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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
5551WELLBOUND OF STOCKTON LLC5525553555 DEER PARK DRIVE SUITE 140STOCKTONCA9521917100%110%17AchievementN/A00N/AN/A6769%136N/AN/A6410%94N/AN/AN/A10100%No reduction07/05/2006SATELLITE HEALTHCARE01/02/2006
5552PISMO BEACH DIALYSIS552556320 JAMES WAY, SUITE 110PISMO BEACHCA9344918100%353%33Achievement597%3697%31Achievement458%39945%367Achievement613%36325%247Achievement5%10101070%No reduction06/28/2006DAVITA04/25/2006
5553RED BLUFF DIALYSIS5525572455 SISTER MARY COLUMBA DRIVERED BLUFFCA9608017100%433%40Achievement10100%4398%42Achievement1075%49169%455Achievement96%44511%314Achievement10%101010100%No reduction07/12/2006DAVITA05/16/2006
5554WELLBOUND OF MILPITAS LLC5525581850 MILMONT DRIVEMILPITASCA9503517100%200%15AchievementN/A00N/AN/A6969N/AN/A6948N/AN/AN/A10100%No reduction08/02/2006SATELLITE HEALTHCARE04/16/2006
5555SATELLITE DIALYSIS5525591860 MILMONT DRIVEMILPITASCA9503517100%716%68Achievement798%60100%59Achievement457%79250%744Achievement89%75015%532Achievement6%10101079%No reduction08/03/2006SATELLITE HEALTHCARE06/02/2006
5556WELLBOUND OF VALLEJO552560480 REDWOOD STREET SUITE 40VALLEJOCA9459017N/A36N/AN/A00N/AN/A036N/AN/A024N/AN/AN/A10100%No reduction10/18/2006SATELLITE HEALTHCARE10/02/2006
5557FMC-LA JOLLA5525614765 CARMEL MOUNTAIN ROAD, SUITE 100SAN DIEGOCA9213018100%413%40Achievement798%42100%41Achievement560%43145%420Achievement105%38412%272Achievement8%10101085%No reduction11/27/2006FRESENIUS MEDICAL CARE06/21/2006
5558FMC-BAKERSFIELD5525628625 LIBERTY PARK DRIVE, SUITE 102BAKERSFIELDCA9331118100%689%70Achievement899%6992%60Achievement766%78363%675Achievement514%74215%478Achievement6%10101082%No reduction11/29/2006FRESENIUS MEDICAL CARE10/02/2006
5559ASH TREE DIALYSIS5525632666 NORTH GROVE INDUSTRIAL DRIVE SUITE 106FRESNOCA937271791%1703%152Achievement597%15696%135Achievement869%172553%1606Achievement514%161222%1141Achievement7%10101073%No reduction08/22/2006DAVITA08/02/2006
5560ALMOND-WOOD DIALYSIS552564501 EAST ALMOND AVENUEMADERACA9363717100%924%85Achievement10100%9796%77Achievement971%108359%928Achievement89%10319%655Achievement9%10101097%No reduction08/23/2006DAVITA01/26/2009
5561SAN BERNARDINO VALLEY HOME DIALYSIS CENTER5525651500 NORTH WATERMAN AVENUE, SUITE BSAN BERNARDINOCA9240418100%330%26AchievementN/A00N/AN/A00N/AN/A00N/AN/AN/A10100%No reduction02/12/2007INDEPENDENT10/02/2006
5562FORT BRAGG DIALYSIS DCI552566512 CYPRESS STREETFORT BRAGGCA9543717N/A927%11N/AN/A810N/A043%10858%127Achievement105%939%85Achievement5%10101055%No reduction11/15/2006DIALYSIS CLINIC, INC.10/02/2006
5563TEMPLETON DIALYSIS5525671310 LAS TABLAS ROAD, SUITE 101TEMPLETONCA9346518100%482%50Achievement10100%5086%42Achievement766%51654%535Achievement89%48722%361Achievement8%10101094%No reduction12/06/2006DAVITA11/02/2006
5564FMC-DIALYSIS SERVICES OF EAST LOS ANGELES5525685220 EAST TELFORD STREETEAST LOS ANGELESCA9002218N/A96N/A10100%116Achievement1098%11467Achievement101%10549Achievement10%101010100%No reduction12/20/2006FRESENIUS MEDICAL CARE02/09/2006
5565NATOMAS DIALYSIS55256930 G0LDENLAND COURT BUILDING GSACRAMENTOCA9583417100%876%82Achievement899%9194%79Achievement664%107264%899Achievement88%100612%603Achievement7%10101085%No reduction01/04/2007DAVITA01/02/2007
5566DIXON DIALYSIS SERVICES552570125 NORTH LINCOLN STREET, SUITE BDIXONCA9562017100%2413%31Achievement696%2490%29Improvement662%25353%318Achievement612%21715%204Achievement6%10101076%No reduction11/17/2006INDEPENDENT11/01/2006
5567NORCO DIALYSIS CENTER5525711901 TOWN AND COUNTRY DRIVE, SUITE 100NORCOCA9286018100%456%50Achievement10100%4498%50Achievement355%46953%491Achievement613%42710%316Achievement5%10101085%No reduction02/16/2007DAVITA02/06/2007
5568CARQUINEZ DIALYSIS CENTER552572125 CORPORATE PLACE SUITE CVALLEJOCA9459017100%434%45Achievement10100%44100%45Achievement043%48456%484Achievement221%42716%329Achievement1%10101073%No reduction01/12/2007DAVITA12/02/2007
5569AZUSA DIALYSIS CENTER, LLC552573312 NORTH AZUSA AVENUEAZUSACA9170218100%2610%31Achievement597%3196%28Achievement870%30961%322Achievement89%27810%217Achievement8%10101079%No reduction03/05/2007INDEPENDENT12/18/2006
5570EAST LOS ANGELES DIALYSIS CENTER5525745830 EAST WHITTIER BOULEVARDEAST LOS ANGELESCA900221891%1017%101Achievement597%10295%98Achievement868%112570%1081Achievement89%106613%759Achievement8%10101076%No reduction03/05/2007INDEPENDENT01/02/2007
5571DAVITA-DIALYSIS CENTER OF VENTURA5525752705 LOMA VISTA ROAD, SUITE 101VENTURACA9300318100%480%70Achievement093%4294%63Achievement662%44464%770Achievement104%4104%557Achievement8%10101064%No reduction04/09/2007DAVITA03/02/2007
5572TOKAY HOME DIALYSIS CENTER552576777 SOUTH HAM DRIVE SUITE LLODICA9524217100%2224%21AchievementN/A00N/AN/A3548N/AN/A2933N/AN/AN/A10100%No reduction04/19/2007DAVITA02/16/2007
5573SATELLITE DIALYSIS OF STOCKTON5525771801 EAST MARCH LANE SUITE A100STOCKTONCA9521017100%876%79Achievement194%84100%74Achievement766%100460%880Achievement711%94114%619Achievement7%10101064%No reduction05/23/2007SATELLITE HEALTHCARE02/02/2007
5574YUCAIPA DIALYSIS CENTER55257833487 YUCAIPA BOULEVARDYUCAIPACA9239918100%185%20Achievement10100%2090%20Achievement664%18249%196Achievement711%15121%127Achievement7%10101091%No reduction05/25/2007DAVITA05/24/2007
5575LONG BEACH HARBOR (UCLA) DIALYSIS CENTER5525791075 EAST PACIFIC COAST HIGHWAYLONG BEACHCA9080618100%307%27Achievement697%3092%25Improvement1086%32972%316Achievement102%3002%225Achievement10%1010085%No reduction05/30/2007DAVITA03/22/2007
