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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
5401DAVITA - LOOMIS RD5225074120 WEST LOOMIS ROADGREENFIELDWI5322111100%326%34Achievement10100%3691%35Achievement662%39672%390Achievement514%36713%267Achievement6%1010085%No reduction03/22/1989DAVITA10/02/2005
5402DAVITA - RIVERCENTER DR522509117 NORTH JEFFERSON STREETMILWAUKEEWI5320211100%430%41Achievement10100%4393%40Achievement663%50861%444Achievement103%4835%303Achievement8%10101094%No reduction01/01/1992DAVITA07/31/2009
5403FMC DIALYSIS - MILWAUKEE522510200 WEST PLEASANT STREETMILWAUKEEWI5321211100%390%40Achievement10100%49100%41Achievement868%54539%424Achievement615%49734%284Improvement7%10101091%No reduction05/19/1992FRESENIUS MEDICAL CARE08/04/2005
5404GREEN BAY NORTHWOOD DIALYSIS OF DAVITA522511W 7305 ELM AVENUESHAWANOWI5416611100%330%42Achievement597%3393%44Achievement1074%39457%438Achievement417%36922%296Achievement7%10101076%No reduction09/04/1992DAVITA05/19/2006
5405FRESENIUS MEDICAL CARE MIDWEST CAPITOL5225124021 NORTH 52ND STREETMILWAUKEEWI5321611100%380%35Achievement10100%4197%33Achievement560%45949%385Achievement516%43032%269Improvement5%10101085%No reduction10/19/1992FRESENIUS MEDICAL CARE01/02/1980
5406PURITY DIALYSIS - BROOKFIELD52251318740 WEST BLUEMOUND ROADBROOKFIELDWI5304511100%196%18Achievement10100%1789%18Achievement355%21853%178Achievement032%18529%118Achievement2%10101076%No reduction11/17/1992OTHER CHAIN(number of facilities <20 )05/19/2006
5407PURITY DIALYSIS - OCONOMOWOC5225171253 CORPORATE CENTER DRIVEOCONOMOWOCWI5306611100%203%31Achievement10100%2788%34Achievement1078%32463%397Achievement613%29324%274Achievement8%10101094%No reduction06/02/1993OTHER CHAIN(number of facilities <20 )01/02/1980
5408ST CROIX FALLS DIALYSIS OF DAVITA522519744 LOUISIANA STREET EASTSAINT CROIX FALLSWI5402411100%160%22Achievement10100%17100%22Achievement1079%18568%223Achievement105%17411%150Achievement10%1010097%No reduction04/21/1989DAVITA05/19/2006
5409PURITY DIALYSIS - MUKWONAGO522521400 BAY VIEW ROAD, SUITE FMUKWONAGOWI5314911100%196%18Achievement10100%22100%19Achievement1079%21957%220Achievement103%20117%137Achievement10%1051098%No reduction05/17/1996OTHER CHAIN(number of facilities <20 )01/02/1980
5410PURITY DIALYSIS - MENOMONEE FALLS522523N87 W17301 MAIN STREETMENOMONEE FALLSWI5305111100%193%31Achievement496%23100%32Achievement1077%28860%321Achievement711%26225%224Achievement9%10101079%No reduction07/22/1997OTHER CHAIN(number of facilities <20 )01/02/1980
5411FRESENIUS MEDICAL CARE MIDWEST GOOD HOPE5225247701 WEST CLINTON AVENUEMILWAUKEEWI5322311100%446%53Achievement10100%5198%48Achievement664%57054%525Achievement710%53220%354Achievement7%10101091%No reduction10/22/1997FRESENIUS MEDICAL CARE01/02/1980
5412PURITY DIALYSIS - WATERTOWN522525123 HOSPITAL DRIVE, #1004WATERTOWNWI5309811100%260%28Achievement10100%2986%28Achievement554%33825%322Improvement532%30463%218Improvement5%10101085%No reduction12/04/1997OTHER CHAIN(number of facilities <20 )01/02/1980
