Understanding Dialysis Care
What patients and families should know
Dialysis is a life-sustaining treatment that filters waste, toxins, and excess fluid from the blood when the kidneys can no longer perform this function. With 7,557 Medicare-certified dialysis facilities across 56 states, patients have access to a wide range of treatment options. The average center operates 18 treatment stations, and 24% of facilities are rated 4 or more stars by CMS.
The dialysis landscape includes both for-profit and non-profit providers: 90% of facilities (6,770) are for-profit organizations, while 787 are non-profit. Texas leads the nation with 748 dialysis centers. When choosing a facility, patients should evaluate quality ratings, treatment modalities offered, staffing ratios, and proximity to home or work.
Dialysis treatment types:
In-Center Hemodialysis: The most common treatment, performed at a dialysis center typically 3 times per week. Blood is filtered through a dialyzer machine during sessions lasting 3 to 4 hours, with trained staff monitoring throughout.
Peritoneal Dialysis: A home-based treatment using the lining of the abdomen as a natural filter. A cleansing solution flows through a catheter, absorbs waste products, and is drained. This treatment is usually performed daily with greater schedule flexibility.
Home Hemodialysis: Hemodialysis performed at home with specialized training and equipment. Allows patients to dialyze more frequently (up to 6 times per week), often resulting in better outcomes and fewer dietary restrictions.
Nocturnal Dialysis: Extended treatments performed overnight, either at home or in-center. Longer, slower sessions of 6 to 8 hours provide more thorough waste removal, often leading to improved energy levels and quality of life.
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Choosing the Right Dialysis Center
Key factors to evaluate when selecting a dialysis facility
Quality Ratings
Review CMS star ratings based on patient survival, hospitalization rates, transfusion rates, and catheter use. Facilities rated 4 or 5 stars consistently demonstrate better patient outcomes and fewer complications.
Treatment Options
Look for centers offering multiple treatment modalities, including in-center hemodialysis, peritoneal dialysis, home hemodialysis, and nocturnal dialysis. Facilities with diverse options can better adapt to your changing needs over time.
Staffing & Care
Ask about the patient-to-nurse ratio, whether nephrologists are on-site, and what training the technicians have. Better-staffed centers typically have lower complication rates and higher patient satisfaction scores.
Infection Control
Infection is a serious risk during dialysis. Ask about the facility's bloodstream infection rate, hepatitis B vaccination protocols, hand hygiene compliance, and how they handle catheter care. CMS tracks these metrics publicly.
Schedule Flexibility
Consider available treatment shifts: early morning, daytime, evening, and nocturnal. Some centers offer Saturday sessions. Flexible scheduling helps you maintain work, family, and social activities alongside treatment.
Location & Transport
With treatments 3 times per week, proximity matters. Consider drive time, parking availability, and whether the center offers transportation assistance. Some patients also evaluate centers near their workplace for mid-day sessions.
What Medicare Covers for Dialysis
Medicare covers dialysis for patients with End-Stage Renal Disease regardless of age
Medicare provides comprehensive coverage for dialysis patients with ESRD. Part B covers outpatient dialysis treatments, and most patients qualify within 3 months of starting dialysis. Medicare also covers home dialysis training, equipment, and supplies for patients who choose to dialyze at home.
After a 3-month waiting period (or immediately with a kidney transplant), Medicare Part A and Part B cover most dialysis costs. You typically pay 20% of the Medicare-approved amount for most services after your Part B deductible is met.
Frequently Asked Questions
Common questions about dialysis care
How many dialysis centers are listed?
We list 7,557 Medicare-certified dialysis facilities across 56 states and territories, including in-center hemodialysis units, peritoneal dialysis programs, and home dialysis training centers.
How are dialysis facility ratings determined?
CMS rates dialysis facilities from 1 to 5 stars based on quality measures including patient survival, hospitalization rates, transfusion rates, catheter use, and other clinical outcomes. Ratings are updated periodically as new data becomes available.
How often is dialysis needed?
Most patients on in-center hemodialysis receive treatment three times per week, with each session lasting 3 to 4 hours. Peritoneal dialysis is typically performed daily, and home hemodialysis schedules can vary from 3 to 6 sessions per week depending on the treatment plan.
What does Medicare cover for dialysis?
Medicare Part B covers outpatient dialysis treatments, supplies, and certain medications for patients with End-Stage Renal Disease (ESRD) regardless of age. Most patients qualify for Medicare coverage within 3 months of starting dialysis. Medicare also covers kidney transplant evaluation and surgery.
What questions should I ask when choosing a dialysis center?
Ask about the facility's CMS star rating, patient-to-staff ratios, infection rates, available treatment schedules, transportation assistance, and whether they offer home dialysis training. Also consider the center's proximity to your home or workplace.
Can I do dialysis at home?
Yes. Home hemodialysis and peritoneal dialysis are both options for many patients. Home dialysis offers greater schedule flexibility, fewer dietary restrictions, and often better outcomes. Your dialysis center can provide training and equipment for home treatment.
What is the difference between hemodialysis and peritoneal dialysis?
Hemodialysis filters blood through an external machine using a dialyzer. Peritoneal dialysis uses the lining of your abdomen as a natural filter. A cleansing solution flows through a catheter, absorbs waste, and is drained. Both are effective; the best choice depends on your health, lifestyle, and preferences.
How do I find a dialysis center near me?
Use our search tool to find dialysis centers by city or state. We list 7,557 Medicare-certified facilities with quality ratings, treatment options, and location details to help you compare and choose the right center.
Ready to Find a Dialysis Center?
Search 7,557 Medicare-certified dialysis facilities to find quality kidney care near you.
Data source: CMS Dialysis Facility Compare ·