2016. An update from CMS was requested, and

units were contacted to ensure no damage. The earthquake lasted only 30 seconds and no

damage was reported. Other minor earthquakes occurred on a regular basis in Southern

California.

In the event that patients are rescheduled due to power outages, the Network is notified

of how many patients were rescheduled and how many patients refused the rescheduling

of their treatment. If patients are moved to another location for treatment, the Network is

notified of how many patients were relocated, and to which locations they will be

treating at. All units inform the Network how long the interruption did or will last. The

Network reached out to the unit, as needed, depending on the severity of the event, or if

the unit requests additional assistance. This information is also shared with the State

Survey Agency, as it is received by the Network, to ensure ongoing collaboration.

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List of Tables Table 1. Incident (New) ESRD Patients in Network 18's Service Area, by Patient Characteristics

Table 2. Prevalent Dialysis Patients in Network 18's Service Area, by Patient Characteristics

Table 3. In-Home Dialysis Patients In Network 18's Service Area, by Dialysis Facility and Modality

Table 4. In-Center Dialysis Patients in Network 18's Service Area, by Dialysis Facility and Modality

Table 5. Number of Transplants Performed in Network 18's Service Area, by Transplant Center and

Donor Type and Number of Patients on Transplant Waiting List* in Network 18's Service Area, by

Transplant Center

Table 6. Renal Transplant* Recipients in Network 18’s Service Area, by Patient Characteristics

Table 7. Deaths among Dialysis Patients in Network 18’s Service Area, by Patient Characteristics

Table 8.A. Vocational Rehabilitation Status, Employment Status, and School Attendance of Prevalent

Dialysis Patients Age 18–54 Years in Network 18’s Service Area

Table 8.B. Vocational Rehabilitation Status, Employment Status, and School Attendance of Prevalent


Table 9.A. Incident ESRD Patients in Network 18’s Service Area, by Ethnicity and Race

Table 9.B. Prevalent Dialysis Patients in Network 18’s Service Area, by Ethnicity and Race

Table 9.C. Renal Transplant Recipients* in Network 18’s Service Area, by Ethnicity and Race

Page 18 of 61

Appendix. Data Tables

Table 1. Incident (New) ESRD Patients in Network 18's Service Area, by Patient Characteristics

January 1, 2016 – December 31, 2016

Network 18's Service Area CA Other Number Percent

Age Group

<= 4 Years 12 0 12 0.1 %

5-9 Years 5 0 5 0.0 %

10-14 Years 16 0 16 0.2 %

15-19 Years 33 0 33 0.3 %

20-24 Years 101 2 103 1.0%

25-29 Years 153 2 155 1.5 %

30-34 Years 208 5 213 2.1 %

35-39 Years 266 5 271 2.6 %

40-44 Years 410 6 416 4.0 %

45-49 Years 662 8 670 6.5 %

50-54 Years 866 12 878 8.5 %

55-59 Years 1137 17 1154 11.2 %

60-64 Years 1275 17 1292 12.5%

65-69 Years 1378 18 1396 13.6%

70-74 Years 1144 22 1166 11.3%

75-79 Years 1037 12 1049 10.2%

80-84 Years 791 8 799 7.8%

>= 85 Years 666 7 673 6.5%

Network-Level Total 10160 141 10301 100.0%

Median Age 64 63 64

Gender

Female 4152 51 4203 40.8%

Male 6008 90 6098 59.2%


Ethnicity*

Hispanic or Latino 4208 28 4236 41.1%

Not Hispanic or Latino 5931 113 6044 58.7%

Not Specified 21 21 0.2%


Race*

American Indian/Alaska Native 26 2 28 0.3%

Asian 1162 14 1176 11.4%

Black or African American 1103 17 1120 10.9%

Native Hawaiian or Other Pacific Islander 246 5 251 2.4%

White 7560 101 7661 74.4%

More Than One Race Reported 42 2 44 0.4%



Primary Cause of ESRD*

Page 19 of 61


Diabetes 5391 54 5445 52.9%

Glomerulonephritis 485 4 489 4.7%

Secondary Glomerulonephritis/Vasculitis 136 4 140 1.4%

Interstitial Nephritis/Pyelonephritis 149 2 151 1.5%

Transplant Complications 37 0 37 0.4%

Hypertension/Large Vessel Disease 2621 29 2650 25.7%

Cystic/Hereditary/Congenital/Other Diseases 255 6 261 2.5%

Neoplasms/Tumors 118 2 120 1.2%

Disorders of Mineral Metabolism 6 0 6 0.1%

Genitourinary System 22 1 23 0.2%

Acute Kidney Failure 276 13 289 2.8%

Miscellaneous Conditions 369 12 381 3.7%

Not Specified 295 14 309 3.0%



*Categories are from the CMS-2728 form.

NOTES:

1. This table includes data on dialysis and transplant patients whose initial “Admit Date” in CROWNWeb was

within the calendar year. Excludes patients with a "Discharge Reason” of acute kidney failure.

2. This table may include data on some patients receiving dialysis services from U.S. Department of Veterans

Affairs (VA) facilities.

3. Data on "ethnicity" and "race" should be interpreted with caution because of the inherent instability of

race/ethnicity data.

Page 20 of 61

Table 2. Prevalent Dialysis Patients in Network 18's Service Area, by Patient Characteristics



Age Group

<= 4 Years 43 0 43 0.1%

5-9 Years 17 0 17 0.0%

10-14 Years 40 0 40 0.1%

15-19 Years 70 1 71 0.2%

20-24 Years 343 4 347 0.8%

25-29 Years 810 6 816 1.8%

30-34 Years 1152 8 1160 2.5%

35-39 Years 1437 13 1450 3.2%

40-44 Years 2026 17 2043 4.5%

45-49 Years 3109 16 3125 6.8%

50-54 Years 4275 34 4309 9.4%

55-59 Years 5456 26 5482 12.0%

60-64 Years 6118 32 6150 13.5%

65-69 Years 6099 43 6142 13.5%

70-74 Years 4965 32 4997 10.9%

75-79 Years 3979 34 4013 8.8%

80-84 Years 2981 14 2995 6.6%

>= 85 Years 2442 21 2463 5.4%


Median Age 63 64 63

Gender

Female 18843 107 18950 41.5%

Male 26519 194 26713 58.5%


Ethnicity*

Hispanic or Latino 21390 92 21482 47.0%

Not Hispanic or Latino 23954 209 24163 52.9%



Race*

American Indian/Alaska Native 128 0 128 0.3%

Asian 4887 28 4915 10.8%

Black or African American 5856 59 5915 13.0%

Native Hawaiian or Other Pacific Islander 1139 9 1148 2.5%

White 33203 205 33408 73.2%

More Than One Race Reported 131 0 131 0.3%




Diabetes 23650 123 23773 52.1%

Glomerulonephritis 3067 24 3091 6.8%

Secondary Glomerulonephritis/Vasculitis 874 6 880 1.9%

Interstitial Nephritis/Pyelonephritis 721 9 730 1.6%

Page 21 of 61


Transplant Complications 34 1 35 0.1%

Hypertension/Large Vessel Disease 12293 92 12385 27.1%

Cystic/Hereditary/Congenital/Other Diseases 1333 10 1343 2.9%

Neoplasms/Tumors 871 5 876 1.9%

Disorders of Mineral Metabolism 6 1 7 0.0%

Genitourinary System 19 1 20 0.0%

Acute Kidney Failure 177 8 185 0.4%

Miscellaneous Conditions 1908 12 1920 4.2%

Not Specified 409 9 418 0.9%




NOTES:

1. This table includes data on all patients identified in CROWNWeb as alive and receiving dialysis services as of

December 31 of the calendar year.





