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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
5351WHEELING DIALYSIS CENTER512513500 MEDICAL PARK SUITE 100WHEELINGWV260035100%522%58Achievement295%57100%50Achievement458%61359%587Achievement221%57318%422Achievement3%10101055%No reduction09/01/1977INDEPENDENT01/02/1980
5352NEW MARTINSVILLE DIALYSIS FACILITY5125141 EAST BENJAMIN DRIVENEW MARTINSVILLEWV261555100%1710%20Achievement10100%22100%18Achievement664%27649%202Achievement105%24412%136Achievement8%010087%No reduction07/13/1998INDEPENDENT01/02/1980
5353FMC - TWO VIRGINIAS512515400 CHERRY STREETBLUEFIELDWV247015100%624%73Achievement10100%63100%67Achievement1082%73972%718Achievement104%7154%508Achievement10%101010100%No reduction04/01/1998FRESENIUS MEDICAL CARE01/02/1980
5354FMC - MERCER COUNTY512516160 SPRINGHAVEN DRIVEPRINCETONWV247405100%350%38Achievement10100%3395%39Achievement870%40262%429Achievement613%36320%292Achievement7%10101091%No reduction04/01/1998FRESENIUS MEDICAL CARE01/02/1980
5355FMC - HURRICANE5125173768 TEAYS VALLEY ROADHURRICANEWV25526573%340%34Achievement10100%3391%32Achievement456%40039%353Achievement516%35629%249Improvement5%10101076%No reduction11/10/1999FRESENIUS MEDICAL CARE11/11/1999
5356WEST VIRGINIA DIALYSIS512518300 PROSPERITY LANESTE 150LOGANWV256015100%296%33Achievement10100%24100%25Achievement146%33658%286Achievement515%2916%191Achievement3%10101079%No reduction03/13/2000DAVITA01/16/2000
5357GRAND CENTRAL DIALYSIS512519800 GRAND CENTRALSUITE 8VIENNAWV261055100%8114%83Achievement999%6890%61Improvement1074%82767%756Achievement89%77710%515Achievement9%10101094%No reduction12/01/2000DAVITA12/02/2000
5358GREATER CHARLESTON DIALYSIS PLLC51252024 MACCORKLE AVENUE SOUTHWESTSOUTH CHARLESTONWV253035100%618%77Achievement194%5093%59Achievement146%59445%660Achievement515%55610%479Achievement3%10101052%0.5%01/01/2002INDEPENDENT05/24/2002
5359FMC - FAIRMONT51252131 LANDING LANEFAIRMONTWV265545100%540%64Achievement10100%5498%62Achievement457%56260%692Achievement221%37427%494Achievement3%10101079%No reduction04/22/2002FRESENIUS MEDICAL CARE05/30/2002
5360RENAL CENTER OF MOOREFIELD, LLC5125228 LEE STREET 2ND FLOORMOOREFIELDWV268365100%200%17Achievement10100%22100%19Achievement1079%26168%217Achievement102%2507%146Achievement10%101010100%No reduction06/03/2004RENAL VENTURES MANAGEMENT07/30/2004
5361FMC - CLARKSBURG51252316 STERLING DRIVEBRIDGEPORTWV263305100%659%76Achievement597%6596%70Achievement767%77763%784Achievement318%72619%544Achievement5%10101070%No reduction02/01/2005FRESENIUS MEDICAL CARE10/01/2010
5362FMC - WESTON512524MARKET PLACE PLAZASTE 1 CWESTONWV26452573%334%28Achievement496%2796%27Achievement869%38662%257Achievement514%35813%167Achievement7%10101064%No reduction02/01/2005FRESENIUS MEDICAL CARE08/02/2005
