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Complete QIP Data - Payment Year 2014

Row numberFacility NameCMS Certification NumberAlternate CCN 1Alternate CCN 2Alternate CCN 3Address 1Address 2CityStateZip CodeNetworkHemoglobin 12 g/dL Measure ScoreHemoglobin 12 g/dL Performance Period RateNumber of Hemoglobin Eligible Patients Performance PeriodHemoglobin 12 g/dL Baseline Period RateNumber of Hemoglobin Eligible Patients Baseline PeriodHemoglobin 12 g/dL Performance Score AppliedURR Measure ScoreURR Performance Period RateNumber of URR Eligible Patients Performance PeriodURR Baseline Period RateNumber of URR Eligible Patients Baseline PeriodURR Performance Score AppliedFistula Measure ScoreFistula Performance Period RateNumber of Fistula Patient Months Performance PeriodFistula Baseline Period RateNumber of Fistula Patient Months Baseline PeriodFistula Performance Score AppliedCatheter Measure ScoreCatheter Performance Period RateNumber of Catheter Patient Months Performance PeriodCatheter Baseline Period RateNumber of Catheter Patient Months Baseline PeriodCatheter Performance Score AppliedVascular Access Combined Measure ScoreICH CAHPS Admin ScoreNHSN Event Reporting ScoreMineral Metabolism Reporting ScoreTotal Performance ScorePY2014 Payment Reduction PercentageCMS Certification DateOwnership as of December 31, 2012Date of ownership record update
301ASHLEY DIALYSIS0425601019 FRED LAGRONE DRIVECROSSETTAR7163513100%383%34Achievement295%3794%32Achievement869%41764%349Achievement318%41120%230Achievement6%1051062%No reduction03/15/2000INDEPENDENT03/02/2000
302US RENAL CARE OF NORTHEAST AR - PARAGOULD042562901 WEST KINGS HIGHWAYPARAGOULDAR7245013100%3517%30Achievement10100%39100%28Achievement045%39043%336Achievement036%36031%230Achievement0%10101070%No reduction03/09/2001US RENAL CARE, INC.01/05/2001
303DAVITA - HEMPSTEAD COUNTY DIALYSIS UNIT0425631803 SOUTH LAURELHOPEAR7180113N/A00%33N/AN/A097%32N/AN/A053%363N/AN/A08%264N/A1010067%No reduction09/28/2001DAVITA09/16/2001
304US RENAL CARE - PINE BLUFF0425642800 WEST 28TH STREETPINE BLUFFAR7160313100%9613%71Achievement899%80100%64Achievement458%86553%787Achievement029%80325%552Achievement2%10101070%No reduction09/27/2001US RENAL CARE, INC.08/31/2001
305PINE BLUFF DIALYSIS - KIDNEY CTR OF MCGEHEE042565610 WEST HOLLY STREETMCGEHEEAR7165413100%289%23Achievement10100%26100%22Achievement035%30434%253Achievement033%27823%171Achievement0%10101070%No reduction10/01/2001US RENAL CARE, INC.08/31/2001
306RVM - RENAL CTR OF MTN HOME042567200 EAST 8TH STREET #101MOUNTAIN HOMEAR7265313100%492%53Achievement092%3896%45Achievement662%46963%551Achievement027%42724%376Achievement3%10101049%0.5%04/01/2002RENAL VENTURES MANAGEMENT03/31/2002
307DAVITA - SPRINGDALE042568708 QUANDT AVENUESPRINGDALEAR7276413100%289%33Achievement10100%3197%32Achievement1076%35276%357Achievement88%31911%237Achievement9%1010094%No reduction07/03/2002DAVITA05/16/2002
308HOPE DIALYSIS CENTER042569407 WEST 16TH STREETHOPEAR7180113N/A76N/AN/A97N/AN/A7959%104N/AN/A3918%67N/A0101067%No reduction08/16/2002INDEPENDENT08/02/2002
309MALVERN KIDNEY CTR0425701590 TANNER ROADMALVERNAR7210413100%267%28Achievement10100%3097%29Achievement353%33642%335Achievement612%32017%235Achievement5%1051083%No reduction04/14/2003INDEPENDENT04/02/2003
310DVA RENAL HEALTHCARE - LITTLE ROCK DIALYSIS0425715800 WEST TENTH STREET SUITE 510LITTLE ROCKAR7220413100%932%88Achievement10100%6793%69Achievement560%83266%823Achievement221%77618%587Achievement4%1010079%No reduction03/01/2003OTHER CHAIN(number of facilities <20 )02/02/2003
311DAVITA - RENAL CARE OF MARION0425732921 HIGHWAY 77 #8BELLA-VISTA COMMONSMARIONAR723641391%728%75Achievement10100%5898%61Achievement042%71341%677Achievement514%6354%474Achievement3%10101076%No reduction03/12/2004DAVITA02/20/2004
312NORTH HILLS DIALYSIS042574107 EAST MONTE PAINTER DRIVEFAYETTEVILLEAR7270313100%9713%113Achievement496%7499%72Achievement662%93258%1007Achievement124%87224%716Achievement4%10101064%No reduction08/03/2005INDEPENDENT05/27/2005
313BENTON COUNTY DIALYSIS CTR042575801 SOUTHEAST PLAZA AVENUE SUITE 1BENTONVILLEAR727121382%437%55Achievement10100%4596%50Achievement663%54061%584Achievement028%48327%394Achievement3%10101073%No reduction09/09/2005INDEPENDENT05/27/2005
314BRADLEY COUNTY DIALYSIS042576204 NORTH BRAGGWARRENAR7167113100%180%20Achievement10100%18100%19Achievement147%21352%228Achievement103%1971%164Achievement6%1051086%No reduction10/14/2005INDEPENDENT10/02/2005
315NEA BAPTIST CLINIC0425773005 MIDDLEFIELD STREETJONESBOROAR7240113100%527%56Achievement10100%4696%47Achievement560%52058%547Achievement320%49227%380Improvement4%10101082%No reduction11/09/2005INDEPENDENT10/02/2005
316DAVITA - MILLER COUNTY DIALYSIS042578816 EAST STREETTEXARKANAAR718541364%534%68Achievement10100%50100%67Achievement042%38845%782Achievement028%22421%544Achievement0%1010055%No reduction08/02/2006DAVITA03/02/2006
317DIALYSIS CENTER OF SILOAM SPRINGS0425802125 EAST MAIN SUITE 12SILOAM SPRINGSAR7276113100%2216%32Achievement10100%2794%32Achievement664%26167%361Achievement027%24923%247Achievement3%10101079%No reduction02/26/2007INDEPENDENT01/18/2007
318VAMANA, INC042581422 BEECH STREETTEXARKANAAR718541328%137%15Achievement194%1795%20Achievement252%15452%236Achievement036%5919%140Achievement1%0101019%2.0%12/05/2007INDEPENDENT12/02/2007
319DAVITA - MENA DIALYSIS0425821200 CRESTWOOD CIRCLEMENAAR7195313100%255%22Achievement10100%2395%21Achievement973%30565%245Achievement710%27114%168Achievement8%10101094%No reduction01/30/2008DAVITA10/02/2007
320DCI - MCCRORY042583139 WEST HIGHWAY 64 SUITE 100MCCRORYAR7210113100%110%12Achievement10100%1383%12Achievement766%15448%130Achievement427%14445%88Improvement6%10101088%No reduction09/24/2008DIALYSIS CLINIC, INC.04/09/2008
321HARRISON DIALYSIS0425841409 GLADDENHARRISONAR7260113100%2011%28Achievement10100%2396%27Achievement1078%27283%315Achievement96%2413%203Achievement10%101010100%No reduction03/13/2009INDEPENDENT11/08/2008
322DAVITA - FORREST CITY0425851501 NORTH WASHINGTON STREETFORREST CITYAR7233513N/A98N/A10100%116Achievement1076%11984Achievement96%10757Achievement10%1010097%No reduction09/28/2009DAVITA07/13/2009
323RENAL SOUTH OF ROGERS, LLC042586101 NORTH 37THROGERSAR7275613N/A70N/AN/A70N/A149%780Achievement037%460Achievement1%1051017%2.0%08/31/2011INDEPENDENT03/11/2011
324DAVITA - MARKED TREE DX042587216 HESTER PARKER DRIVEMARKED TREEAR7236513N/A80N/AN/A70N/AN/A820N/AN/A580N/A101010100%No reduction09/29/2011DAVITA04/23/2011