Page 22 of 61

Table 3. In-Home Dialysis Patients In Network 18's Service Area, by Dialysis Facility and Modality


State HD CAPD CCPD Other

Modalities

Total In-Home

Patients

Total In-Center and In-

Home Patients

CA 402 885 3887 0 5174 45680

Network

Total

402 885 3887 0 5174 45680

Facility

CCN

HD CAPD CCPD Other

Modalities

Total In-Home

Patients


Home Patients

050022 0 0 0 0 0 0

050025 0 0 0 0 0 0

050069 0 0 0 0 0 0

050069 6 1 17 0 24 192

050100 0 0 0 0 0 0

050138 3 4 63 0 70 237

050139 0 11 90 0 101 101

050140 0 7 141 0 148 148

050245 0 0 0 0 0 58

050261 0 0 7 0 7 100

050262 0 0 0 0 0 0

050262 0 0 0 0 0 0

05027F 0 0 0 0 0 72

05029F 0 0 0 0 0 102

050327 0 0 0 0 0 0

050327 0 0 0 0 0 13

050348 0 0 0 0 0 0

050376 0 0 0 0 0 0

050424 0 0 0 0 0 0

050502 0 0 0 0 0 0

050561 0 1 31 0 32 32

050609 0 5 59 0 64 64

050625 0 0 0 0 0 0

050677 0 16 22 0 38 38

050686 0 2 111 0 113 113

050696 0 0 0 0 0 0

050723 0 7 76 0 83 83

05114F 0 4 7 0 11 74

05128F 0 0 13 0 13 74

052404 0 7 52 0 59 59

052500 0 0 0 0 0 110

052502 0 0 0 0 0 195

Page 23 of 61

Facility

CCN

HD CAPD CCPD Other

Modalities

Total In-Home

Patients


Home Patients

052503 20 0 8 0 28 175

052505 0 0 0 0 0 164

052513 0 1 4 0 5 66

052515 0 0 0 0 0 125

052521 0 13 7 0 20 194

052522 1 0 0 0 1 70

052523 0 0 0 0 0 101

052525 0 0 0 0 0 138

052532 0 0 0 0 0 181

052536 0 0 0 0 0 123

052538 0 0 0 0 0 185

052539 0 0 0 0 0 180

052541 0 0 0 0 0 114

052544 0 0 5 0 5 127

052545 2 0 0 0 2 173

052549 0 3 5 0 8 124

052550 0 0 45 0 45 164

052552 0 0 26 0 26 177

052554 0 0 10 0 10 213

052556 1 0 0 0 1 88

052558 0 1 3 0 4 214

052561 0 5 21 0 26 173

052564 0 0 0 0 0 141

052574 0 0 0 0 0 111

052575 0 0 0 0 0 174

052576 0 18 72 0 90 292

052579 0 0 0 0 0 60

052580 0 0 0 0 0 111

052581 0 0 0 0 0 91

052582 0 0 0 0 0 131

052585 0 0 0 0 0 100

052588 0 0 1 0 1 91

052589 1 1 34 0 36 189

052590 0 0 0 0 0 128

052591 0 8 11 0 19 215

052597 1 1 14 0 16 121

052599 0 0 0 0 0 150

052606 0 3 6 0 9 127

052613 0 2 8 0 10 159

052617 0 0 0 0 0 69

Page 24 of 61

Facility

CCN

HD CAPD CCPD Other

Modalities

Total In-Home

Patients


Home Patients

052619 0 14 0 0 14 219

052620 0 0 0 0 0 182

052621 0 0 0 0 0 81

052622 0 12 29 0 41 227

052627 0 6 3 0 9 87

052628 0 0 0 0 0 78

052631 1 20 24 0 45 185

052632 0 1 14 0 15 156

052633 0 2 18 0 20 177

052634 0 0 0 0 0 111

052635 0 0 0 0 0 121

052637 0 0 0 0 0 138

052638 0 0 16 0 16 101

052641 0 0 0 0 0 53

052643 0 0 0 0 0 0

052644 0 0 0 0 0 78

052648 0 1 5 0 6 89

052652 0 0 0 0 0 178

052653 0 0 0 0 0 171

052654 0 0 0 0 0 139

052656 1 1 40 0 42 163

052657 7 3 24 0 34 106

052658 0 0 0 0 0 83

052661 0 0 0 0 0 142

052665 0 0 0 0 0 126

052666 0 0 0 0 0 96

052668 0 0 0 0 0 44

052670 0 9 12 0 21 181

052671 0 0 0 0 0 190

052673 0 6 32 0 38 304

052674 0 0 0 0 0 179

052678 0 0 0 0 0 140

052679 0 0 0 0 0 42

052682 0 0 0 0 0 172

052683 3 2 13 0 18 143

052684 0 2 25 0 27 27

052686 0 0 0 0 0 170

052687 0 0 0 0 0 61

052690 0 0 0 0 0 63

052695 0 1 8 0 9 180

Page 25 of 61

Facility

CCN

HD CAPD CCPD Other

Modalities

Total In-Home

Patients


Home Patients

052696 0 18 52 0 70 222

052699 0 0 0 0 0 64

052700 0 6 10 0 16 152

052701 0 0 0 0 0 53

052708 0 0 0 0 0 201

052710 0 0 0 0 0 135

052712 0 6 7 0 13 234

052713 0 0 0 0 0 145

052714 1 14 7 0 22 211

052715 0 0 0 0 0 131

052716 0 0 0 0 0 100

052717 0 0 0 0 0 73

052718 0 0 0 0 0 88

052720 0 0 0 0 0 89

052724 0 0 0 0 0 58

052725 0 0 0 0 0 134

052726 0 0 0 0 0 116

052727 5 1 1 0 7 117

052730 0 0 0 0 0 132

052731 0 0 0 0 0 206

052734 0 0 7 0 7 171

052735 0 0 0 0 0 126

052739 0 0 0 0 0 105

052740 0 0 0 0 0 111

052743 0 9 19 0 28 212

052744 5 0 0 0 5 142

052746 2 0 0 0 2 318

052747 0 5 28 0 33 194

052755 0 0 0 0 0 67

052756 0 0 13 0 13 79

052760 0 0 0 0 0 72

052761 0 5 12 0 17 293

052762 0 0 0 0 0 129

052764 0 3 11 0 14 14

052768 0 0 0 0 0 76

052771 0 9 26 0 35 35

052772 0 0 0 0 0 95

052773 0 3 3 0 6 140

052776 0 3 6 0 9 84

052778 0 0 0 0 0 156

Page 26 of 61

Facility

CCN

HD CAPD CCPD Other

Modalities

Total In-Home

Patients


Home Patients

052779 16 7 85 0 108 320

052780 0 10 29 0 39 192

052781 0 0 8 0 8 189

052782 0 0 0 0 0 63

052785 0 0 0 0 0 120

052788 0 0 0 0 0 99

052789 0 0 0 0 0 55

052790 0 1 15 0 16 141

052791 0 0 0 0 0 66

052792 0 0 0 0 0 182

052794 0 13 72 0 85 334

052798 0 0 0 0 0 152

052799 0 0 0 0 0 106

052800 0 0 0 0 0 55

052801 0 0 0 0 0 127

052802 0 36 37 0 73 237

052803 0 0 0 0 0 118

052804 0 0 0 0 0 182

052806 0 0 0 0 0 32

052807 0 0 0 0 0 201

052808 0 0 0 0 0 97

052809 10 1 4 0 15 147

052811 0 1 0 0 1 43

052812 0 0 0 0 0 24

052816 0 3 1 0 4 71

052817 0 0 0 0 0 126

052818 0 0 0 0 0 118

052820 6 0 0 0 6 101

052821 1 8 50 0 59 179

052827 0 0 8 0 8 195

052828 0 0 0 0 0 142

052829 0 0 0 0 0 32

052830 0 0 0 0 0 127

052832 0 0 0 0 0 69

052834 23 1 28 0 52 132

052835 0 0 0 0 0 222

052836 0 0 0 0 0 33

052837 0 1 40 0 41 164

052838 0 1 1 0 2 121

052839 0 0 0 0 0 80

Page 27 of 61

Facility

CCN

HD CAPD CCPD Other

Modalities

Total In-Home

Patients


Home Patients

052840 0 0 0 0 0 113

052842 6 16 33 0 55 204

052843 0 0 0 0 0 59

052844 0 0 0 0 0 214

052846 0 0 0 0 0 91

052847 0 1 0 0 1 122

052848 0 0 0 0 0 178

052852 0 4 39 0 43 155

052854 0 14 1 0 15 115

052855 13 0 0 0 13 147

052856 0 0 0 0 0 134

052858 0 0 0 0 0 110

