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Dialysis Center Five-Star Rating System FAQs

The Centers for Medicare & Medicaid Services (CMS) created the Five-Star Quality Rating System to help patients, their families and caregivers easily compare the quality of dialysis centers. DaVita and the entire kidney care community is committed to working with CMS through this transparent system to empower patients to make the best decisions for their health.

Improving the health-related quality of life for our patients is—and always will be—our focus. The FAQs below provide more information about the Five-Star Quality Rating System.

What is the Five-Star Quality Rating System?
What is DaVita's position on the Five-Star Quality Rating System?
What does the Five-Star rating mean?
How is Five-Star calculated?
My center has received a one- or two-star rating. Does this mean my care team and center isn't meeting certain standards?
Why is my center not rated?
What does it mean to not be rated?
Will my center ever be rated?
If my center isn't rated, does this system apply to me?

Frequently Asked Questions

What is the Five-Star Quality Rating System?

The Five-Star Quality Rating System allows anyone to compare dialysis centers based on quality measures defined by CMS. For example, this tool may be used when a patient is deciding where they would like to receive care.

What is DaVita's position on the Five-Star Quality Rating System?

We are an industry leader in clinical outcomes, yet we are always looking to improve our centers and will continue to do so. We’ve improved clinical outcomes for 18 years, and we will keep working hard to help our patients experience the best health-related quality of life.

What does the Five-Star rating mean?

CMS uses a Five-Star rating to measure patient outcomes at dialysis centers to give consumers a better picture of how quality compares from center to center. Historically, seven quality measures were used to determine the clinical Star Rating; however, starting in October 2018, a number of changes will be implemented. At that time, the following eight quality measures will be considered to establish the clinical rating:

  1. Standardized mortality ratio (SMR)
  2. Standardized hospitalization ratio (SHR)
  3. Standardized transfusion ratio (STrR)
  4. Standardized readmission ratio (SRR)
  5. Kt/V - The percentage of total diaysis eligible for the measure who had enough wastes removed from their blood
  6. The percentage of adult dialysis patients who had hypercalcemia
  7. Standardized fistula rate (SFR)
  8. Long-term catheter rate

A separate patient experience Star Rating will be determined using the CAHPS® In-Center Hemodialysis Survey.

How is Five-Star calculated?

The clinical Five-Star rating comes from weighing the above eight measures. A baseline year is established as a performance starting point, and the center’s performance in each measure is compared to this baseline.

The patient experience Star Rating is the average of the three composites and three global ratings:

  1. Nephrologists’ communication and caring
  2. Quality of dialysis center care and operations
  3. Providing information to patients
  4. Rating of nephrologist
  5. Rating of dialysis center staff
  6. Rating of the dialysis facility

My center has received a one- or two-star rating. Does this mean my care team and center isn't meeting certain standards?

No. DaVita and your clinical team have improved patient outcomes for 18 years straight. In fact, DaVita is a clinical leader in two separate quality assessments programs from CMS. Through the Five-Star Quality Rating System, DaVita has the highest number of centers rated with four and five stars. And DaVita was recognized as a clinical leader through the Quality Incentive Program.

Why is my center not rated?

If you are receiving care at a hospital or a center that provides only pediatric care, the Five-Star Quality Rating System will not apply at this time.

What does it mean to not be rated?

Not receiving a rating simply means that you may not be visiting a center that is eligible to participate in the Five-Star Quality Rating System at this time.

Will my center ever be rated?

Should CMS decide to include hospitals or pediatric centers in the future, you may find that reflected in the ratings. Additionally, if a center’s patient census increases, it may become eligible. Many of the measures require 11 patients.

If my center isn't rated, does this system apply to me?

The system applies to any health care consumer who may need to receive dialysis treatments. Although your center may not be rated, you may choose to change providers and find yourself using Dialysis Facility Compare.

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