5413DAVITA - FOND DU LAC DIALYSIS522526210 WISCONSIN AMERICAN DRIVEDIALYSIS UNITFOND DU LACWI5493711N/A020%15N/AN/A086%14N/AN/A079%149N/AN/A98%98N/A101010100%No reduction06/30/1998DAVITA02/02/2012
5414DAVITA - SHEBOYGAN DIALYSIS5225272414 KOHLER MEMORIAL DRIVESHEBOYGANWI5308111100%343%38Achievement10100%3182%33Achievement870%37757%411Achievement423%35837%291Improvement6%1010085%No reduction07/23/1998DAVITA02/02/2012
5415FRESENIUS MEDICAL CARE MIDWEST RYAN ROAD5225289420 SOUTH 22ND STREETOAK CREEKWI5315411100%500%54Achievement10100%5298%55Achievement1077%63969%560Achievement613%58620%379Achievement8%10101094%No reduction01/25/1999FRESENIUS MEDICAL CARE01/02/1980
5416DAVITA - CEDARBURG522529N54 WEST 6135 MILL STREETCEDARBURGWI5301211100%310%33Achievement10100%33100%31Achievement869%37364%353Achievement318%34112%222Achievement6%1010085%No reduction02/18/1999DAVITA10/02/2005
5417FMC - CENTRE POINT52253011340 WEST THEODORE TRECKER WAYWEST ALLISWI5321411100%732%63Achievement798%6398%54Achievement355%74650%717Achievement417%70819%496Achievement4%10101073%No reduction04/01/1999FRESENIUS MEDICAL CARE05/19/2006
5418FMC - SHOREWOOD5225311409 EAST CAPITOL DRIVESHOREWOODWI5321111100%372%41Achievement10100%3698%42Achievement035%41031%446Achievement031%38128%314Achievement0%10101070%No reduction04/01/1999FRESENIUS MEDICAL CARE04/02/1999
5419DAVITA - CAPITOL DRIVE52253219395 WEST CAPITOL DRIVE, SUITE 100BROOKFIELDWI5304511100%160%21Achievement10100%2095%20Achievement1077%21461%236Achievement711%18522%167Achievement9%10101097%No reduction11/05/1999DAVITA10/02/2005
5420PURITY DIALYSIS - FORT ATKINSON522533525 HANDEYSIDE LANEFORT ATKINSONWI5353811100%243%32Achievement082%2884%32Achievement250%33255%354Achievement221%31317%245Achievement2%10101046%0.5%11/01/1999OTHER CHAIN(number of facilities <20 )05/19/2006
5421TRI STATE DIALYSIS - PLATTEVILLE5225341250 EAST BUSINESS HIGHWAY 151, SUITE BPLATTEVILLEWI5381811100%2310%39Achievement10100%27100%38Achievement1085%33972%441Achievement89%31515%293Achievement9%10101097%No reduction08/09/2000INDEPENDENT05/19/2006
5422PURITY DIALYSIS - WAUKESHA SOUTH5225351260 SENTRY DRIVEWAUKESHAWI5318611100%210%24Achievement10100%26100%26Achievement1078%27482%256Achievement102%2596%178Achievement10%101010100%No reduction08/14/2000OTHER CHAIN(number of facilities <20 )05/19/2009
5423DAVITA - BLUEMOUND PD522536601 NORTH 99TH STREETSUITE 300WAUWATOSAWI5322611100%420%34AchievementN/A00N/AN/A00N/AN/A00N/AN/AN/A10100%No reduction10/24/2000DAVITA05/02/2010
5424DAVITA - LAKE GENEVA DIALYSIS522537146 EAST GENEVA SQUARELAKE GENEVAWI5314711100%446%48Achievement10100%4989%45Achievement1081%55479%535Achievement96%50210%353Achievement10%101010100%No reduction01/10/2001DAVITA02/02/2012
5425FMC DIALYSIS - SUPERIOR5225383500 TOWER AVENUESUPERIORWI5488011100%220%24Achievement496%25100%22Achievement1076%27980%252Achievement710%2551%176Achievement9%10101079%No reduction09/01/2000FRESENIUS MEDICAL CARE08/04/2005