325ST BERNARDS-WYNNE043501310 SOUTH FALLS BOULEVARDPO BOX 590WYNNEAR7239613100%170%18Achievement10100%16100%16Achievement044%20348%197Achievement026%18823%137Achievement0%10101070%No reduction09/21/2001INDEPENDENT09/16/2001
326SANTA CLARA VALLEY RENAL CARE CENTER0500380523052220 MOORPARK AVENUESAN JOSECA9512817100%12112%130Achievement594%10188%104Improvement354%107458%1007Achievement612%95512%729Achievement5%1001067%No reduction08/22/1977INDEPENDENT09/19/2001
327ST. JOSEPH HOSPITAL RENAL CENTER0500690523681100 WEST STEWART DRIVESR. ELIZABETH BLDG.ORANGECA928681873%1004%114Achievement899%8898%96Achievement868%115264%1196Achievement710%110511%849Achievement8%10101079%No reduction08/15/1977INDEPENDENT05/19/1999
328KAISER PERMANENTE - SANTA CLARA050071052392710 LAWRENCE EXPRESSWAY #460SANTA CLARACA9505117N/A00N/AN/A00N/AN/A00N/AN/A00N/AN/AN/A10100%No reduction06/20/1996OTHER CHAIN(number of facilities <20 )01/02/1980
329KAISER PERMANENTE MARTINEZ050072052403200 MUIR ROAD, HACIENDA BUILDING, SECOND FLOORMARTINEZCA9455317N/A00N/AN/A00N/AN/A00N/AN/A00N/AN/AN/A10100%No reduction02/16/2010OTHER CHAIN(number of facilities <20 )02/17/2010
330KAISER FOUNDATION HOSPITAL MEDICAL CTR.- SUNSET0501380523234700 SUNSET BOULEVARD, 2ND FLOORDIALYSIS UNITLOS ANGELESCA9002718N/A00N/AN/A00N/AN/A00N/AN/A00N/A101010100%No reduction07/25/1977OTHER CHAIN(number of facilities <20 )05/19/1999
331KAISER FOUNDATION HOSPITAL MEDICAL CTR. -DOWNEY0501390523899333 EAST IMPERIAL HIGHWAYCAPD DEPARTMENT-BASEMENTDOWNEYCA9024218N/A00N/AN/A00N/AN/A00N/AN/A00N/AN/AN/A10100%No reduction12/01/1994OTHER CHAIN(number of facilities <20 )01/02/1980
332KAISER FOUNDATION HOSPITAL MEDICAL CTR.- FONTANA0501400523809985 SIERRA AVENUE MOB-3PERITONEAL DIALYSIS UNITFONTANACA9233518N/A00N/AN/A00N/AN/A00N/AN/A00N/AN/AN/A10100%No reduction07/24/1991OTHER CHAIN(number of facilities <20 )10/12/2005
333ARROWHEAD REGIONAL MEDICAL CENTER050245052334400 NORTH PEPPER AVENUECOLTONCA9232418100%1810%20Achievement10100%12100%20Achievement345%15629%189Improvement031%8623%98Achievement2%10101076%No reduction04/28/2006INDEPENDENT11/08/2005
334SIERRA VIEW DISTRICT HOSPITAL DIALYSIS CENTER050261052401283 NORTH PEARSON DRIVEPORTERVILLECA932571864%468%49Achievement088%5293%45Achievement148%60353%539Achievement042%55534%374Achievement1%10101031%1.5%08/15/2007INDEPENDENT07/02/2007
335EL CAMINO DIALYSIS CENTER0503080523412490 GRANT ROADOAK PAVILLION 110MOUNTAIN VIEWCA9404017100%892%106Achievement597%7193%81Achievement868%100960%1052Achievement88%95510%739Achievement8%010072%No reduction08/12/1977INDEPENDENT01/02/1980
336LOMA LINDA UNIVERSITY MEDICAL CENTER05032705234211234 ANDERSON STREET, ROOM 2812CHILDRENS HOSPITALLOMA LINDACA9235418N/A42N/AN/A42N/AN/A4117N/AN/A4111N/AN/A1010100%No reduction08/11/1977INDEPENDENT06/04/1999
337KAISER HOSPITAL ESRD PD UNIT05051205239827303 SLEEPY HOLLOWHAYWARDCA9454517N/A00N/AN/A00N/AN/A00N/AN/A00N/AN/AN/A10100%No reduction03/18/2005OTHER CHAIN(number of facilities <20 )03/02/2005
338KAISER FOUNDATION HOSPITAL MEDICAL CTR.- WEST LOS ANGELES0505610523846041 CADILLAC AVENUE, SUITE 442DIALYSIS UNITLOS ANGELESCA9003418N/A00N/AN/A00N/AN/A00N/AN/A00N/AN/A01050%0.5%04/26/1993OTHER CHAIN(number of facilities <20 )01/02/1980
339KAISER FOUNDATION HOSPITAL MEDICAL CTR.- ANAHEIM0506090523943460 EAST LA PALMA AVENUEPERITONEAL DIALYSIS UNITANAHEIMCA9280618N/A00N/AN/A00N/AN/A00N/AN/A00N/AN/AN/A10100%No reduction11/30/1999OTHER CHAIN(number of facilities <20 )09/23/2009