5576DAVITA-MAR VISTA5525802020 SANTA MONICA BOULEVARD, SUITE 100 & 120SANTA MONICACA9040418100%544%50Achievement10100%51100%43Achievement250%55747%457Achievement124%52123%319Achievement2%1010073%No reduction07/18/2007DAVITA06/05/2007
5577CERES DIALYSIS CENTER5525811768 MITCHELL ROAD SUITE 308CERESCA9530717100%627%42Achievement10100%5397%38Achievement972%60769%441Achievement612%54515%303Achievement8%10101094%No reduction08/01/2007DAVITA05/08/2007
5578WELLBOUND OF SAN MATEO5525822000 SOUTH EL CAMINO REAL 2ND FLOORSAN MATEOCA9440317100%267%27AchievementN/A00N/AN/A3334N/AN/A2725N/AN/AN/A10100%No reduction07/12/2007SATELLITE HEALTHCARE07/02/2007
5579METROPOLITAN DIALYSIS CENTER, LLC5525833100 DEL MAR AVENUEROSEMEADCA9177018100%992%89Achievement10100%9099%85Achievement662%115061%1033Achievement613%10847%739Achievement6%10101088%No reduction09/24/2007INDEPENDENT07/18/2007
5580FMC-DIALYSIS SERVICES OF MID-WILSHIRE5525843545 WILSHIRE BOULEVARD, SUITE 100-103LOS ANGELESCA9001018100%330%15Achievement10100%3393%14Achievement1081%35355%136Achievement612%31922%77Achievement8%10101094%No reduction09/26/2007FRESENIUS MEDICAL CARE05/31/2007
5581PERITONEAL DIALYSIS CENTER OF AMERICA, INC.5525853112 WEST BEVERLY BOULEVARDMONTEBELLOCA9064018100%300%13AchievementN/A00N/AN/A00N/AN/A00N/AN/AN/A10100%No reduction10/19/2007INDEPENDENT08/07/2007
5582CLEARLAKE DIALYSIS CENTER55258614400 OLYMPIC DRIVECLEARLAKECA9542217100%408%38Achievement495%4391%35Improvement354%48853%403Achievement96%4492%271Achievement6%10101070%No reduction10/23/2007DAVITA10/02/2007
5583WELLBOUND OF SACRAMENTO5525872610 EL PASEO LANE SUITE F19SACRAMENTOCA9582117N/A45N/AN/A00N/AN/A2434N/AN/A2425N/AN/AN/A10100%No reduction10/04/2007SATELLITE HEALTHCARE10/02/2007
5584DAVITA-BELLFLOWER DIALYSIS CENTER55258815736 WOODRUFF AVENUEBELLFLOWERCA9070618100%716%78Achievement10100%69100%66Achievement869%72966%716Achievement514%6679%489Achievement7%10101091%No reduction10/19/2007DAVITA07/02/2007
5585DAVITA-NORTH GLENDALE5525891505 WILSON TERRACE, SUITE 190GLENDALECA9120618100%1325%120Achievement10100%12798%112Achievement869%154258%1408Achievement96%14617%993Achievement9%10101097%No reduction12/14/2007DAVITA09/18/2007
5586QUOTIDIAN DIALYSIS5525901055 EAST LA HABRA BOULEVARD, SUITE 6LA HABRACA9063118N/A79N/AN/A00N/AN/A8653%110N/A612%679%74Achievement6%N/A01059%No reduction10/16/2007INDEPENDENT07/02/2007
5587WEST SACRAMENTO DIALYSIS CLINIC5525913450 INDUSTRIAL BOULEVARD SUITE 100WEST SACRAMENTOCA956911791%684%70Achievement194%4998%56Achievement354%64049%732Achievement123%60220%507Achievement2%10101046%0.5%11/07/2007DAVITA11/08/2007
5588STOCKTON KIDNEY CLINIC5525921523 EAST MARCH LANE SUITE 200STOCKTONCA9521017100%585%56Achievement798%6295%57Achievement664%69557%633Achievement88%65816%447Achievement7%10101082%No reduction11/28/2007DAVITA07/02/2009
