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ESRD QIP - Complete QIP Data - Payment Year 2015

Row numberFacility NameCMS Certification Number (CCN)Alternate CCN 1Alternate CCN 2Alternate CCN 3Address 1Address 2CityStateZip CodeNetworkHemoglobin 12 g/dL Measure ScoreHemoglobin 12 g/dL Performance Period RateNumber of Patients Included in Hemoglobin Measure Score Performance PeriodHemoglobin 12 g/dL Baseline Period RateNumber of Patients Included in Hemoglobin Measure Score Baseline PeriodHemoglobin 12 g/dL Performance Score AppliedKt/V Adult Hemodialysis Measure ScoreKt/V Adult Hemodialysis Performance Period RateNumber of Patients Included in Kt/V Adult Hemodialysis Measure Score Performance PeriodNumber of Kt/V Adult Hemodialysis Patient Months Performance PeriodKt/V Adult Hemodialysis Baseline Period RateNumber of Kt/V Adult Hemodialysis Patient Months Baseline PeriodKt/V Adult Hemodialysis Performance Score AppliedKt/V Adult Peritoneal Dialysis Measure ScoreKt/V Adult Peritoneal Dialysis Performance Period RateNumber of Patients Included in Kt/V Adult Peritoneal Dialysis Measure Score Performance PeriodNumber of Kt/V Adult Peritoneal Dialysis Patient Months Performance PeriodKt/V Adult Peritoneal Dialysis Baseline Period RateNumber of Kt/V Adult Peritoneal Dialysis Patient Months Baseline PeriodKt/V Adult Peritoneal Dialysis Performance Score AppliedKt/V Pediatric Hemodialysis Measure ScoreKt/V Pediatric Hemodialysis Performance Period RateNumber of Patients Included in Kt/V Pediatric Hemodialysis Measure Score Performance PeriodNumber of Kt/V Pediatric Hemodialysis Patient Months Performance PeriodKt/V Pediatric Hemodialysis Baseline Period RateNumber of Kt/V Pediatric Hemodialysis Patient Months Baseline PeriodKt/V Pediatric Hemodialysis Performance Score AppliedKt/V Dialysis Adequacy Combined Measure ScoreFistula Measure ScoreFistula Performance Period RateNumber of Patients Included in Fistula Measure Score Performance PeriodNumber of Fistula Patient Months Performance PeriodFistula Baseline Period RateNumber of Fistula Patient Months Baseline PeriodFistula Performance Score AppliedCatheter Measure ScoreCatheter Performance Period RateNumber of Patients Included in Catheter Measure Score Performance PeriodNumber 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 ScoreAnemia Management Reporting ScoreTotal Performance ScorePY2015 Payment Reduction PercentageCMS Certification DateOwnership as of December 31, 2013Date of ownership record update
5651DAVITA-ROSEMEAD SPRINGS DIALYSIS CENTER5525113212 ROSEMEAD BOULEVARDEL MONTECA9173118100%500%53Achievement1098%6657597%559AchievementN/AInsufficient dataN/A0Insufficient data0N/AN/AInsufficient dataN/A0Insufficient data0N/A10458%5559757%567Achievement612%5756211%543Achievement5%1010101088%No reduction07/07/2003DAVITA07/05/2012
5652FMC DIABLO BRENTWOOD5525124510 OHARA AVENUE SUITE BBRENTWOODCA9451317100%440%46Achievement591%6850391%528AchievementN/AInsufficient dataN/A0Insufficient data0N/AN/AInsufficient dataN/A0Insufficient data0N/A5972%5856473%552Achievement415%5949812%515Achievement6%101010977%No reduction10/28/2003FRESENIUS MEDICAL CARE01/30/2009