052859 9 0 0 0 9 149

052860 0 0 0 0 0 126

052861 0 0 0 0 0 158

052862 0 0 0 0 0 132

052863 0 0 0 0 0 151

052864 0 0 0 0 0 136

052865 0 0 20 0 20 35

052865 9 6 52 0 67 167

052866 0 3 8 0 11 180

052867 0 0 4 0 4 95

052868 0 1 0 0 1 119

052869 0 0 0 0 0 157

052871 0 14 13 0 27 233

052872 0 0 0 0 0 120

052873 0 1 6 0 7 73

052875 0 0 0 0 0 89

052878 0 0 0 0 0 116

052879 0 6 0 0 6 82

052880 0 0 0 0 0 185

052881 0 0 0 0 0 73

052882 0 0 0 0 0 129

052883 0 0 11 0 11 147

052884 0 13 8 0 21 193

052885 0 0 0 0 0 118

052886 0 0 0 0 0 69

052889 0 0 0 0 0 74

052890 6 3 13 0 22 179

052893 0 0 0 0 0 133

Page 28 of 61

Facility

CCN

HD CAPD CCPD Other

Modalities

Total In-Home

Patients


Home Patients

052894 0 0 0 0 0 114

052895 0 0 0 0 0 116

052896 0 0 0 0 0 109

052897 0 5 14 0 19 151

052898 1 1 2 0 4 104

052899 0 9 12 0 21 145

053302 0 0 0 0 0 0

053302 0 0 19 0 19 50

053303 0 0 13 0 13 22

053303 0 0 0 0 0 0

053506 0 1 19 0 20 176

053512 0 0 0 0 0 37

053527 0 0 0 0 0 134

552501 0 0 0 0 0 88

552502 0 0 0 0 0 65

552506 0 0 0 0 0 145

552507 0 0 1 0 1 115

552508 0 0 0 0 0 102

552509 0 6 8 0 14 117

552511 0 0 0 0 0 93

552513 0 7 20 0 27 136

552515 0 4 24 0 28 137

552516 0 0 0 0 0 92

552517 0 0 2 0 2 88

552518 0 1 5 0 6 104

552520 0 3 32 0 35 136

552521 4 22 49 0 75 190

552525 0 0 0 0 0 155

552526 0 6 26 0 32 151

552527 5 2 13 0 20 189

552532 0 0 0 0 0 134

552538 0 0 0 0 0 91

552541 8 0 0 0 8 134

552543 7 2 63 0 72 72

552544 0 4 8 0 12 139

552545 0 0 0 0 0 71

552546 4 2 16 0 22 22

552547 0 0 0 0 0 118

552548 0 0 0 0 0 135

552551 0 1 4 0 5 45

Page 29 of 61

Facility

CCN

HD CAPD CCPD Other

Modalities

Total In-Home

Patients


Home Patients

552552 8 1 23 0 32 148

552553 0 0 0 0 0 203

552554 0 0 0 0 0 116

552556 0 0 0 0 0 61

552561 0 0 0 0 0 74

552562 1 2 36 0 39 192

552565 0 2 38 0 40 40

552567 0 5 9 0 14 82

552568 0 0 0 0 0 89

552571 0 0 0 0 0 135

552573 0 0 0 0 0 90

552574 0 4 9 0 13 203

552575 0 1 10 0 11 85

552578 0 0 0 0 0 69

552579 0 0 0 0 0 68

552580 0 0 34 0 34 91

552583 0 0 0 0 0 113

552584 0 0 0 0 0 91

552585 0 3 86 0 89 89

552588 0 0 0 0 0 135

552589 0 0 8 0 8 227

552590 21 2 1 0 24 24

552593 0 1 27 0 28 142

552594 0 0 0 0 0 67

552595 3 1 1 0 5 78

552596 0 0 0 0 0 169

552597 0 0 0 0 0 82

552598 14 1 19 0 34 201

552599 0 0 0 0 0 133

552601 0 1 3 0 4 58

552609 0 3 25 0 28 164

552613 0 0 0 0 0 103

552614 0 0 0 0 0 158

552616 5 3 12 0 20 126

552617 13 0 0 0 13 13

552618 17 21 53 0 91 238

552622 0 0 0 0 0 202

552623 0 0 10 0 10 82

552624 0 0 0 0 0 165

552626 0 1 13 0 14 133

Page 30 of 61

Facility

CCN

HD CAPD CCPD Other

Modalities

Total In-Home

Patients


Home Patients

552627 0 60 108 0 168 168

552628 12 1 17 0 30 204

552630 0 0 0 0 0 75

552631 0 0 10 0 10 86

552636 7 1 5 0 13 113

552639 0 0 0 0 0 108

552640 0 0 0 0 0 124

552641 0 1 10 0 11 104

552644 5 14 36 0 55 55

552649 0 4 9 0 13 124

552655 0 11 28 0 39 39

552657 0 5 48 0 53 310

552659 0 0 0 0 0 111

552660 0 4 12 0 16 135

552661 0 0 0 0 0 91

552662 2 0 0 0 2 69

552663 0 0 0 0 0 110

552666 0 8 52 0 60 60

552667 0 0 0 0 0 150

552671 0 0 4 0 4 137

552673 0 1 2 0 3 56

552674 0 0 0 0 0 146

552675 17 0 7 0 24 24

552676 0 0 25 0 25 163

552677 4 18 70 0 92 92

552678 0 0 0 0 0 103

552679 0 0 0 0 0 77

552684 0 6 11 0 17 137

552686 0 0 0 0 0 52

552687 9 2 48 0 59 59

552690 0 0 0 0 0 155

552691 0 7 21 0 28 101

552692 0 0 0 0 0 114

552693 1 4 23 0 28 28

552694 8 34 47 0 89 89

552695 0 2 34 0 36 151

552696 0 0 0 0 0 120

552700 0 4 18 0 22 147

552701 0 0 0 0 0 144

552706 0 2 28 0 30 92

Page 31 of 61

Facility

CCN

HD CAPD CCPD Other

Modalities

Total In-Home

Patients


Home Patients

552707 0 0 0 0 0 113

552708 0 1 37 0 38 202

552709 0 0 0 0 0 159

552715 0 0 0 0 0 161

552718 10 0 0 0 10 59

552721 0 0 0 0 0 89

552722 0 0 0 0 0 69

552727 0 0 0 0 0 46

552728 6 0 3 0 9 63

552732 0 1 20 0 21 21

552734 0 7 7 0 14 87

552735 0 0 11 0 11 115

552740 0 2 8 0 10 103

552741 0 5 1 0 6 94

552742 0 0 0 0 0 70

552744 0 0 0 0 0 147

552745 0 0 0 0 0 154

552753 0 0 0 0 0 61

552755 0 0 0 0 0 53

552757 15 2 64 0 81 81

552758 0 1 8 0 9 9

552759 0 3 9 0 12 122

552762 0 0 0 0 0 77

552764 0 0 5 0 5 77

552766 0 0 0 0 0 87

552769 0 10 8 0 18 105

552770 16 2 1 0 19 84

552773 0 3 3 0 6 61

552774 0 0 0 0 0 138

552775 0 1 2 0 3 88

552776 1 11 38 0 50 50

552777 0 29 1 0 30 173

552778 0 0 0 0 0 71

552780 11 17 120 0 148 148

552781 4 0 2 0 6 77

552783 0 0 0 0 0 68

552784 0 2 28 0 30 30

552785 0 0 0 0 0 20

552786 3 0 0 0 3 45

552787 0 0 0 0 0 51

Page 32 of 61

Facility

CCN

HD CAPD CCPD Other

Modalities

Total In-Home

Patients


Home Patients

552789 0 0 0 0 0 1

552790 0 0 1 0 1 13

552791 0 0 0 0 0 77

552792 0 4 46 0 50 50

552793 0 0 0 0 0 40

552795 1 0 1 0 2 2

552796 0 0 0 0 0 9

552798 0 0 0 0 0 8

552799 0 19 0 0 19 19

552800 0 0 0 0 0 8

552801 0 0 3 0 3 30

552805 0 0 0 0 0 0

CA Total 402 885 3887 0 5174 45680

Source of data: ESRD Facility Survey (CMS-2744A) as recorded in CROWNWeb.

HD = Hemodialysis

CAPD = Continuous Ambulatory Peritoneal Dialysis

CCPD = Continuous Cycling Peritoneal Dialysis

NOTE: This table may include data for some U.S. Department of Veterans Affairs (VA) facilities.

Page 33 of 61

Table 4. In-Center Dialysis Patients in Network 18's Service Area, by Dialysis Facility and Modality