5589ANTELOPE VALLEY KIDNEY INSTITUTE55259343932 15TH STREET, SUITE 103LANCASTERCA9353418100%704%52Achievement898%6483%54Improvement457%72060%630Achievement033%67528%440Achievement2%10101070%No reduction03/10/2008INDEPENDENT11/02/2007
5590DAVITA-EXETER DIALYSIS5525941116 WEST VISALIA ROAD, SUITE 106EXETERCA9322118100%482%43Achievement10100%5395%41Achievement868%63461%539Achievement514%58419%374Achievement7%10101091%No reduction03/05/2008DAVITA02/12/2008
5591FMC-MISSION VIEJO55259523681 VIADUCT LINDA, SUITE EASTMISSION VIEJOCA9269118100%149Achievement10100%1710Achievement1085%18884%105Achievement101%1700%68Achievement10%101010100%No reduction03/21/2008FRESENIUS MEDICAL CARE02/12/2008
5592ONTARIO DIALYSIS INC.5525961001 WEST SIXTH STREET, SUITE AONTARIOCA9176218100%6113%54Achievement290%6086%50Improvement561%72956%575Achievement318%67119%372Achievement4%10101058%No reduction03/07/2008INDEPENDENT12/04/2007
5593DAVITA-SANTA FE SPRINGS DIALYSIS55259711147 WASHINGTON BOULEVARDWHITTIERCA9060618100%413%35Achievement10100%42100%34Achievement870%45174%350Achievement515%40710%222Achievement7%10101091%No reduction04/25/2008DAVITA02/02/2008
5594RAI-GOLDENWEST-WESTMINSTER55259815330 GOLDENWEST STREETWESTMINSTERCA9268318100%921%102Achievement899%7497%72Achievement766%99160%993Achievement612%94819%684Achievement7%10101085%No reduction04/30/2008RENAL ADVANTAGE04/02/2008
5595DAVITA-MORENO VALLEY55259922620 GOLDENCREST DRIVE, SUITE 101-103MORENO VALLEYCA9255318100%4016%56Achievement898%4084%50Improvement355%41843%582Achievement319%37825%381Achievement3%10101073%No reduction06/27/2008DAVITA09/02/2007
5596WELLBOUND OF SAN LEANDRO5526001040 DAVIS STREET SUITE 101SAN LEANDROCA9457717100%180%19AchievementN/A00N/AN/A1022N/AN/A413N/AN/AN/A10100%No reduction07/17/2008SATELLITE HEALTHCARE07/18/2008
5597SIMI DIALYSIS CENTER, LLC5526011407 EAST LOS ANGELES AVENUE, SUITE GSIMI VALLEYCA9306518100%254%28Achievement10100%2290%20Achievement252%27652%242Achievement228%25934%168Improvement2%10101076%No reduction07/31/2008INDEPENDENT05/29/2008
5598SAN JOSE AT HOME5526024400 STEVENS CREEK BOULEVARD SUITE 50SAN JOSECA9512917100%264%23AchievementN/A00N/AN/A8180N/AN/A7056N/AN/AN/A10100%No reduction08/28/2008DAVITA08/28/2008
5599JOY OF DIXON DIALYSIS CENTER5526031640 NORTH LINCOLN STREETDIXONCA9562017100%130%12Achievement10100%12100%12Achievement869%14957%142Achievement104%1293%103Achievement9%10101097%No reduction08/19/2008DAVITA08/21/2008
5600WEST ELK GROVE DIALYSIS CENTER5526042208 KAUSEN DRIVE SUITE 100ELK GROVECA9575817100%833%86Achievement10100%8596%83Achievement973%96369%878Achievement88%8888%606Achievement9%1010094%No reduction08/27/2008DAVITA08/28/2008

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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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