5653COLLEGE DIALYSIS5525136535 UNIVERSITY AVENUESAN DIEGOCA9211518100%560%52Achievement389%9848795%431Achievement888%2218281%155AchievementN/AInsufficient dataN/A0Insufficient data0N/A4046%5449551%432Achievement88%614368%385Achievement4%1010101070%No reduction10/31/2003DAVITA03/13/2014
5654WELLBOUND OF MENLO PARK LLC552514927 HAMILTON AVENUEMENLO PARKCA9402517100%210%25Achievement0Insufficient data0N/A889%2419388%249AchievementN/AInsufficient dataN/A0Insufficient data0N/A8N/A5040N/AN/A4441N/AN/AN/AN/AN/ANo reduction10/29/2003SATELLITE HEALTHCARE01/14/2014
5655CARMEL MOUNTAIN DIALYSIS5525159850 CARMEL MOUNTAIN ROAD, A-DSAN DIEGOCA9212918100%550%48Achievement591%8755493%453AchievementN/AInsufficient dataN/A76Insufficient data42N/AN/AInsufficient dataN/A0Insufficient data0N/A5869%6160068%465Achievement513%6453115%418Achievement6%1010101078%No reduction10/31/2003DAVITA05/03/2013
5656FMC-RANCHO55251611031 VIADUCT FRONTERA, SUITE CSAN DIEGOCA9212718100%360%45Achievement693%7649291%510AchievementN/AInsufficient dataN/A0Insufficient data0N/AN/AInsufficient dataN/A0Insufficient data0N/A6457%5353459%536Achievement88%555045%490Achievement6%1010101080%No reduction10/31/2003FRESENIUS MEDICAL CARE07/25/2012
5657ARROYO DIALYSIS CENTER5525171111 SOUTH ARROYO PARKWAY, SUITE 150PASADENACA9110518100%901%89Achievement1097%119110498%1096AchievementN/AInsufficient dataN/A45Insufficient data44N/AN/AInsufficient dataN/A0Insufficient data0N/A10767%106115270%1125Achievement317%114110914%1100Achievement5%101091087%No reduction10/22/2003NOT A CHAIN08/22/2012
5658COSTA MESA DIALYSIS5525181590 SCENIC AVENUECOSTA MESACA926261862%550%53Achievement592%7651894%537AchievementN/AInsufficient dataN/A6Insufficient data0N/AN/AInsufficient dataN/A11Insufficient data11N/A51075%5959277%607Achievement88%635507%555Achievement9%1010101075%No reduction12/12/2003DAVITA02/24/2011
5659DCI RANCHO DIALYSIS CLINIC55251910294 ROCKINGHAM DRIVESACRAMENTOCA958271743%340%36Achievement794%4030996%307AchievementN/AInsufficient dataN/A0Insufficient data0N/AN/AInsufficient dataN/A0Insufficient data0N/A7355%3937861%375Achievement220%4235122%347Achievement2%1010101058%0.5%12/24/2003DIALYSIS CLINIC, INC.01/29/2008
5660BANNING DIALYSIS5525206090 WEST RAMSEY STREETBANNINGCA9222018100%310%31Achievement794%5332395%403AchievementN/AInsufficient dataN/A51Insufficient data36N/AN/AInsufficient dataN/A0Insufficient data0N/A7458%3534359%402Achievement710%4131112%360Achievement6%1010101083%No reduction01/14/2004DAVITA05/18/2011
5661WHITE LANE DIALYSIS5525217701 WHITE LANE, SUITE DBAKERSFIELDCA9330918100%1070%115Achievement895%9380197%863Achievement992%5238795%335AchievementN/AInsufficient dataN/A0Insufficient data0N/A8768%8993665%1027Achievement79%949028%948Achievement7%1010101088%No reduction12/23/2003DAVITA08/22/2013
5662RAI CHADBOURNE552522490 CHADBOURNE ROAD SUITE DFAIRFIELDCA9453417100%343%33Achievement895%5138395%353AchievementN/AInsufficient dataN/A0Insufficient data0N/AN/AInsufficient dataN/A0Insufficient data0N/A8973%3939269%357Achievement79%433674%321Achievement8%10991089%No reduction03/10/2004RENAL ADVANTAGE07/09/2012
5663STOCKTON HOME DIALYSIS CENTER552523545 EAST CLEVELAND STREET #ASTOCKTONCA9520417100%150%15Achievement0Insufficient data0N/A1096%2718490%201AchievementN/AInsufficient dataN/A0Insufficient data0N/A10N/A00N/AN/A00N/AN/AN/AN/AN/ANo reduction07/14/2004DAVITA01/17/2010
5664WELLBOUND OF MODESTO5525241315 TENTH STREET #100MODESTOCA9535417100%550%53Achievement2Insufficient data2N/A1095%7162993%656AchievementN/AInsufficient dataN/A0Insufficient data0N/A10N/A9089%132N/AN/A9210%120N/AN/AN/A1010100%No reduction07/13/2004SATELLITE HEALTHCARE08/30/2013
5665FMC-SAN FERNANDO552525451 SOUTH BRAND BOULEVARD, SUITE 100SAN FERNANDOCA9134018100%140%20Achievement693%2218587%193AchievementN/AInsufficient dataN/A0Insufficient data0N/AN/AInsufficient dataN/A0Insufficient data0N/A6974%2323765%230Achievement024%2421925%193Achievement4%1010101075%No reduction04/28/2004FRESENIUS MEDICAL CARE02/19/2013
5666BARNNY JEPP, LLC5525261400 SOUTH GRAND AVENUE, SUITE 105LOS ANGELESCA9001518100%680%74Achievement079%7871794%734Achievement682%1917172%169AchievementN/AInsufficient dataN/A0Insufficient data0N/A1663%6771561%739Achievement104%747049%708Achievement8%1010101073%No reduction05/10/2004US RENAL CARE, INC.10/01/2013
5667RAI-HARBOR BLVD.-GARDEN GROVE55252712761 HARBOR BOULEVARD, SUITE I-3GARDEN GROVECA928401881%830%95Achievement794%10674294%818Achievement454%2113615%139ImprovementN/AInsufficient dataN/A0Insufficient data0N/A7973%8282169%939Achievement103%947975%888Achievement10%1010101088%No reduction04/23/2004FRESENIUS MEDICAL CARE04/18/2013
5668TURLOCK DIALYSIS CLINIC55252850 WEST SYRACUSE AVENUETURLOCKCA9538017100%470%39Achievement996%8348096%420AchievementN/AInsufficient dataN/A0Insufficient data0N/AN/AInsufficient dataN/A0Insufficient data0N/A91085%5653675%451Achievement96%5746710%393Achievement9%1010101095%No reduction08/25/2004DAVITA12/21/2010
5669ELK GROVE DIALYSIS5525299281 OFFICE PARK CIRCLE #105ELK GROVECA9575817100%810%82Achievement996%11091596%967AchievementN/AInsufficient dataN/A0Insufficient data0N/AN/AInsufficient dataN/A0Insufficient data0N/A9560%9196458%990Achievement79%9992510%919Achievement6%1010101088%No reduction07/30/2004DAVITA11/03/2010
5670SOUTH CHICO DIALYSIS CENTER5525302345 FOREST AVENUECHICOCA959281706%333%35Achievement996%4941794%419AchievementN/AInsufficient dataN/A0Insufficient data0N/AN/AInsufficient dataN/A0Insufficient data0N/A9974%4444373%448Achievement88%4741410%402Achievement8%1010101068%No reduction08/11/2004DAVITA07/09/2012
5671FMC-SOUTH BAY5525321221 WEST PACIFIC COAST HIGHWAYHARBOR CITYCA9071018N/A910N/A10100%149494%100AchievementN/AInsufficient dataN/A0Insufficient data0N/AN/AInsufficient dataN/A0Insufficient data0N/A10N/A99106N/A100%12920%106Achievement10%10991099%No reduction09/15/2004FRESENIUS MEDICAL CARE01/20/2011
5672MARYSVILLE DIALYSIS CENTER5525331015 8TH STREETMARYSVILLECA9590117100%310%43Achievement1097%4627895%354Achievement889%1714779%185AchievementN/AInsufficient dataN/A0Insufficient data0N/A9871%3131073%375Achievement612%393168%357Achievement7%1010101090%No reduction11/12/2004DAVITA07/09/2012
5673COLUSA INDIAN HEALTH CLINIC DIALYSIS5525343710 HIGHWAY 45 SUITE ACOLUSACA9593217016%1210Achievement490%1815584%131AchievementN/AInsufficient dataN/A0Insufficient data0N/AN/AInsufficient dataN/A0Insufficient data0N/A41095%1717366%150Achievement100%1715114%130Achievement10%100101054%0.5%10/21/2004NOT A CHAIN02/03/2007