5426FMC DIALYSIS - CHEQUAMEGON BAY5225391815 BEASER AVENUEASHLANDWI5480611100%156%16Achievement10100%17100%17Achievement561%20673%177Achievement89%1938%116Achievement7%10101091%No reduction09/01/2000FRESENIUS MEDICAL CARE08/04/2005
5427FRESENIUS MEDICAL CARE MIDWEST RACINE5225405409 DURAND AVENUERACINEWI5340611100%1915%20Achievement10100%2295%20Achievement559%28953%222Achievement613%2578%146Achievement6%10101088%No reduction02/26/2001FRESENIUS MEDICAL CARE05/19/2006
5428FRESENIUS MEDICAL CARE MIDWEST GLENDALE522542400 WEST ESTABROOK BOULEVARDMILWAUKEEWI5321211100%474%48Achievement10100%49100%47Achievement560%55365%530Achievement89%51115%373Achievement7%10101091%No reduction05/07/2001FRESENIUS MEDICAL CARE02/02/2001
5429DAVITA - SOUTH RIDGE5225437740 WEST LAYTON AVENUEGREENFIELDWI5322011100%690%70Achievement597%7499%71Achievement1074%82371%840Achievement89%73816%590Achievement9%10101082%No reduction10/19/2001DAVITA05/02/2010
5430FRESENIUS MEDICAL CARE MIDWEST WEST BEND5225442050 CONTINENTAL DRIVEWEST BENDWI5309511100%370%40Achievement10100%4198%45Achievement765%47865%491Achievement025%44826%341Achievement4%10101082%No reduction11/30/2001FRESENIUS MEDICAL CARE05/19/2006
5431FMC DIALYSIS - OSHKOSH5225452700 WEST 9TH AVENUESUITE 101AOSHKOSHWI5490411100%210%30Achievement10100%27100%29Achievement560%29353%329Achievement88%27622%232Achievement7%10101091%No reduction02/17/2003FRESENIUS MEDICAL CARE05/02/2007
5432FMC DIALYSIS - APPLETON5225462701 NORTH ONEIDA STREET, SUITE EASTAPPLETONWI5491111100%593%60Achievement798%61100%63Achievement560%65162%652Achievement123%60320%459Achievement3%10101070%No reduction02/15/2002FRESENIUS MEDICAL CARE01/02/2010
5433FMC - RIPON SOUTH52254737 STONEY RIDGE ROADSTE 100RIPONWI5497111N/A910N/A10100%1110Achievement353%12469%116Achievement124%9910%86Achievement2%10101064%No reduction04/26/2002FRESENIUS MEDICAL CARE01/20/2009
5434DAVITA - WEST APPLETON52254810130 WEST APPLETON AVENUE, SUITE 500MILWAUKEEWI5322511100%759%87Achievement10100%8193%88Achievement765%90056%975Achievement88%85418%698Achievement8%10101094%No reduction07/22/2002DAVITA05/02/2010
5435FMC - KAUKAUNA5225502259 PROGRESS WAYKAUKAUNAWI5413011100%160%18Achievement10100%15100%20Achievement765%16570%207Achievement417%1489%148Achievement6%10101088%No reduction09/23/2002FRESENIUS MEDICAL CARE03/02/2002
5436DAVITA - MARINETTE DIALYSIS5225514061 OLD PESHTIGO ROADPO BOX 18MARINETTEWI5414311100%254%26Achievement10100%2395%22Achievement971%25176%236Achievement89%23611%157Achievement9%10101097%No reduction02/07/2003DAVITA02/02/2012
5437DAVITA - GREEN BAY DIALYSIS5225521751 DECKNER AVENUEGREEN BAYWI5430211100%258%24Achievement10100%23100%19Achievement561%25153%227Achievement124%23923%158Achievement3%1010076%No reduction01/21/2003DAVITA02/02/2012
5438DAVITA - BAY SHORE5225545650 NORTH GREEN BAY AVENUE #150GLENDALEWI532091191%1161%123Achievement697%11592%118Improvement561%128262%1303Achievement416%120521%912Achievement5%10101070%No reduction05/16/2003DAVITA05/02/2010
