In 1993, only 6 percent were found to have similar deficiencies. This story provides a summary of the reports and is typical of what is being reported in the general press . Senator Grassley announced that the public record will be open for two more weeks for additional comments. The quality of care for US dialysis patients as measured in URR, anemia management, and mortality has been steadily improving. Money spent per patient has been essentially unchanged over the last several years.
More facilities are out of compliance with regulations.
The number of yearly inspections of dialysis facilities has been decreasing and needs to be stepped up again. ESRD Networks and state surveyors need to work more closely together to address deficiencies in problem facilities. Dialysis chains provide sophisticated medical informatics systems, economies of scale, and comparable quality care as it is measured today, but may be associated with lower patient satisfaction. Complaint handling and medical error reporting processes need improvement. With current system, patients and staff feel vulnerable and fear retaliation if they complain.