DOI: 10.3886/e244469v1
title: Medicare Dialysis Facilities

description: The Medicare Dialysis Facilities data provides information on clinical and patient measures for Medicare-certified ESRD facilities, also known as dialysis facilities. It contains data on patient characteristics, treatment patterns, hospitalization, mortality, and transplantation patterns in Medicare-certified dialysis facilities.

The following four data files are available for download each year, where yyyy denotes the fiscal year.

- DFR_Data_FYyyyy.csv file includes all summaries (facility- and regional-level) reported in the Dialysis Facility Report (DFR). The file includes one record for each dialysis facility and is the file recommended for download (i.e., wide format).
- dfr_facility_socrata_fyyyyy.csv file includes only facility-level summaries reported in the DFR. The file includes one record per measure per year (i.e., long format) and contains more records than most spreadsheet programs can handle, which will result in an incomplete load of data. Use of a database or statistical software is required.
- dfr_us_state_socrata_fyyyyyy.csv file includes state- and national-level summaries reported in DFR. The file includes one record per measure per year (i.e., long format).
- dfr_network_socrata_fyyyyyy.csv file includes ESRD network-level summaries reported in the DFR. The file includes one record per measure per year (i.e., long format).

Resources for Using and Understanding the Data

The dataset is compiled using the University of Michigan Kidney Epidemiology and Cost Center (UM-KECC) End Stage-Renal Disease (ESRD) patient database, which is largely derived from the data reported in CMS’ ESRD Quality Reporting System (EQRS), Medicare claims, and data collected for CMS.

The FY 2025 DFR dataset contains data measures between January 2020 and December 2023. DFRs are produced for all Medicare-certified dialysis facilities. The DFR Data files available for download are restricted to facilities with at least 11 patients in the fiscal year indicated. All data elements reported in the DFRs for these facilities are included.

Certain data elements based on small sample sizes are not reported in the DFRs and are therefore also not available in the DFR Data files:

1. Facility Standardized Mortality Ratios (SMRs) statistics are suppressed if the facility had fewer than 3 expected deaths.
2. Facility Standardized Hospitalization Ratios (SHRs) and Standardized 3. Emergency Department Encounter Ratio (SEDR) statistics are suppressed if the facility had fewer than 5 patient-years at risk for hospitalizations.
4. Facility Standardized Readmission Ratio (SRR) and Standardized Ratio of ED Encounters Occurring within 30 Days of Hospital Discharge (ED30) statistics are suppressed if the facility had fewer than 11 index discharges.
5. Facility Standardized 1st Transplantation Ratio (STR) statistics are suppressed if the facility had fewer than 3 expected transplants. In addition, beginning with FY 2011, the STR statistics are only reported for the four year period since the expected number of transplants is less than 3 nationally.
6. Facility age-adjusted percentage of prevalent and active patients waitlisted statistics are suppressed if the facility had fewer than 11 eligible patients.
7. Facility Standardized Waitlist Ratio (SWR) statistics are suppressed if the facility had less than 2 expected waitlisted events or fewer than 11 eligible patients.
8. Facility Standardized Transfusion Ratio (STrR) statistics are suppressed if the facility had fewer than 10 patient-years at risk for transfusions.
9. Facility Standardized Fistula Ratio (SFR) statistics are suppressed if the facility had fewer than 11 eligible adult hemodialysis patients.
State summaries based on fewer than 3 facilities are suppressed.
10. Pediatric summaries are only calculated for dialysis facilities with at least 5 pediatric patients over the 4-year DFR reporting period.
11. Nursing home summaries are only calculated for facilities having more than ten patients treated in the facility on December 31st and in a nursing home at least one day during the most recent year of the reporting period.
12. Pediatric and nursing home state, Network, and US average patient counts are not reported.
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