State HD PD Total In-Center

Patients


Home Patients

CA 40499 7 40506 45680

Network Total 40499 7 40506 45680

Facility CCN HD PD Total In-Center

Patients


Home Patients

050022 0 0 0 0

050025 0 0 0 0

050069 0 0 0 0

050069 168 0 168 192

050100 0 0 0 0

050138 167 0 167 237

050139 0 0 0 101

050140 0 0 0 148

050245 58 0 58 58

050261 93 0 93 100

050262 0 0 0 0

050262 0 0 0 0

05027F 72 0 72 72

05029F 102 0 102 102

050327 0 0 0 0

050327 13 0 13 13

050348 0 0 0 0

050376 0 0 0 0

050424 0 0 0 0

050502 0 0 0 0

050561 0 0 0 32

050609 0 0 0 64

050625 0 0 0 0

050677 0 0 0 38

050686 0 0 0 113

050696 0 0 0 0

050723 0 0 0 83

05114F 63 0 63 74

05128F 61 0 61 74

052404 0 0 0 59

052500 110 0 110 110

052502 195 0 195 195

Page 34 of 61


Patients


Home Patients

052503 147 0 147 175

052505 164 0 164 164

052513 61 0 61 66

052515 125 0 125 125

052521 174 0 174 194

052522 69 0 69 70

052523 101 0 101 101

052525 138 0 138 138

052532 181 0 181 181

052536 123 0 123 123

052538 185 0 185 185

052539 180 0 180 180

052541 114 0 114 114

052544 122 0 122 127

052545 171 0 171 173

052549 116 0 116 124

052550 119 0 119 164

052552 151 0 151 177

052554 203 0 203 213

052556 87 0 87 88

052558 210 0 210 214

052561 147 0 147 173

052564 141 0 141 141

052574 111 0 111 111

052575 174 0 174 174

052576 202 0 202 292

052579 60 0 60 60

052580 111 0 111 111

052581 91 0 91 91

052582 131 0 131 131

052585 100 0 100 100

052588 90 0 90 91

052589 153 0 153 189

052590 128 0 128 128

052591 196 0 196 215

052597 105 0 105 121

052599 150 0 150 150

052606 118 0 118 127

052613 149 0 149 159

052617 69 0 69 69

Page 35 of 61


Patients


Home Patients

052619 205 0 205 219

052620 182 0 182 182

052621 81 0 81 81

052622 186 0 186 227

052627 78 0 78 87

052628 78 0 78 78

052631 139 1 140 185

052632 140 1 141 156

052633 157 0 157 177

052634 111 0 111 111

052635 121 0 121 121

052637 138 0 138 138

052638 85 0 85 101

052641 53 0 53 53

052643 0 0 0 0

052644 78 0 78 78

052648 83 0 83 89

052652 178 0 178 178

052653 171 0 171 171

052654 139 0 139 139

052656 121 0 121 163

052657 72 0 72 106

052658 83 0 83 83

052661 142 0 142 142

052665 126 0 126 126

052666 96 0 96 96

052668 44 0 44 44

052670 158 2 160 181

052671 190 0 190 190

052673 266 0 266 304

052674 179 0 179 179

052678 140 0 140 140

052679 42 0 42 42

052682 172 0 172 172

052683 125 0 125 143

052684 0 0 0 27

052686 170 0 170 170

052687 61 0 61 61

052690 63 0 63 63

052695 171 0 171 180

Page 36 of 61


Patients


Home Patients

052696 151 1 152 222

052699 64 0 64 64

052700 136 0 136 152

052701 53 0 53 53

052708 201 0 201 201

052710 135 0 135 135

052712 221 0 221 234

052713 145 0 145 145

052714 189 0 189 211

052715 131 0 131 131

052716 100 0 100 100

052717 73 0 73 73

052718 88 0 88 88

052720 89 0 89 89

052724 58 0 58 58

052725 134 0 134 134

052726 116 0 116 116

052727 110 0 110 117

052730 132 0 132 132

052731 206 0 206 206

052734 164 0 164 171

052735 126 0 126 126

052739 105 0 105 105

052740 111 0 111 111

052743 184 0 184 212

052744 137 0 137 142

052746 316 0 316 318

052747 161 0 161 194

052755 67 0 67 67

052756 66 0 66 79

052760 72 0 72 72

052761 276 0 276 293

052762 129 0 129 129

052764 0 0 0 14

052768 76 0 76 76

052771 0 0 0 35

052772 95 0 95 95

052773 134 0 134 140

052776 75 0 75 84

052778 156 0 156 156

Page 37 of 61


Patients


Home Patients

052779 212 0 212 320

052780 153 0 153 192

052781 181 0 181 189

052782 63 0 63 63

052785 120 0 120 120

052788 99 0 99 99

052789 55 0 55 55

052790 125 0 125 141

052791 66 0 66 66

052792 182 0 182 182

052794 249 0 249 334

052798 152 0 152 152

052799 106 0 106 106

052800 55 0 55 55

052801 127 0 127 127

052802 164 0 164 237

052803 118 0 118 118

052804 182 0 182 182

052806 32 0 32 32

052807 201 0 201 201

052808 97 0 97 97

052809 132 0 132 147

052811 42 0 42 43

052812 24 0 24 24

052816 67 0 67 71

052817 126 0 126 126

052818 118 0 118 118

052820 95 0 95 101

052821 120 0 120 179

052827 187 0 187 195

052828 142 0 142 142

052829 32 0 32 32

052830 127 0 127 127

052832 69 0 69 69

052834 80 0 80 132

052835 222 0 222 222

052836 33 0 33 33

052837 123 0 123 164

052838 119 0 119 121

052839 80 0 80 80

Page 38 of 61


Patients


Home Patients

052840 113 0 113 113

052842 149 0 149 204

052843 59 0 59 59

052844 214 0 214 214

052846 91 0 91 91

052847 120 1 121 122

052848 178 0 178 178

052852 112 0 112 155

052854 100 0 100 115

052855 134 0 134 147

052856 134 0 134 134

052858 110 0 110 110

052859 140 0 140 149

052860 126 0 126 126

052861 158 0 158 158

052862 132 0 132 132

052863 151 0 151 151

052864 136 0 136 136

052865 15 0 15 35

052865 100 0 100 167

052866 169 0 169 180

052867 91 0 91 95

052868 118 0 118 119

052869 157 0 157 157

052871 206 0 206 233

052872 120 0 120 120

052873 66 0 66 73

052875 89 0 89 89

052878 116 0 116 116

052879 76 0 76 82

052880 185 0 185 185

052881 73 0 73 73

052882 129 0 129 129

052883 136 0 136 147

052884 172 0 172 193

052885 118 0 118 118

052886 69 0 69 69

052889 74 0 74 74

052890 157 0 157 179