5439WI DIALYSIS INC - FITCHBURG CLINIC5225553034 FISH HATCHERY ROADMADISONWI5371311100%971%91Achievement597%9898%86Achievement560%120460%1013Achievement031%106625%702Achievement3%10101064%No reduction07/01/2003INDEPENDENT05/19/2006
5440DAVITA - STURGEON BAY DIALYSIS522556108 SOUTH 10TH AVENUESTURGEON BAYWI5423511100%137%14Achievement194%16100%12Achievement869%16964%146Achievement103%1480%87Achievement9%1010067%No reduction07/10/2003DAVITA02/02/2012
5441DAVITA - TITLE TOWN522558120 SIEGLER STREETGREEN BAYWI5430311100%392%49Achievement798%4594%48Achievement1078%52061%495Achievement613%49631%339Achievement8%10101085%No reduction08/14/2003DAVITA10/02/2005
5442WI DIALYSIS INC - EAST5225594600 AMERICAN PARKWAY, SUITE 108MADISONWI5371811100%188%24Achievement10100%2596%23Achievement561%25946%244Achievement428%23845%170Improvement5%10101085%No reduction11/11/1996INDEPENDENT07/14/2003
5443DAVITA - OSHKOSH DIALYSIS522560855 NORTH WESTHAVEN DRIVEDIALYSIS UNITOSHKOSHWI5490411100%366%35Achievement10100%40100%35Achievement251%46755%414Achievement416%42115%294Achievement3%10101079%No reduction04/02/2004DAVITA02/02/2012
5444FRESENIUS MEDICAL CARE MIDWEST LAKESHORE5225612000 EAST LAYTON AVENUE SUITE 200SAINT FRANCISWI5323511100%180%19Achievement10100%2594%18Achievement1080%27573%217Achievement613%24915%155Achievement8%10101094%No reduction06/17/2004FRESENIUS MEDICAL CARE05/19/2006
5445DAVITA - MANITOWOC DIALYSIS522562601 REED AVENUEMANITOWOCWI5422011100%204%26Achievement10100%2095%21Achievement1078%22664%261Achievement612%21622%180Achievement8%10101094%No reduction08/31/2004DAVITA02/02/2012
5446DAVITA - WAUTOMA DIALYSIS522563900 EAST DIVISION STREETWAUTOMAWI5498211100%196%16Achievement10100%22100%16Achievement035%21531%200Achievement319%19418%132Achievement2%10101076%No reduction04/04/2005DAVITA02/02/2012
5447FRESENIUS MEDICAL CARE MIDWEST KENOSHA5225646804 GREEN BAY ROADSUITE 108KENOSHAWI5314211100%136%17Achievement10100%1893%15Achievement354%22271%164Achievement89%18610%111Achievement6%10101088%No reduction03/29/2005FRESENIUS MEDICAL CARE05/19/2006
5448ARA - MILWAUKEE5225654775 NORTH GREEN BAY AVENUEMILWAUKEE DIALYSIS CENTERMILWAUKEEWI5320911100%540%63Achievement10100%57100%61Achievement354%65455%699Achievement122%63316%509Achievement2%10101076%No reduction12/05/2005AMERICAN RENAL ASSOCIATES10/02/2005
5449DAVITA - BLUEMOUND522566601 NORTH 99TH STREETSUITE 100WAUWATOSAWI532261191%923%96Achievement899%74100%72Achievement767%114560%1151Achievement89%105015%809Achievement8%10101085%No reduction01/10/2006DAVITA05/02/2010
5450KIDNEY REPLACEMENT THERAPIES5225686125 GREEN BAY ROADSUITE 100KENOSHAWI5314211N/A12N/AN/A00N/AN/A00N/AN/A00N/AN/AN/A10100%No reduction05/01/2006INDEPENDENT06/14/2005

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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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