340KAISER FOUNDATION HOSPITAL MEDICAL CTR.- WOODLAND HILLS0506770523815601 DE SOTO AVENUEPERITONEAL UNITWOODLAND HILLSCA9136518N/A00N/AN/A00N/AN/A00N/AN/A00N/AN/AN/A10100%No reduction10/02/1991OTHER CHAIN(number of facilities <20 )05/19/1999
341KAISER FOUNDATION HOSPITAL MEDICAL CTR.- RIVERSIDE05068605238210800 MAGNOLIA AVENUE, MODULE 1XPERITONEAL DIALYSIS UNITRIVERSIDECA9250518N/A00N/AN/A00N/AN/A00N/AN/A00N/AN/AN/A10100%No reduction11/25/1992OTHER CHAIN(number of facilities <20 )05/28/1999
342KAISER FOUNDATION HOSPITAL MEDICAL CTR.- BALDWIN PARK0507230523991813 NHACIENDA BOULEVARDPERITONEAL DIALYSIS UNITLA PUENTECA9174418N/A00N/AN/A00N/AN/A00N/AN/A00N/AN/AN/A10100%No reduction02/07/2006OTHER CHAIN(number of facilities <20 )10/10/2003
343FMC-HILLCREST DIALYSIS0525003960 THIRD AVENUESAN DIEGOCA9210318100%663%63Achievement10100%6895%63Achievement147%77645%688Achievement711%70411%470Achievement4%10101082%No reduction08/11/1977FRESENIUS MEDICAL CARE01/03/1977
344DAVITA-KIDNEY DIALYSIS CARE UNIT0525023600 EAST MARTIN LUTHER KING JR BOULEVARDLYNWOODCA9026218100%357%102Achievement10100%4098%102Achievement149%29153%751Achievement417%1564%430Achievement3%1010076%No reduction12/14/1977DAVITA02/02/2010
345DAVITA-MAIN PLACE DIALYSIS CENTER052503972 TOWN & COUNTRY ROADORANGECA928681873%7410%61Achievement899%6793%56Achievement971%78772%647Achievement710%7358%456Achievement8%10101079%No reduction08/17/1977DAVITA06/08/1999
346FULLERTON DIALYSIS052505238 ORANGEFAIR MALLFULLERTONCA9283218100%858%93Achievement899%8499%88Achievement869%97366%1014Achievement88%9039%718Achievement8%10101088%No reduction09/27/1993DAVITA12/13/2005
347RAI HAIGHT0525071800 HAIGHT STREETSAN FRANCISCOCA9411717100%388%39Achievement092%37100%38Achievement972%43055%422Achievement711%39817%296Achievement8%10101064%No reduction08/08/1977RENAL ADVANTAGE11/24/2005
348FMC-SANTA BARBARA COMMUNITY DIALYSIS CENTER052513222 PESETAS LANESANTA BARBARACA931101837%297%29Achievement10100%26100%29Achievement767%31754%304Achievement418%28029%206Improvement6%10101067%No reduction08/29/1978FRESENIUS MEDICAL CARE05/19/1999
349SATELLITE DIALYSIS CUPERTINO05251410596 NORTH TANTAU AVENUECUPERTINOCA9501417100%711%75Achievement798%6198%66Achievement662%75259%812Achievement514%69821%557Achievement6%10101079%No reduction08/10/1977SATELLITE HEALTHCARE09/12/2006
350LOS ALAMITOS HEMODIALYSIS CENTER0525153810 KATELLA AVENUELOS ALAMITOSCA9072018100%680%72Achievement091%6494%70Achievement664%76653%817Achievement417%72624%568Achievement5%10101055%No reduction08/15/1977INDEPENDENT06/04/1999

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created Oct 23, 2012

updated Jan 15, 2014

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Description

Includes data for number of eligible patients by measure, % patients with Hemoglobin >12, % patients with median URR >=65%, % of hemodialysis patients using an arteriovenous fistula during last treatment of the month, % of hemodialysis patients using an intravenous catheter during the last treatment of the month and for at least 89 days priorHemoglobin measure score, URR measure score, the Total Performance Score, and payment reduction percentage.

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