052893 133 0 133 133

Page 39 of 61


Patients


Home Patients

052894 114 0 114 114

052895 116 0 116 116

052896 109 0 109 109

052897 132 0 132 151

052898 100 0 100 104

052899 124 0 124 145

053302 0 0 0 0

053302 31 0 31 50

053303 9 0 9 22

053303 0 0 0 0

053506 156 0 156 176

053512 37 0 37 37

053527 134 0 134 134

552501 88 0 88 88

552502 65 0 65 65

552506 145 0 145 145

552507 114 0 114 115

552508 102 0 102 102

552509 103 0 103 117

552511 93 0 93 93

552513 109 0 109 136

552515 109 0 109 137

552516 92 0 92 92

552517 86 0 86 88

552518 98 0 98 104

552520 101 0 101 136

552521 115 0 115 190

552525 155 0 155 155

552526 119 0 119 151

552527 169 0 169 189

552532 134 0 134 134

552538 91 0 91 91

552541 126 0 126 134

552543 0 0 0 72

552544 127 0 127 139

552545 71 0 71 71

552546 0 0 0 22

552547 118 0 118 118

552548 135 0 135 135

552551 40 0 40 45

Page 40 of 61


Patients


Home Patients

552552 116 0 116 148

552553 203 0 203 203

552554 116 0 116 116

552556 61 0 61 61

552561 74 0 74 74

552562 153 0 153 192

552565 0 0 0 40

552567 68 0 68 82

552568 89 0 89 89

552571 135 0 135 135

552573 90 0 90 90

552574 190 0 190 203

552575 74 0 74 85

552578 69 0 69 69

552579 68 0 68 68

552580 57 0 57 91

552583 113 0 113 113

552584 91 0 91 91

552585 0 0 0 89

552588 135 0 135 135

552589 219 0 219 227

552590 0 0 0 24

552593 114 0 114 142

552594 67 0 67 67

552595 73 0 73 78

552596 169 0 169 169

552597 82 0 82 82

552598 167 0 167 201

552599 133 0 133 133

552601 54 0 54 58

552609 136 0 136 164

552613 103 0 103 103

552614 158 0 158 158

552616 106 0 106 126

552617 0 0 0 13

552618 147 0 147 238

552622 202 0 202 202

552623 72 0 72 82

552624 165 0 165 165

552626 119 0 119 133

Page 41 of 61


Patients


Home Patients

552627 0 0 0 168

552628 174 0 174 204

552630 75 0 75 75

552631 76 0 76 86

552636 100 0 100 113

552639 108 0 108 108

552640 124 0 124 124

552641 93 0 93 104

552644 0 0 0 55

552649 111 0 111 124

552655 0 0 0 39

552657 257 0 257 310

552659 111 0 111 111

552660 119 0 119 135

552661 91 0 91 91

552662 67 0 67 69

552663 110 0 110 110

552666 0 0 0 60

552667 150 0 150 150

552671 133 0 133 137

552673 53 0 53 56

552674 146 0 146 146

552675 0 0 0 24

552676 138 0 138 163

552677 0 0 0 92

552678 103 0 103 103

552679 77 0 77 77

552684 120 0 120 137

552686 52 0 52 52

552687 0 0 0 59

552690 155 0 155 155

552691 73 0 73 101

552692 114 0 114 114

552693 0 0 0 28

552694 0 0 0 89

552695 115 0 115 151

552696 120 0 120 120

552700 124 1 125 147

552701 144 0 144 144

552706 62 0 62 92

Page 42 of 61


Patients


Home Patients

552707 113 0 113 113

552708 164 0 164 202

552709 159 0 159 159

552715 161 0 161 161

552718 49 0 49 59

552721 89 0 89 89

552722 69 0 69 69

552727 46 0 46 46

552728 54 0 54 63

552732 0 0 0 21

552734 73 0 73 87

552735 104 0 104 115

552740 93 0 93 103

552741 88 0 88 94

552742 70 0 70 70

552744 147 0 147 147

552745 154 0 154 154

552753 61 0 61 61

552755 53 0 53 53

552757 0 0 0 81

552758 0 0 0 9

552759 110 0 110 122

552762 77 0 77 77

552764 72 0 72 77

552766 87 0 87 87

552769 87 0 87 105

552770 65 0 65 84

552773 55 0 55 61

552774 138 0 138 138

552775 85 0 85 88

552776 0 0 0 50

552777 143 0 143 173

552778 71 0 71 71

552780 0 0 0 148

552781 71 0 71 77

552783 68 0 68 68

552784 0 0 0 30

552785 20 0 20 20

552786 42 0 42 45

552787 51 0 51 51

Page 43 of 61


Patients


Home Patients

552789 1 0 1 1

552790 12 0 12 13

552791 77 0 77 77

552792 0 0 0 50

552793 40 0 40 40

552795 0 0 0 2

552796 9 0 9 9

552798 8 0 8 8

552799 0 0 0 19

552800 8 0 8 8

552801 27 0 27 30

552805 0 0 0 0

CA Total 40499 7 40506 45680

Source of data: ESRD Facility Survey (CMS-2744A) as recorded in CROWNWeb.

HD = Hemodialysis

PD = Peritoneal Dialysis

NOTE: This table may include data for some U.S. Department of Veterans Affairs (VA) facilities.

Page 44 of 61

Table 5. Number of Transplants Performed in Network 18's Service Area, by Transplant Center and

Donor Type and Number of Patients on Transplant Waiting List* in Network 18's Service Area, by

Transplant Center


State Deceased

Donor

Living

Related

Donor

Living

Unrelated

Donor

Unknown

Donor Type

Total

Transplants

Performed

Patients on

Transplant

Waiting List

CA 922 168 173 0 1263 8571

Network

Total

922 168 173 0 1263 8571

Transplant

Center CCN

Deceased

Donor

Living

Related

Donor

Living

Unrelated

Donor

Unknown

Donor Type

Total

Transplants

Performed

Patients on

Transplant

Waiting List

050022 24 0 2 0 26 52

050025 43 7 11 0 61 744

050069 14 2 2 0 18 171

050100 34 17 14 0 65 516

050262 203 55 81 0 339 2255

050262 12 5 1 0 18 41

050327 91 23 15 0 129 1140

050348 28 5 3 0 36 696

050376 22 0 2 0 24 386

050424 40 5 13 0 58 683

050502 74 4 1 0 79 342

050625 174 27 24 0 225 1319

050696 141 12 4 0 157 157

053302 12 2 0 0 14 37

053303 10 4 0 0 14 32

CA Total 922 168 173 0 1263 8571

Source of data: CROWNWeb. Information on patients awaiting transplant comes from the ESRD Facility Survey

completed by transplant centers (Form CMS-2744B).

