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Home ->Data ->Data Compliance

 CMS Data Forms Compliance 
CMS has established a performance rate of 90% or better for the timely and accuracy submission of Medical Evidence (2728) and Death Notification (2746) forms. The ESRD Networks issue a CMS Forms Compliance Reports to all units, detailing performance outcomes. These reports are also forwarded to each Network’s CMS Project Officer.

The following is a list of Network 9/10 facilities that have acheived the performance rate of 90% or better.

100% Compliance
Network 9Network 10
ProviderFacilityPercentProviderFacilityPercent
153520 Ball Dialysis – Daleville 100% 142676 Affiliated Dialysis Centers 100%
360095 Blanchard Valley/Creighton Dialysis Center 100% 142658 Aledo Kidney Center LLC 100%
362578 CDC Home Care 100% 142606 Dupage Peritoneal Dialysis Services Inc. 100%
363303 Childrens Hospital Medical Ctr – Akron 100% 142673 FMC – Antioch 100%
362687 DaVita – White Oak Home Dialysis 100% 143528 Olney Dialysis Center 100%
362686 FMC – Westerville Dialysis 100% 142614 Tri Cities Dialysis LLC 100%
360141 Forum Health – CAPD 100%
182579 Grayson Dialysis and Kidney Center 100%
362535 Guernsey County Dialysis 100%
362560 Hillmed Dialysis Center – Hemo – Cleveland 100%
180040 Jewish Hospital Renal Transplant 100%
182520 Lexington Clinic Kidney Center 100%
360009 Lima Memorial Hospital 100%
152555 NRI-Dialysis Institute of Noblesville 100%
362526 Peritoneal Dialysis Ctr of NW Ohio Inc. 100%
360064 St Elizabeth Health Center 100%
153509 St. Elizabeth Dialysis at Clinton County 100%
362624 Wildwood Dialysis Center 100%
95% to 99.9% Compliance
Network 9Network 10
362677 Chillicothe Regional Dialysis Center 99.30% 142526 Quad Cities Kidney Center – LTD 99.40%
362592 Community/Physicians Dial Ctr – Springfield 99.30% 142568 Fox Valley Dialysis 98.80%
362584 Innovative Dialysis of Toledo 99.10% 14003F Jesse Brown VA Medical Center – Westside 97.80%
362562 Renal Care Group – Salem 99% 142598 Quality Renal Care 97.30%
362595 Dialysis Centers of Dayton South 98.90% 143521 DaVita – Churchview Dialysis Center 96.80%
362641 Alexis Dialysis Center 98.80% 142645 Dixon Dialysis Center 95.80%
152535 Nephrology Inc. – La Porte 98.70% 142662 ARA – South Barrington Dialysis Center 95.70%
182563 RCG-Lexington North 98.70% 142607 FMC – Neomedica – Hazelcrest 95.70%
152517 RCG-Northeast Indiana Kidney Ctr – New Haven 98.60% 142541 DaVita – Mt Vernon Dialysis 95.50%
362657 RCG – Mt Carmel East 98.30% 140155 Provena St Mary’s Hospital 95.50%
152592 Davita – Vincennes Dialysis 98.10% 142651 DaVita – Dixon Kidney Center 95%
362609 RCG – Westlake Dialysis Center 98.10%
362504 DCI – Cincinnati 98%
36003F VA Medical Center – Cincinnati 98.00%
362668 FMC – Hamilton 97.90%
362508 FMC – Mansfield Kidney Center 97.90%
182512 DCI – Southland 97.80%
362596 Dialysis Specialists of Coshocton 97.80%
362667 FMC – Valley City 97.60%
360112 St Vincent Mercy Medical Center 97.60%
152532 Dialysis Center of Wabash Valley 97.50%
362615 FMC – Madeira Dialysis Center 97.50%
362614 Lake County Dialysis 97.40%
362665 RCG – Defiance 97.40%
362543 Columbus Dialysis 97.30%
182502 DCI – Lexington 97.20%
362510 Clark County Dialysis Facility 97.10%
362645 Community Physicians Dialysis Ctr – Fairborn 97.10%
362581 FMC Medina County Kidney Center 97.10%
152520 Nephrology Inc.- Mishawaka 96.90%
362505 CDC – Mentor 96.70%
362684 DaVita Dialysis Strongsville 96.70%
362571 FMC – Dialysis Specialists of Marietta 96.70%
362670 FMC Massillon Dialysis Center 96.70%
362534 FMC – Portsmouth 96.40%
362671 Belpre Dialysis 96.30%
362516 DCI – East Liverpool 96.30%
360051 Miami Valley Hospital – Dialysis 96.30%
182503 FMC – Louisville 96.20%
363510 Middletown Regional Hosp Outpatient Dial Ctr 96.20%
152542 Nephrology Inc. – Blackthorn 96.00%
182518 DaVita – Taylor County Dialysis 95.90%
362621 DCI – Western Hills 95.80%
360123 St John Westshore Dialysis Ctr 95.80%
180035 St Elizabeth Hospital Med Ctr – Covington 95.70%
152594 FMC-Lawrence County 95.60%
362661 Kidney Center of Columbus South 95.60%
360068 The Toledo Hospital Dialysis 95.60%
182571 FMC of Cynthiana 95.50%
362656 Kidney Services of West Central Ohio 95.50%
362674 Putnam Cty Ambulatory Care Ctr – Dialysis 95.50%
152511 Davita – Lawrenceburg Dialysis, LLC 95.20%
362528 Dayton Regional Dialysis – South, Inc. 95.10%
152530 Nephrology Inc. – Elkhart 95.10%
182544 Gardenside Dialysis 95.00%
182569 NALCO, LLC 95.00%
182537 NRI – Louisville 95.00%
90% to 94.9% Compliance
Network 9Network 10
362629 Columbus East Dialysis 94.90% 142664 ARA – Crystal Lake Dialysis Center 94.90%
360024 Firelands Dialysis Center South 94.90% 142671 Manteno Dialysis Centre 94.40%
362537 FMC – Portage County Kidney Center 94.90% 142566 FMC – Neomedica – Marquette Park 94.30%
363504 LMH Satellite at St Marys 94.90% 140010 Evanston Northwestern Healthcare 93.50%
362610 Rocky River Dialysis 94.80% 142509 FMC – Central Dupage Dialysis Center 93.30%
152515 RCG-Northeast Indiana Kidney Ctr – Ft Wayne 94.50% 142643 Quality Renal Care LLC 93.30%
362561 Belmont Dialysis at Crestview 94.40% 142569 RCG – Prairie 93.10%
362512 Dayton Regional Dialysis, Inc. – North 94.40% 142597 Renal Care Group – Univ Program 93%
182533 DCI – Richmond 94.40% 142668 DaVita – Little Village Dialysis 92.90%
362517 Dialysis Centers of Dayton – South 94.40% 142553 Sun Health Inc. 92.90%
362542 PDCI-Home Dialysis of Dayton LTD 94.40% 140015 Blessing Hospital Renal Dialysis 92.60%
362541 Peritoneal Dialysis Concepts Inc. 94.40% 142539 FMC – Blue Island Dialysis Center 92.50%
362589 RCG – Elyria Renal Care Group 94.40% 142625 Danville Dialysis Services LLC 92.30%
363501 UVMC Dialysis Services 94.30% 142589 FMC – Randolph County 92.30%
182558 RCG-Kentucky Renal Care Group-Lexington East 94.20% 142632 FMC – Willowbrook 92.30%
362617 FMC – