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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
251KINGMAN DIALYSIS CLINIC (FMC)0326281739 EAST BEVERLY AVENUE SUITE 208KINGMANAZ8640115100%4111%35Achievement10100%5097%35Achievement869%59447%409Achievement89%54334%264Achievement8%10101094%No reduction06/16/2009FRESENIUS MEDICAL CARE06/17/2009
252SOUTH TUCSON DIALYSIS (FMC)0326292802 SOUTH 6TH AVENUETUCSONAZ8571315100%270%16Achievement10100%31100%15Achievement765%36665%168Achievement88%3277%117Achievement8%10101094%No reduction07/29/2009FRESENIUS MEDICAL CARE07/30/2009
253BROOKWOOD DIALYSIS CLINIC (DVA)0326308910 NORTH 43RD AVENUE SUITE 107GLENDALEAZ8530215100%403%30Achievement10100%42100%33Achievement456%46151%318Achievement318%41823%197Achievement4%10101082%No reduction10/05/2009DAVITA10/06/2009
254OCOTILLO DIALYSIS (DVA)032631975 WEST CHANDLER HEIGHTS SUITE 101CHANDLERAZ8524815100%200%25Achievement10100%19100%24Achievement1078%22165%242Achievement710%20322%153Achievement9%10101097%No reduction02/08/2010DAVITA02/09/2010
255RITA RANCH DIALYSIS (DVA)0326327355 SOUTH HOUGHTON ROAD SUITE 101TUCSONAZ8574715100%118%12Achievement10100%13100%14Achievement1087%14685%165Achievement710%1309%111Achievement9%1010094%No reduction02/23/2010DAVITA02/24/2010
256SANTAN DIALYSIS (FMC)032633300 WEST HIGHWAY 287 SUITE 300FLORENCEAZ8523215100%220%21Achievement10100%24100%21Achievement869%26353%223Achievement88%25213%157Achievement8%10101094%No reduction03/01/2010FRESENIUS MEDICAL CARE03/02/2010
257SOUTHWEST KIDNEY DIALYSIS - MARYVALE (DVA)0326344845 WEST MCDOWELL ROAD SUITE 10APHOENIXAZ8503515100%258%12Achievement10100%26100%11Achievement1079%25051%124Achievement97%21716%75Achievement10%1010097%No reduction06/09/2010DAVITA06/10/2010
258GILBERT DIALYSIS (FMC)0326353511 MERCY ROAD SUITE 101GILBERTAZ8529715100%180Achievement10100%190Achievement1094%2080Achievement102%1890Achievement10%101010100%No reduction03/23/2011FRESENIUS MEDICAL CARE03/24/2011
259DSI FLAGSTAFF0326362268 NORTH WALGREENS STREETFLAGSTAFFAZ8600415N/A40N/AN/A100N/A038%950Achievement122%550Achievement1%10101019%2.0%02/29/2012LIBERTY DIALYSIS HAWAII03/01/2012
260- WICKENBURG DIALYSIS (DVA)032637811 NORTH TEGNER STREET #101WICKENBURGAZ8539015N/A00N/AN/A00N/AN/A00N/AN/A00N/AN/A10N/A100%No reduction08/20/2012DAVITA09/20/2012
261PHOENIX CHILDRENS HOSPITAL- DIALYSIS CENTER0333020323141920 EAST CAMBRIDGE ROAD SUITE 102PHOENIXAZ8501615N/A22N/AN/A01N/AN/A011N/AN/A09N/AN/A1010100%No reduction10/22/2001INDEPENDENT08/02/2002
262GILA RIVER DIALYSIS WEST0335039721 WEST PECOS RD- RR2, BOX 807LAVEENAZ8533915100%4024%37Achievement10100%41100%34Achievement1079%45674%400Achievement105%4249%283Achievement10%101010100%No reduction08/24/2005INDEPENDENT01/07/2005
263ST BERNARDS REGIONAL MED CTR-DIALYSIS040020042303540 EAST WASHINGTONJONESBOROAR724011391%877%58Achievement798%6396%53Achievement560%75140%607Achievement420%71230%423Improvement5%10101073%No reduction09/05/1978INDEPENDENT09/06/1978
264BAPTIST HEALTH MED CTR - DIALYSIS0401140423099601 I 630 EXIT 7LITTLE ROCKAR7220513N/A58N/AN/A55N/A128%8522%104ImprovementN/A4945N/A1%10101019%2.0%12/08/1988INDEPENDENT09/01/1977
265ARKANSAS CHILDRENS HOSPITAL-DIALYSIS0401170423101 CHILDRENS WAY-SLOT 204LITTLE ROCKAR7220213N/A00N/AN/A00N/AN/A00N/AN/A00N/AN/A1010100%No reduction01/11/1979INDEPENDENT01/12/1979
266FT SMITH REGIONAL DIALYSIS CTR0425012201 BROOKEN HILL DRIVEFORT SMITHAR7290813100%1932%204Achievement899%13797%143Achievement458%163849%1698Achievement328%154939%1208Improvement4%10101076%No reduction05/11/1977INDEPENDENT05/02/1977
267OUACHITA REGIONAL DIALYSIS CTR0425071900 MALVERN AVENUE SUITE 102HOT SPRINGSAR7190113100%2319%69Achievement496%2698%51Achievement353%30955%631Achievement89%2779%398Achievement6%1051068%No reduction04/12/1982INDEPENDENT04/13/1982
268RIVER VALLEY KIDNEY CTR0425083121 WEST SECOND COURTRUSSELLVILLEAR7280113100%661%72Achievement10100%66100%66Achievement766%73559%808Achievement318%70124%570Achievement5%1051083%No reduction10/08/1983INDEPENDENT10/09/1983
269FMCNA - HELENA042510108 D ANNA PLACEHELENAAR7234213100%5014%49Achievement798%53100%44Achievement149%59948%537Achievement515%57022%381Achievement3%10101070%No reduction03/14/1984FRESENIUS MEDICAL CARE03/15/1984
270DEGRAY KIDNEY CTR042512312 PROFESSIONAL PARK DRIVE SUITE HARKADELPHIAAR719231382%429%44Achievement10100%4390%42Achievement869%46960%501Achievement104%44316%355Achievement9%1051089%No reduction09/12/1986INDEPENDENT09/13/1986
271DAVITA - SPRINGHILL DIALYSIS0425133401 SPRINGHILL DRIVE SUITE 190SPRINGHILL MEDICAL PLAZANORTH LITTLE ROCKAR7211713100%1065%137Achievement10100%6884%76Achievement458%77854%828Achievement711%73117%572Achievement6%10101088%No reduction07/10/1987DAVITA07/11/1987
272DAVITA - SEARCY DIALYSIS CTR0425143208 LANGLEY STREETSEARCYAR7214313100%574%70Achievement10100%4091%55Achievement552%45829%579Improvement430%42754%407Improvement5%10101085%No reduction07/29/1987DAVITA07/30/1987
273MAGNOLIA DIALYSIS CTR0425151411 NORTH JACKSONMAGNOLIAAR7175413N/A77N/AN/A89N/AN/A9464%100N/AN/A7956N/A0101067%No reduction09/02/1987INDEPENDENT09/03/1987
274DAVITA - CONWAY DIALYSIS CTR0425172445 CHRISTINA LANECONWAYAR720341391%932%60Achievement10100%69100%52Achievement345%71731%632Improvement514%67725%451Achievement4%10101079%No reduction08/23/1988DAVITA08/24/1988
275FMCNA - FAULKNER COUNTY042518201 SKYLINE DRIVE SUITE 32CONWAYAR7203213100%2421%28Achievement10100%23100%25Achievement767%27859%294Achievement96%26112%205Achievement8%10101094%No reduction12/19/1988FRESENIUS MEDICAL CARE12/20/1988
276FMCNA - LITTLE ROCK DIALYSIS04252110310 WEST MARKHAM SUITE 100LITTLE ROCKAR722051382%12910%126Achievement798%8797%78Achievement145%97438%934Improvement711%90724%655Achievement4%10101067%No reduction06/14/1989FRESENIUS MEDICAL CARE06/15/1989
277OUACHITA VALLEY DIALYSIS0425251114 WASHINGTON NORTHWESTCAMDENAR717011382%4810%60Achievement798%4695%56Achievement456%53847%621Achievement711%51224%438Achievement6%1051071%No reduction07/13/1990INDEPENDENT07/14/1990
278LAKE VILLAGE042527505 SAINT MARYS STREETLAKE VILLAGEAR7165313100%2011%18Achievement082%2288%17Achievement041%25655%185Achievement025%23413%116Achievement0%001033%1.0%09/28/1990RENAL CARE GROUP INC.09/29/1990
279FMCNA - EAST ARKANSAS042528310 SOUTH RHODESWEST MEMPHISAR7230113100%600%67Achievement10100%6399%70Achievement1074%74981%800Achievement612%7058%568Achievement8%1010091%No reduction07/09/1990FRESENIUS MEDICAL CARE07/10/1990
280DAVITA - HOT SPRINGS DIALYSIS042531115 WRIGHTS STREETHOT SPRINGSAR719131391%8213%64Achievement10100%69100%51Achievement766%91458%583Achievement105%83812%368Achievement9%1051092%No reduction02/21/1992INDEPENDENT02/22/1992
281FMCNA - PINE BLUFF0425322801 SOUTH OLIVEJEFFERSON SQUARE STE 19PINE BLUFFAR7160313100%588%66Achievement798%5792%61Achievement458%64659%679Achievement711%60817%490Achievement6%10101079%No reduction04/21/1993FRESENIUS MEDICAL CARE04/22/1993
282FMCNA - ST FRANCIS COUNTY DIALYSIS042533210 BARROW HILL ROADFORREST CITYAR7233513100%545%63Achievement10100%5797%68Achievement456%69651%707Achievement220%66915%497Achievement3%10101079%No reduction11/10/1993FRESENIUS MEDICAL CARE11/11/1993
283DAVITA - OSCEOLA RENAL CTR0425341420 WEST KEISER AVENUEOSCEOLAAR7237013100%263%31Achievement10100%26100%28Achievement149%29348%322Achievement103%2836%230Achievement6%10101088%No reduction01/01/1994DAVITA01/02/1994
284DAVITA - PULASKI COUNTY DX042535202 JOHN HARDIN DRIVEJACKSONVILLEAR7207613100%2312%25Achievement10100%24100%25Achievement555%23434%251Improvement519%21139%170Improvement5%10101085%No reduction01/09/1995DAVITA01/10/1995
285SOUTH ARKANSAS DIALYSIS042536620 WEST GROVE STREETEL DORADOAR7173013100%863%96Achievement10100%86100%92Achievement766%94860%1019Achievement416%88625%719Achievement6%1051086%No reduction03/01/1995INDEPENDENT03/02/1995
286FMCNA - STUTTGART DIALYSIS0425372202 SOUTH MAIN STREETSTUTTGARTAR7216013100%386%32Achievement10100%3997%32Achievement352%46839%362Improvement710%44414%257Achievement5%10101085%No reduction12/19/1995FRESENIUS MEDICAL CARE12/20/1995
287DAVITA - FAYETTEVILLE042539509 EAST MILLSAP SUITE 111FAYETTEVILLEAR7270313100%180%17Achievement10100%17100%17Achievement972%18664%185Achievement89%1639%130Achievement9%1010094%No reduction01/01/1996DAVITA01/02/1996
288DAVITA - BENTONVILLE0425401104 SOUTHEAST 30TH STREETBENTONVILLEAR7271213100%2810%39Achievement10100%3297%38Achievement1079%32871%403Achievement97%30919%262Achievement10%101010100%No reduction01/01/1996DAVITA01/02/1996
289FMCNA - MONTICELLO042543774 JORDAN DRIVEMONTICELLOAR7165513100%253%29Achievement10100%2496%27Achievement458%26650%316Achievement225%25732%219Improvement3%10101079%No reduction03/31/1997FRESENIUS MEDICAL CARE04/01/1997
290DAVITA - SW ARKANSAS DIALYSIS-MAGNOLIA042545225 NORTH DUDNEYMAGNOLIAAR7175313100%200%21Achievement295%2196%25Achievement971%16451%284Achievement710%8820%197Achievement8%1010067%No reduction07/25/1997DAVITA07/16/1997
291DAVITA - LITTLE ROCK MIDTOWN DIALYSIS042547#2 LILE COURT SUITE 102LITTLE ROCKAR7220513100%769%82Achievement10100%7591%85Achievement038%83240%932Achievement319%79618%645Achievement2%10101076%No reduction05/15/1998DAVITA05/16/1998
292DAVITA - NORTH LITTLE ROCK DIALYSIS CTR0425484505 EAST MCCAIN BOULEVARDNORTH LITTLE ROCKAR7211713100%4610%42Achievement898%4683%42Improvement353%55360%483Achievement318%52012%347Achievement3%10101073%No reduction05/29/1998DAVITA05/30/1998
293DAVITA - SILOAM SPRINGS042549500 SOUTH MOUNT OLIVE SUITE 107SILOAM SPRINGSAR7276113100%147%15Achievement10100%11100%16Achievement1093%9777%178Achievement105%6314%122Achievement10%1010097%No reduction06/17/1998DAVITA06/18/1998
294FMCNA - BLYTHEVILLE0425501001 EAST MOULTRIEBLYTHEVILLEAR7231513100%395%43Achievement10100%41100%43Achievement147%48043%463Achievement416%45011%331Achievement3%10101079%No reduction07/01/1998FRESENIUS MEDICAL CARE06/02/1998
295LEWISVILLE DIALYSIS CTR042551PO BOX 742LEWISVILLEAR7184513N/A55N/AN/A88N/A021%9987Achievement025%7559Achievement0%010107%2.0%10/22/1998INDEPENDENT10/23/1998
296DAVITA - JACKSONVILLE CENTRAL DIALYSIS CTR042553400 T P WHITE DRIVEJACKSONVILLEAR7207613100%487%45Achievement10100%3791%32Achievement353%43951%402Achievement711%42225%261Achievement5%1010082%No reduction12/07/1998DAVITA12/08/1998
297DAVITA - JACKSON COUNTY DX0425541912 MCCLAINPRATT SQUARENEWPORTAR7211213100%1610%21Achievement10100%1571%21Achievement447%20528%247Improvement138%18846%169Improvement3%1010076%No reduction02/05/1999DAVITA02/06/1999
298FMCNA - BENTON0425562101 CONGO ROADBENTONAR7201513100%2023%22Achievement10100%18100%18Achievement146%24646%194Achievement89%2128%128Achievement5%10101085%No reduction04/12/1999FRESENIUS MEDICAL CARE04/02/1999
299DAVITA - INDEPENDENCE COUNTY DX0425571700 HARRISON STREET SUITE FBATESVILLEAR7250113100%4114%44Achievement10100%4390%41Achievement558%46737%476Improvement331%43348%333Improvement4%10101082%No reduction08/30/1999DAVITA07/02/1999
300DAVITA - SALINE COUNTY DIALYSIS042558GROUND LEVEL-1200 NORTH MAIN SUITE 2BENTONAR7201513100%2816%25Achievement10100%2797%29Achievement146%32542%298Achievement222%26727%206Improvement2%10101076%No reduction09/15/1999DAVITA07/02/1999

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cms cms

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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