*As of December 31, 2016.

NOTE: Cumulative total for January 1, 2016 – December 31, 2016. A patient who had more than one transplant

during the calendar year is represented more than once in the table.

Page 45 of 61

Table 6. Renal Transplant* Recipients in Network 18’s Service Area, by Patient Characteristics


Network 18's Service Area Transplant Recipients Percent

Age Group

<= 4 Years 8 0.6%

5-9 Years 4 0.3%

10-14 Years 12 1.0%

15-19 Years 35 2.8%

20-24 Years 37 2.9%

25-29 Years 63 5.0%

30-34 Years 66 5.2%

35-39 Years 83 6.6%

40-44 Years 107 8.5%

45-49 Years 137 10.9%

50-54 Years 129 10.2%

55-59 Years 161 12.8%

60-64 Years 192 15.2%

65-69 Years 144 11.4%

70-74 Years 70 5.5%

75-79 Years 13 1.0%

80-84 Years 1 0.1%

>= 85 Years 0 0.0%

Network-Level Total 1262 100.0%

Median Age 52

Gender

Female 539 42.7%

Male 723 57.3%


Ethnicity*

Hispanic or Latino 574 45.5%

Not Hispanic or Latino 688 54.5%


Race*

American Indian/Alaska Native 1 0.1%

Asian 116 9.2%

Black or African American 128 10.1%

Native Hawaiian or Other Pacific Islander 22 1.7%

White 991 78.5%

More Than One Race Reported 4 0.3%


Primary Cause of ESRD**

Diabetes 329 26.1%

Glomerulonephritis 197 15.6%

Secondary Glomerulonephritis/Vasculitis 47 3.7%

Interstitial Nephritis/Pyelonephritis 28 2.2%

Transplant Complications 1 0.1%

Page 46 of 61

Network 18's Service Area Transplant Recipients Percent

Hypertension/Large Vessel Disease 273 21.6%

Cystic/Hereditary/Congenital/Other Diseases 137 10.9%

Neoplasms/Tumors 72 5.7%

Disorders of Mineral Metabolism 0 0.0%

Genitourinary System 0 0.0%

Acute Kidney Failure 51 4.0%

Miscellaneous Conditions 109 8.6%

Not Specified 18 1.4%



*Data are shown for unduplicated patients. A patient who had more than one transplant during the calendar year is

counted only once in the table.

**Categories are from the CMS-2728 form.

NOTES:

1. Data on “ethnicity” and “race” should be interpreted with caution because of the inherent instability of


Page 47 of 61

Table 7. Deaths among Dialysis Patients in Network 18’s Service Area, by Patient Characteristics


Network 18's Service Area Number Percent

Age Group

<= 4 Years 3 0.0%

5-9 Years 2 0.0%

10-14 Years 0 0.0%

15-19 Years 0 0.0%

20-24 Years 6 0.1%

25-29 Years 29 0.4%

30-34 Years 40 0.6%

35-39 Years 64 1.0%

40-44 Years 110 1.7%

45-49 Years 206 3.1%

50-54 Years 365 5.6%

55-59 Years 578 8.8%

60-64 Years 724 11.1%

65-69 Years 916 14.0%

70-74 Years 910 13.9%

75-79 Years 903 13.8%

80-84 Years 779 11.9%

>= 85 Years 916 14.0%


Median Age 71

Gender

Female 2850 43.5%

Male 3701 56.5%


Ethnicity*

Hispanic or Latino 2387 36.4%

Not Hispanic or Latino 4160 63.5%



Race*

American Indian/Alaska Native 17 0.3%

Asian 686 10.5%


Native Hawaiian or Other Pacific Islander 138 2.1%

White 4824 73.6%





Diabetes 3657 55.8%

Glomerulonephritis 261 4.0%

Secondary Glomerulonephritis/Vasculitis 66 1.0%

Interstitial Nephritis/Pyelonephritis 119 1.8%

Page 48 of 61

Network 18's Service Area Number Percent

Transplant Complications 5 0.1%

Hypertension/Large Vessel Disease 1792 27.4%

Cystic/Hereditary/Congenital/Other Diseases 79 1.2%

Neoplasms/Tumors 130 2.0%

Disorders of Mineral Metabolism 0 0.0%

Genitourinary System 3 0.0%

Acute Kidney Failure 42 0.6%

Miscellaneous Conditions 336 5.1%



Primary Cause of Death**

Cardiac 3303 50.4%

Endocrine 0 0.0%

Gastrointestinal 49 0.7%

Infection 514 7.8%

Liver Disease 55 0.8%

Metabolic 24 0.4%

Vascular 214 3.3%

Other 1077 16.4%

Unknown 1166 17.8%






NOTES:

1. This table may include data on some patients who received dialysis services from U.S. Department of Veterans


2. Data on “ethnicity” and “race” should be interpreted with caution because of the inherent instability of


Page 49 of 61

Table 8.A. Vocational Rehabilitation Status, Employment Status, and School Attendance of Prevalent