5363MOUNTAIN RIDGE DIALYSIS512525229 MERCHANTS WALKSUMMERSVILLEWV266515100%170%18Achievement10100%19100%15Achievement1082%23755%201Achievement105%20415%130Achievement10%101010100%No reduction02/06/2006FRESENIUS MEDICAL CARE02/17/2006
5364GENTLE DIALYSIS CENTER512526166 THOMPSON DRIVE SUITE BBRIDGEPORTWV263305N/A54N/AN/A00N/AN/A00N/AN/A00N/AN/AN/A00%2.0%08/10/2006INDEPENDENT08/31/2006
5365FMC - BRUCETON MILLS512527RR 3 BOX 300 CASTEEL ROADBRUCETON MILLSWV265255100%1512%17Achievement10100%14100%13Achievement561%15243%147Achievement524%14844%97Improvement5%10101085%No reduction10/25/2006FRESENIUS MEDICAL CARE12/05/2006
5366FMC - CHARLES TOWN512528179 EAST BURR BOULEVARDUNIT AKEARNEYSVILLEWV25430573%376%36Achievement597%3794%34Achievement247%45637%394Improvement418%40928%270Improvement3%10101055%No reduction02/01/2007FRESENIUS MEDICAL CARE02/28/2007
5367FMC - RIPLEY5125291000 NEW STONE RIDGE ROADRIPLEYWV252715100%220%28Achievement395%2092%25Improvement149%27657%279Achievement029%25315%194Achievement1%10101052%0.5%05/23/2007FRESENIUS MEDICAL CARE06/26/2007
5368POINT PLEASANT DIALYSIS5125303683 OHIO RIVER ROADPOINT PLEASANTWV255505100%2010Achievement10100%1810Achievement1077%17660%137Achievement710%14018%95Achievement9%1010094%No reduction01/13/2009INDEPENDENT01/14/2009
5369GREATER BOONE DIALYSIS LLC512531300 4TH STREETDANVILLEWV250535100%166%17Achievement089%1894%18Achievement352%24442%198Improvement514%21614%135Achievement4%1051050%0.5%02/04/2009INDEPENDENT02/05/2009
5370J ROBERT PRITCHARD DIALYSIS CENTER5125321690 MEDICAL CENTER DRIVEHUNTINGTONWV257015100%706%89Achievement899%6998%81Achievement766%85256%911Achievement420%77233%637Improvement6%10101082%No reduction04/01/2009FRESENIUS MEDICAL CARE04/02/2009
5371FMC - KANAWHA COUNTY512533951 DUNBAR VILLAGEDUNBARWV25064573%373%37Achievement194%3193%27Achievement346%46130%344Improvement227%37635%228Improvement3%1010040%1.0%09/01/2009FRESENIUS MEDICAL CARE09/02/2009
5372FMC - GREENBRIER COUNTY5125341215 MAPLEWOOD AVENUELEWISBURGWV249015100%170%16Achievement295%20100%15Achievement765%22246%167Achievement417%20326%114Achievement6%10101064%No reduction11/18/2009FRESENIUS MEDICAL CARE11/19/2009
5373FMC - RIVER HILLS5125355170 US RTE 60 EASTHUNTINGTONWV25705528%406%18Achievement194%3493%14Achievement458%43144%190Achievement231%38439%119Improvement3%10101028%1.5%05/25/2010FRESENIUS MEDICAL CARE05/26/2010
5374FMC - OCEANA5125361777 COOK PARKWAYOCEANAWV248705100%125Achievement083%126Achievement559%12644Achievement88%10719Achievement7%10101061%No reduction11/17/2010FRESENIUS MEDICAL CARE11/18/2010
5375RENAL CENTER OF KEYSER, LLC5125371080 NEW CREEK HIGHWAYKEYSERWV267265100%140Achievement10100%140Achievement456%1600Achievement027%1250Achievement2%10101076%No reduction10/26/2011RENAL VENTURES MANAGEMENT10/27/2011
5376MAYO CLINIC DIALYSIS - MENOMONIE520003522331407 21ST STREETMENOMONIEWI5475111022%234%23Achievement10100%29100%26Achievement972%31865%278Achievement416%27721%193Achievement7%10101061%No reduction10/06/1999OTHER CHAIN(number of facilities <20 )04/10/2012
5377LAKEVIEW MEDICAL CENTER5200115223201700 WEST STOUT STREETRICE LAKEWI5486811100%363%40Achievement194%4893%41Achievement765%56349%448Achievement328%49639%310Improvement5%10101058%No reduction03/01/1978INDEPENDENT01/10/2012
5378SACRED HEART HOSPITAL DIALYSIS520013522327900 WEST CLAIREMONT AVENUEEAU CLAIREWI5470111100%386%33Achievement10100%34100%31Achievement767%45664%398Achievement96%42311%270Achievement8%10101094%No reduction07/09/1998INDEPENDENT01/02/1980
5379ST CATHERINES KIDNEY CTR - UNITED HOSP SYSTEM5200215223359555 76TH STREETST CATHERINES MEDICAL CTR CAMPUSPLEASANT PRAIRIEWI5315811100%617%69Achievement10100%6297%63Achievement556%69638%683Improvement525%64647%461Improvement5%10101085%No reduction10/01/2000INDEPENDENT10/02/2000
5380WAUPUN REGIONAL DIALYSIS52002552230110 BEAVER DAM STREETWAUPUNWI5396311100%220%21Achievement10100%22100%23Achievement458%26148%255Achievement331%24047%170Improvement4%10101082%No reduction09/01/1977INDEPENDENT11/02/1972
5381DIVINE SAVIOR HEALTHCARE DIALYSIS5200415223392817 NEW PINERY ROADPORTAGEWI539011148%1215%13Improvement10100%15100%15Achievement767%15161%176Achievement104%14510%128Achievement9%10101079%No reduction08/12/2004INDEPENDENT05/18/2006
5382ST NICHOLAS HOSPITAL - DIALYSIS5200445223232925 SAEMANN AVENUESHEBOYGANWI530811155%220%28Achievement10100%25100%30Achievement1079%25372%326Achievement97%24213%233Achievement10%10101085%No reduction03/15/1982INDEPENDENT05/18/2006
5383ST CLARE DIALYSIS CTR5200575223321600 JEFFERSON STREETSUITE 200BARABOOWI5391311100%472%42Achievement10100%5096%46Achievement664%59164%530Achievement026%56824%371Achievement3%10101079%No reduction06/28/2000INDEPENDENT12/25/2008
5384MERCY REGIONAL DIALYSIS CENTER520066522329903 MINERAL POINT AVENUEJANESVILLEWI5354811100%438%39Achievement10100%4597%39Achievement663%50762%467Achievement030%46724%313Achievement3%0101076%No reduction11/08/1999INDEPENDENT05/18/2006
5385LUTHER HOSPITAL - MAYO CLINIC DIALYSIS5200705223111221 WHIPPLE STREETEAU CLAIREWI5470211014%2214%28Achievement10100%3097%31Achievement869%26455%314Achievement515%16826%152Achievement7%10101061%No reduction09/01/1977OTHER CHAIN(number of facilities <20 )05/18/2006
5386ST VINCENT HOSPITAL REGIONAL DIALYSIS CTR5200755223121920 LIBAL STREETGREEN BAYWI5430111100%497%54Achievement798%57100%65Achievement447%65827%778Improvement436%63558%551Improvement4%10101073%No reduction09/01/1977INDEPENDENT04/13/1975
5387SSM DIALYSIS - MADISON STATION5200835223332840 INDEX ROADMADISONWI5371311100%1172%121Achievement597%11896%116Achievement766%145961%1475Achievement124%137528%1032Achievement4%10101067%No reduction06/22/2000INDEPENDENT05/18/2006
5388GUNDERSEN LUTHERAN RENAL DIALYSIS - LA CROSSE5200875223131900 SOUTH AVENUELA CROSSEWI5460111100%110%18AchievementN/A395%19N/AN/A2754%136N/AN/A197%46N/A101010100%No reduction09/01/1977OTHER CHAIN(number of facilities <20 )05/18/2006
5389BELOIT HEALTH SYSTEM - DIALYSIS5201005223241969 WEST HART ROADBELOITWI5351111100%490%43Achievement496%4895%41Achievement355%53352%465Achievement125%49529%320Improvement2%10101058%No reduction12/07/1987INDEPENDENT01/02/2010
5390HESS MEMORIAL HOSPITAL5201095223281050 DIVISION STREETMAUSTONWI5394811100%190%18Achievement091%2395%20Achievement252%22851%226Achievement043%20944%158Achievement1%10101043%0.5%03/04/1999INDEPENDENT01/02/1980
5391BAY AREA MEDICAL CENTER5201135223173100 SHORE DRIVEMARINETTEWI5414311100%1633%21Achievement10100%1795%21Achievement347%18932%237Improvement128%18131%168Improvement2%0101073%No reduction09/01/1977INDEPENDENT05/18/2006
5392MEMORIAL HOSPITAL OF LAFAYETTE COUNTY521312522340800 CLAY STREETPO BOX 70DARLINGTONWI5353011N/A67N/AN/A67N/AN/A6787N/AN/A6660N/A101010100%No reduction11/03/2004INDEPENDENT07/03/2009
5393MEMORIAL HEALTH CENTER DIALYSIS521324522343135 SOUTH GIBSON STREETMEDFORDWI5445111N/A106N/A10100%128Achievement663%15699Achievement029%14369Achievement3%10101068%No reduction01/27/2010INDEPENDENT04/11/2012
5394UPLAND HILLS DIALYSIS CTR521352522341800 COMPASSION WAYDODGEVILLEWI5353311100%170%19Achievement10100%17100%20Achievement1077%19482%198Achievement318%17512%133Achievement7%10101091%No reduction09/08/2008INDEPENDENT04/03/2008
5395FMC - NEENAH522500300 NORTH COMMERCIAL STREET, SUITE 100NEENAHWI5495611100%446%48Achievement10100%33100%37Achievement656%42028%409Improvement711%40519%266Achievement7%10101091%No reduction09/01/1977FRESENIUS MEDICAL CARE01/06/2009
5396DAVITA - FOX RIVER5225011910 RIVERSIDE DRIVEGREEN BAYWI5430111100%724%74Achievement798%5196%53Achievement766%69255%682Achievement614%62530%484Improvement7%10101082%No reduction10/02/1985DAVITA05/18/2006
5397DAVITA - WISCONSIN AVE5225023801 WEST WISCONSIN AVENUEMILWAUKEEWI5320811100%474%48Achievement10100%49100%46Achievement767%55766%522Achievement97%53712%363Achievement8%10101094%No reduction12/09/1986DAVITA01/02/1980
5398DAVITA - JANESVILLE5225031305 WOODMAN ROADJANESVILLEWI5354511100%442%45Achievement10100%4198%41Achievement1077%46375%444Achievement89%40511%310Achievement9%10101097%No reduction10/07/1987DAVITA10/02/2005
5399PURITY DIALYSIS - WAUKESHA522504721 AMERICAN AVENUE, SUITE 204WAUKESHAWI531881182%516%62Achievement10100%4594%52Achievement868%50258%527Achievement613%46124%364Achievement7%10101085%No reduction10/09/1987OTHER CHAIN(number of facilities <20 )01/02/1980
5400FRESENIUS MEDICAL CARE MIDWEST SOUTH5225063267 SOUTH 16TH STREET SUITE 203MILWAUKEEWI5321511100%413%37Achievement10100%4393%40Achievement558%48540%408Improvement618%44942%282Improvement6%10101088%No reduction02/09/1989FRESENIUS MEDICAL CARE05/19/2006

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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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