5674CONCORD DIALYSIS CENTER5525352300 STANWELL DRIVE SUITE CCONCORDCA9452017100%320%32Achievement996%5635192%356AchievementN/AInsufficient dataN/A0Insufficient data0N/AN/AInsufficient dataN/A0Insufficient data0N/A9766%3736962%353Achievement513%3933216%307Achievement6%1010101088%No reduction11/14/2004DAVITA09/26/2013
5675SATELLITE DIALYSIS CENTRAL MODESTO5525361315 10TH STREET, SUITE 300MODESTOCA9535417100%1000%93Achievement794%11799693%936AchievementN/AInsufficient dataN/A0Insufficient data0N/AN/AInsufficient dataN/A0Insufficient data0N/A71078%111114176%1098Achievement514%113107213%1042Achievement7%1010101085%No reduction12/17/2004SATELLITE HEALTHCARE07/18/2013
5676DCI REDDING552537180 NORTHPOINT DRIVEREDDINGCA960031781%741%80Achievement286%8467282%712Improvement888%2118986%165AchievementN/AInsufficient dataN/A0Insufficient data0N/A3972%7375467%815Achievement611%8273813%751Achievement7%1010101070%No reduction01/05/2005DIALYSIS CLINIC, INC.10/26/2011
5677MOHAN DIALYSIS CENTER OF GLENDORA552538638 SOUTH GLENDORA AVENUEGLENDORACA9174018100%390%43Achievement490%5543392%476AchievementN/AInsufficient dataN/A0Insufficient data0N/AN/AInsufficient dataN/A0Insufficient data0N/A4044%4950645%543Achievement031%5347531%498Achievement0%1010101060%No reduction10/25/2004NOT A CHAIN02/13/2012
5678WELLBOUND OF EMERYVILLE5525392000 POWELL STREET SUITE 140EMERYVILLECA9460817100%120%14Achievement4Insufficient data5N/A10100%1312095%108AchievementN/AInsufficient dataN/A0Insufficient data0N/A10N/A5783N/AN/A5680N/AN/AN/A1010100%No reduction03/09/2005SATELLITE HEALTHCARE03/15/2013
5679RAI SECRET RAVINE PARKWAY5525401451 SECRET RAVINE PARKWAY SUITE 130ROSEVILLECA956611762%540%57Achievement693%5742992%416Achievement664%1914117%152ImprovementN/AInsufficient dataN/A0Insufficient data0N/A6458%5351260%470Achievement122%5546125%441Achievement2%108101059%0.5%02/14/2005RENAL ADVANTAGE11/03/2010
5680DAVITA-CITRUS VALLEY DIALYSIS552541894 HARDT STREETSAN BERNARDINOCA9240818100%480%45Achievement996%6648497%468AchievementN/AInsufficient dataN/A0Insufficient data0N/AN/AInsufficient dataN/A0Insufficient data0N/A9972%5754964%493Achievement87%604868%451Achievement8%1010101093%No reduction03/31/2005DAVITA02/02/2011
5681RAI ELK GROVE BLVD.5525428139 ELK GROVE BOULEVARD SUITE 200ELK GROVECA9575817100%290%32Achievement895%3729194%305AchievementN/AInsufficient dataN/A0Insufficient data25N/AN/AInsufficient dataN/A0Insufficient data0N/A8871%3130267%305Achievement317%3128215%301Achievement6%1010101085%No reduction01/28/2005RENAL ADVANTAGE07/09/2012
5682HOME DIALYSIS THERAPIES OF SAN DIEGO-NORTH55254310672 WEXFORD STREET, SUITE 250SAN DIEGOCA9213118100%360%32Achievement1Insufficient data4N/A784%5140879%365AchievementN/AInsufficient dataN/A0Insufficient data0N/A7N/A7128N/AN/A5514N/AN/AN/AN/A986%No reduction05/09/2005NOT A CHAIN04/02/2013
5683DAVITA-CROSSROADS DIALYSIS CENTER5525443214 YORBA LINDA BOULEVARDFULLERTONCA9283118100%650%82Achievement996%8466896%804Achievement1099%1514997%130AchievementN/AInsufficient dataN/A0Insufficient data0N/A9974%7070174%760Achievement88%736599%734Achievement8%1010101093%No reduction07/29/2005DAVITA01/06/2014
5684DAVITA-ANAHEIM HILLS DIALYSIS5525454201 EAST LA PALMA AVENUEANAHEIMCA9280718100%335%37Achievement794%5536894%363AchievementN/AInsufficient dataN/A0Insufficient data0N/AN/AInsufficient dataN/A0Insufficient data0N/A71082%3736975%406Achievement102%383418%368Achievement10%1010101093%No reduction07/15/2005DAVITA01/25/2013
5685HOME DIALYSIS THERAPIES OF SAN DIEGO-SOUTH5525462060 OTAY LAKES ROAD, SUITE 120CHULA VISTACA9191518N/A310N/A3Insufficient data7N/AN/AInsufficient dataN/A38Insufficient data75N/AN/AInsufficient dataN/A0Insufficient data0N/AN/A1235N/AN/A1435N/AN/AN/AN/A10No reduction07/13/2005NOT A CHAIN02/04/2014
5686CANYON COUNTRY DIALYSIS CENTER, LLC55254718520 VIADUCT PRINCESSA, BUILDING C-1CANYON COUNTRYCA9138718100%520%53Achievement078%8565894%551AchievementN/AInsufficient dataN/A0Insufficient data0N/AN/AInsufficient dataN/A0Insufficient data0N/A0767%7875572%604Achievement219%7966017%564Achievement4%1010101060%No reduction09/14/2005NOT A CHAIN09/30/2013
5687DAVITA-ONTARIO DIALYSIS5525481950 SOUTH GROVE AVENUE, SUITE 101ONTARIOCA9176118100%630%64Achievement1097%7862495%691AchievementN/AInsufficient dataN/A0Insufficient data0N/AN/AInsufficient dataN/A0Insufficient data0N/A10869%7270962%741Achievement79%7565813%697Achievement7%1010101093%No reduction08/31/2005DAVITA09/13/2012
5688UNIVERSITY DIALYSIS CENTER552549777 CAMPUS COMMON ROAD, SUITE 100SACRAMENTOCA958251743%710%70Achievement1098%8773196%745AchievementN/AInsufficient dataN/A0Insufficient data0N/AN/AInsufficient dataN/A0Insufficient data0N/A10972%8183871%808Achievement105%867949%757Achievement10%1010101085%No reduction02/22/2006DAVITA01/26/2011
5689WELLBOUND OF SANTA ROSA5525502301 CIRCADIAN WAY SUITE BSANTA ROSACA9540717100%230%29Achievement0Insufficient data0N/A888%2524583%279AchievementN/AInsufficient dataN/A0Insufficient data0N/A8N/A5867N/AN/A5868N/AN/AN/AN/AN/ANo reduction02/24/2006SATELLITE HEALTHCARE07/10/2012
5690DAVITA-DIALYSIS CENTER OF CAMARILLO5525512438 NORTH PONDEROSA DRIVE, SUITE C-101CAMARILLOCA9301018100%520%49Achievement996%7549397%516AchievementN/AInsufficient dataN/A60Insufficient data44N/AN/AInsufficient dataN/A0Insufficient data0N/A9767%5654764%511Achievement103%624939%494Achievement9%1010101095%No reduction05/17/2006DAVITA01/04/2012
5691SAN DIMAS DIALYSIS CENTER, INC.5525521335 CYPRESS STREET, SUITE 102SAN DIMASCA9177318100%470%50Achievement490%6149289%486AchievementN/AInsufficient dataN/A58Insufficient data27N/AN/AInsufficient dataN/A0Insufficient data0N/A4354%5858151%565Achievement415%6155122%506Achievement4%1010101070%No reduction05/12/2006NOT A CHAIN01/28/2014
5692MAGNOLIA WEST DIALYSIS55255311161 MAGNOLIA AVENUERIVERSIDECA9250518100%551%69Achievement1098%9966397%764AchievementN/AInsufficient dataN/A0Insufficient data0N/AN/AInsufficient dataN/A0Insufficient data0N/A10972%7168568%789Achievement710%7964010%710Achievement8%1010101095%No reduction05/26/2006DAVITA01/27/2012
5693FMC-BRAWLEY552554751 LEGION ROAD, SUITE 100BRAWLEYCA9222718100%780%72Achievement895%10187895%875AchievementN/AInsufficient dataN/A0Insufficient data0N/AN/AInsufficient dataN/A0Insufficient data0N/A8768%8991472%869Achievement104%908474%832Achievement9%10N/A91092%No reduction05/31/2006FRESENIUS MEDICAL CARE02/08/2012
5694WELLBOUND OF STOCKTON LLC5525553555 DEER PARK DRIVE SUITE 140STOCKTONCA9521917100%130%15Achievement0Insufficient data0N/A1098%1613891%118AchievementN/AInsufficient dataN/A0Insufficient data0N/A10N/A6889N/AN/A6286N/AN/AN/AN/AN/ANo reduction07/05/2006SATELLITE HEALTHCARE02/15/2013
5695PISMO BEACH DIALYSIS552556320 JAMES WAY, SUITE 110PISMO BEACHCA9344918100%390%35Achievement996%5641688%414AchievementN/AInsufficient dataN/A0Insufficient data0N/AN/AInsufficient dataN/A0Insufficient data0N/A9665%4645958%399Achievement88%4741013%363Achievement7%1010101090%No reduction06/28/2006DAVITA06/22/2011
5696RED BLUFF DIALYSIS5525572455 SISTER MARY COLUMBA DRIVERED BLUFFCA9608017100%380%43Achievement591%5839594%460AchievementN/AInsufficient dataN/A0Insufficient data0N/AN/AInsufficient dataN/A0Insufficient data0N/A51083%4542875%495Achievement103%513886%449Achievement10%1010101088%No reduction07/12/2006DAVITA06/20/2012
5697WELLBOUND OF MILPITAS LLC5525581850 MILMONT DRIVEMILPITASCA9503517100%200%20Achievement0Insufficient data0N/A1097%2421795%199AchievementN/AInsufficient dataN/A0Insufficient data0N/A10N/A5272N/AN/A4973N/AN/AN/AN/AN/ANo reduction08/02/2006SATELLITE HEALTHCARE01/09/2014
5698SATELLITE DIALYSIS5525591860 MILMONT DRIVEMILPITASCA9503517100%770%71Achievement895%7364493%564AchievementN/AInsufficient dataN/A0Insufficient data0N/AN/AInsufficient dataN/A0Insufficient data0N/A8459%8185657%792Achievement710%847999%750Achievement6%1010101085%No reduction08/03/2006SATELLITE HEALTHCARE07/18/2013
5699WELLBOUND OF VALLEJO552560480 REDWOOD STREET SUITE 40VALLEJOCA9459017N/A33N/A0Insufficient data0N/AN/AInsufficient dataN/A53Insufficient data47N/AN/AInsufficient dataN/A0Insufficient data0N/AN/A00N/AN/A00N/AN/AN/AN/AN/ANo reduction10/18/2006SATELLITE HEALTHCARE08/30/2013
5700FMC-LA JOLLA5525614765 CARMEL MOUNTAIN ROAD, SUITE 100SAN DIEGOCA9213018100%380%41Achievement693%5838891%397AchievementN/AInsufficient dataN/A0Insufficient data0N/AN/AInsufficient dataN/A0Insufficient data0N/A6149%4444160%431Achievement611%463945%383Achievement4%1010101075%No reduction11/27/2006FRESENIUS MEDICAL CARE01/20/2011

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cms cms

created Oct 23, 2012

updated Jan 21, 2015

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Description

The data set includes the number of eligible patients by clinical measure; % patients with Hemoglobin > 12; ESRD QIP data by facility: % of hemodialysis patient-months with spKt/V >= 1.2; % of peritoneal patient-months with Kt/V >= 1.7 Kt/V (dialytic + residual) during the four-month study period; % of pediatric in-center hemodialysis patient-months with spKt/V >= 1.2; % 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 prior; Hemoglobin > 12 measure score; Dialysis Adequacy Measure Topic score; Vascular Access Type Measure Topic score; ICH CAHPS Admin score; NHSN Event Reporting score; Mineral Metabolism Reporting score; Anemia Management Reporting score; the Total Performance Score; and payment reduction percentage.

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