State Aged 18

through

54

Referred to Voc

Rehab Services

Receiving Voc

Rehab Services

Employed Full-

Time or Part-

Time

Attending School

Full-Time or Part-

Time

CA 13278 106 61 2413 142

Network Total 13278 106 61 2413 142

Facility CCN Aged 18

through

54

Referred to Voc

Rehab Services

Receiving Voc

Rehab Services

Employed Full-

Time or Part-

Time

Attending School

Full-Time or Part-

Time

050069 62 1 0 17 5

050138 53 0 0 17 1

050139 45 0 1 20 1

050140 51 1 1 26 1

050245 25 0 0 1 0

050261 34 0 0 4 1

05027F 6 0 0 1 0

05029F 6 0 0 1 0

050327 1 0 0 0 0

050561 12 0 0 9 1

050609 28 0 0 19 0

050677 12 0 0 6 0

050686 42 0 0 16 1

050723 29 0 0 17 0

05114F 10 0 0 2 0

05128F 5 0 0 1 0

052404 22 1 0 9 1

052500 30 1 0 0 0

052502 66 0 0 6 0

052503 86 0 0 18 0

052505 48 0 0 10 0

052513 12 0 0 4 0

052515 25 1 1 7 0

052521 81 0 0 7 1

052522 27 0 0 0 0

052523 40 0 0 6 0

052525 32 0 0 3 0

052532 60 0 1 7 3

052536 17 0 0 3 0

052538 54 0 0 12 3

052539 54 1 0 13 0

052541 30 0 0 3 0

052544 29 0 0 6 0

052545 42 0 0 6 1

052549 27 0 0 10 0

052550 64 2 0 17 8

Page 50 of 61


through

54

Referred to Voc

Rehab Services

Receiving Voc

Rehab Services

Employed Full-

Time or Part-

Time

Attending School

Full-Time or Part-

Time

052552 56 0 0 15 3

052554 66 0 0 30 1

052556 11 0 0 1 0

052558 71 1 0 19 1

052561 74 1 0 9 0

052564 31 0 0 10 1

052574 27 0 0 6 0

052575 58 0 0 1 0

052576 105 0 1 32 2

052579 8 0 0 4 1

052580 34 0 0 5 0

052581 21 0 15 9 0

052582 31 0 0 7 0

052585 36 0 0 6 0

052588 15 0 0 2 0

052589 94 0 1 14 2

052590 48 1 0 6 0

052591 58 0 0 10 0

052597 33 0 0 5 0

052599 44 0 0 6 0

052606 48 0 0 6 0

052613 41 0 0 11 0

052617 17 0 0 1 0

052619 54 1 1 22 6

052620 47 0 0 2 0

052621 14 0 0 2 0

052622 77 0 0 7 0

052627 24 0 0 2 0

052628 22 0 0 1 0

052631 47 0 0 4 0

052632 40 0 0 13 0

052633 53 1 0 10 0

052634 23 0 0 2 0

052635 42 0 0 3 0

052637 42 0 0 7 0

052638 31 0 0 8 1

052641 22 0 0 13 0

052644 20 0 0 2 0

052648 21 0 0 5 1

052652 60 0 0 4 0

052653 36 0 0 4 1

052654 33 0 0 8 0

052656 51 1 0 19 3

052657 35 0 0 8 0

052658 24 0 0 1 0

052661 41 0 1 2 2

Page 51 of 61


through

54

Referred to Voc

Rehab Services

Receiving Voc

Rehab Services

Employed Full-

Time or Part-

Time

Attending School

Full-Time or Part-

Time

052665 26 0 0 6 3

052666 31 0 0 2 0

052668 4 0 0 2 0

052670 57 0 0 7 0

052671 68 0 0 7 0

052673 126 0 0 13 0

052674 54 0 0 3 0

052678 39 0 0 3 0

052679 8 0 0 4 0

052682 48 0 0 5 0

052683 44 0 0 2 0

052684 15 0 0 1 0

052686 43 0 0 2 1

052687 18 0 0 2 0

052690 18 0 0 0 0

052695 72 1 1 6 0

052696 97 0 0 13 3

052699 23 0 0 3 0

052700 42 0 0 6 0

052701 8 0 1 6 0

052708 52 0 0 11 0

052710 52 1 1 13 1

052712 50 1 0 13 0

052713 62 0 0 4 0

052714 63 0 0 5 1

052715 30 0 0 2 0

052716 27 0 0 5 0

052717 25 0 0 1 0

052718 33 0 0 5 0

052720 18 0 0 0 0

052724 18 0 0 0 0

052725 41 0 0 3 0

052726 24 0 0 3 0

052727 27 0 0 6 0

052730 24 1 1 3 1

052731 36 0 0 9 0

052734 44 0 0 3 0

052735 31 0 0 9 0

052739 27 0 0 6 0

052740 28 0 0 8 1

052743 72 0 0 12 0

052744 30 1 0 8 0

052746 113 0 0 18 1

052747 50 0 0 15 0

052755 16 0 0 4 0

052756 19 0 0 4 0

Page 52 of 61


through

54

Referred to Voc

Rehab Services

Receiving Voc

Rehab Services

Employed Full-

Time or Part-

Time

Attending School

Full-Time or Part-

Time

052760 27 0 0 10 0

052761 110 0 0 15 4

052762 31 1 0 5 0

052764 10 0 0 1 0

052768 23 0 0 1 0

052771 17 0 0 6 0

052772 29 1 0 6 1

052773 31 0 0 4 0

052776 24 0 0 0 0

052778 33 0 0 4 0

052779 89 0 1 32 1

052780 58 0 0 8 1

052781 68 1 0 6 2

052782 15 5 0 4 0

052785 28 0 0 4 0

052788 30 0 0 8 0

052789 12 0 1 2 1

052790 39 0 0 3 1

052791 20 0 0 0 0

052792 42 0 0 3 0

052794 167 0 0 8 0

052798 38 0 0 7 0

052799 39 0 1 2 2

052800 13 0 0 2 0

052801 37 0 0 1 0

052802 135 0 1 10 1

052803 25 0 0 9 0

052804 57 0 0 12 1

052806 14 0 0 2 0

052807 74 0 0 7 0

052808 26 0 0 11 0

052809 41 0 0 4 0

052811 8 0 0 2 0

052812 8 1 0 1 0

052816 28 0 0 1 0

052817 28 0 0 3 0

052818 47 0 3 9 3

052820 18 2 2 3 2

052821 44 0 1 13 1

052827 54 0 1 5 2

052828 45 0 0 2 0

052829 7 0 0 0 0

052830 29 0 0 1 0

052832 20 0 0 1 1

052834 34 0 0 11 0

052835 52 0 0 14 0

Page 53 of 61


through

54

Referred to Voc

Rehab Services

Receiving Voc

Rehab Services

Employed Full-

Time or Part-

Time

Attending School

Full-Time or Part-

Time

052836 9 0 0 3 0

052837 45 1 0 16 0

052838 31 0 0 6 1

052839 28 0 0 1 0

052840 38 0 0 5 0

052842 68 0 0 19 1

052843 15 0 0 3 0

052844 70 2 0 23 1

052846 26 1 0 1 0

052847 18 0 0 2 0

052848 45 0 0 17 0

052852 34 0 0 5 0

052854 24 0 0 8 0

052855 27 0 0 14 1

052856 55 0 0 4 0

052858 34 0 0 4 0

052859 33 0 0 10 0

052860 28 1 0 10 0

052861 44 0 0 15 0

052862 25 1 1 11 1

052863 40 2 0 4 0

052864 32 0 0 3 1

052865 67 0 0 18 1

052866 50 0 1 5 0

052867 30 0 1 3 1

052868 27 0 0 0 0

052869 54 0 1 3 1

052871 76 0 0 16 1

052872 55 0 0 8 0

052873 14 1 0 2 0

052875 27 0 0 4 0

052878 26 1 0 6 0

052879 9 0 0 4 0

052880 39 0 1 10 1

052881 12 1 0 9 0

052882 23 0 0 12 0

052883 40 0 0 2 0

052884 35 10 2 10 4

052885 25 0 0 2 0

052886 21 0 0 3 0

052889 13 0 0 6 0

052890 49 0 0 8 0

052893 36 0 0 10 1

052894 24 0 0 2 0

052895 36 1 1 7 1

052896 23 0 0 0 0

Page 54 of 61


through

54

Referred to Voc

Rehab Services

Receiving Voc

Rehab Services

Employed Full-

Time or Part-

Time

Attending School

Full-Time or Part-

Time

052897 58 0 0 13 0

052898 18 0 0 5 0

052899 29 0 0 5 0

053302 1 0 0 0 0

053303 5 0 0 0 0

053506 48 0 0 11 0

053512 9 0 0 0 0

053527 35 0 0 12 0

552501 20 20 0 3 0

552502 15 0 0 4 0

552506 27 0 0 6 0

552507 31 0 0 3 0

552508 15 0 0 6 0

552509 30 0 0 9 0

552511 27 0 0 3 0

552513 45 0 0 5 0

552515 23 0 1 12 1

552516 18 0 0 3 0

552517 20 0 1 7 1

552518 34 0 0 4 0

552520 42 2 0 10 1

552521 60 0 0 10 2

552525 36 0 0 14 1

552526 71 0 0 5 0

552527 55 0 0 6 0

552532 22 0 0 7 0

552538 22 0 0 3 0

552541 41 0 0 6 0

552543 21 3 0 12 4

552544 35 0 0 10 0

552545 15 0 0 2 0

552546 12 0 0 3 0

552547 38 2 0 13 2

552548 36 0 0 7 0

552551 10 0 0 2 0

552552 48 0 0 8 0

552553 61 0 1 7 0

552554 33 0 0 4 1

552556 6 0 0 3 0

552561 14 0 0 3 0

552562 55 0 0 9 0

552565 23 2 0 9 3

552567 21 0 0 5 0

552568 19 0 0 6 0

552571 33 0 1 4 1

552573 30 3 0 6 0

Page 55 of 61


through

54

Referred to Voc

Rehab Services

Receiving Voc

Rehab Services

Employed Full-

Time or Part-

Time

Attending School

Full-Time or Part-

Time

552574 46 0 1 3 0

552575 30 0 0 1 0

552578 18 2 0 0 0

552579 32 0 0 1 0

552580 21 0 0 11 0

552583 12 0 0 0 0

552584 30 0 1 7 0

552585 26 0 0 2 0

552588 47 1 0 6 0

552589 42 0 0 12 0

552590 12 0 0 2 0

552593 44 0 0 4 0

552594 12 0 0 1 0

552595 22 0 0 14 0

552596 60 0 0 12 0

552597 23 0 0 3 0

552598 52 0 2 8 3

552599 35 6 0 3 0

552601 9 0 0 2 0

552609 62 0 0 12 0

552613 25 0 0 0 1

552614 44 0 0 4 0

552616 51 0 0 6 0

552617 10 0 0 2 0

552618 96 0 0 15 0

552622 70 0 1 12 0

552623 32 0 1 2 0

552624 44 0 0 9 0

552626 34 0 0 1 0

552627 65 0 0 15 0

552628 59 0 0 6 1

552630 21 0 0 4 2

552631 26 1 0 6 1

552636 32 0 0 5 0

552639 23 0 0 6 0

552640 38 0 0 0 0

552641 29 0 0 3 0

552644 27 0 0 7 1

552649 54 0 1 2 1

552655 17 0 0 2 0

552657 92 0 0 10 0

552659 48 0 0 10 1

552660 30 0 1 5 1

552661 38 0 1 0 0

552662 9 0 0 2 0

552663 32 1 0 3 0

Page 56 of 61


through

54

Referred to Voc

Rehab Services

Receiving Voc

Rehab Services

Employed Full-

Time or Part-

Time

Attending School

Full-Time or Part-

Time

552666 20 0 0 10 0

552667 46 0 0 7 0

552671 46 0 0 2 0

552673 13 1 0 3 0

552674 39 0 0 6 0

552675 10 0 0 3 0

552676 58 0 0 13 0

552677 20 0 0 9 0

552678 29 0 0 2 0

552679 21 0 0 2 0

552684 54 0 0 6 0

552686 11 1 0 1 0

552687 24 0 0 11 0

552690 23 0 0 9 0

552691 19 0 0 5 0

552692 30 0 0 2 0

552693 13 0 0 5 0

552694 50 0 0 11 3

552695 46 0 0 6 0

552696 24 0 0 7 0

552700 41 0 0 5 0

552701 34 1 0 13 0

552706 14 0 0 5 0

552707 26 0 0 5 0

552708 71 0 0 11 0

552709 46 0 0 3 0

552715 44 0 0 7 0

552718 12 0 0 5 0

552721 19 0 0 3 0

552722 25 0 0 0 0

552727 11 0 1 1 1

552728 21 1 0 6 0

552732 8 0 0 3 0

552734 20 0 0 11 0

552735 37 0 0 6 0

552740 35 0 0 1 0

552741 25 2 0 6 0

552742 17 0 0 2 0

552744 36 0 0 10 0

552745 34 0 0 6 0

552753 19 0 0 1 0

552755 11 3 0 3 0

552757 39 0 0 10 0

552758 1 0 0 0 0

552759 29 0 0 8 1

552762 22 0 0 3 0

Page 57 of 61


through

54

Referred to Voc

Rehab Services

Receiving Voc

Rehab Services

Employed Full-

Time or Part-

Time

Attending School

Full-Time or Part-

Time

552764 27 0 0 2 0

552766 21 0 0 3 0

552769 32 0 0 1 0

552770 28 0 1 2 1

552773 18 0 0 2 0

552774 41 0 0 9 0

552775 36 1 0 3 0

552776 30 0 0 5 0

552777 31 0 0 9 0

552778 14 0 0 4 0

552780 68 0 0 20 1

552781 30 0 0 10 0

552783 24 0 0 4 0

552784 11 0 0 6 0

552785 6 0 0 0 0

552786 10 1 0 4 0

552787 7 0 0 0 0

552789 1 0 0 0 0

552790 3 0 0 0 0

552791 25 0 0 1 0

552792 18 0 0 8 0

552793 11 0 0 0 0

552795 1 0 0 1 0

552796 3 0 0 0 0

552798 5 0 0 0 0

552799 12 0 0 6 0

552800 3 0 0 3 0

552801 9 0 0 1 0

552805 2 0 0 1 0

CA Total 13278 106 61 2413 142

Page 58 of 61

Table 8.B. Vocational Rehabilitation Status, Employment Status, and School Attendance of Prevalent



Category Referred

to Voc

Rehab

Services

Receiving

Voc

Rehab

Services

Completed

Voc

Rehab

Services

Not

Eligible

for Voc

Rehab

Services

Declined

Voc

Rehab

Services

No

Voc

Rehab

Status

Employed Full-Time

Attending School Full-Time 0 0 0 1 1 1

Attending School Part-Time 0 1 0 0 1 5

Not Attending School 6 2 1 84 159 80

School Status Not Specified 3 5 1 6 20 1449

Employed Part-Time





Employment Status Not Specified





Homemaker





Retired*





Medical Leave of Absence





Other**






*Retired due to preference or disability.

**Other = Employment Status of Student or Unemployed

Voc Rehab = Vocational Rehabilitation

Page 59 of 61

Table 9.A. Incident ESRD Patients in Network 18’s Service Area, by Ethnicity and Race


Ethnicity* Category Race* Category Number Percent

Hispanic or Latino American Indian/Alaska Native 1 0.0%

Asian 15 0.4%


Native Hawaiian or Other Pacific

Islander

19 0.4%

White 4187 98.8%


Total 4236 100.0%

Not Hispanic or Latino American Indian/Alaska Native 27 0.4%

Asian 1161 19.2%



Islander

232 3.8%

White 3474 57.5%


Total 6044 100.0%

Ethnicity Not Specified American Indian/Alaska Native 0 0.0%

Asian 0 0.0%



Islander

0 0.0%

White 0 0.0%



Total 21 100.0%

Total: Incident ESRD Patients 10301



NOTES:

1. This table includes data on dialysis and transplant patients whose initial "Admit Date" in CROWNWeb was

within the calendar year. Excludes patients with a "Discharge Reason" of acute kidney failure.





Page 60 of 61

Table 9.B. Prevalent Dialysis Patients in Network 18’s Service Area, by Ethnicity and Race


Ethnicity* Category Race* Category Number Percent


Asian 47 0.2%



Islander

75 0.3%

White 21291 99.1%


Total 21482 100.0%


Asian 4868 20.1%



Islander

1073 4.4%

White 12116 50.1%



Total 24163 100.0%


Asian 0 0.0%



Islander

0 0.0%

White 1 5.6%



Total 18 100.0%

Total: Prevalent ESRD Patients 45663



NOTES:

1. This table includes data on all patients identified in CROWNWeb as alive and receiving dialysis services as of

December 31 of the calendar year.





Page 61 of 61

Table 9.C. Renal Transplant Recipients* in Network 18’s Service Area, by Ethnicity and Race


Ethnicity** Category Race** Category Number Percent


Asian 1 0.2%



Islander

2 0.3%

White 570 99.3%


Total 574 100.0%


Asian 115 16.7%



Islander

20 2.9%

White 421 61.2%


Total 688 100.0%


Asian 0 0.0%



Islander

0 0.0%

White 0 0.0%


Total 0 0.0%

Total: Transplant ESRD Patients 1262


*Data are shown for unduplicated patients. A patient who had more than one transplant during the calendar year is

counted only once in the table.


NOTES:



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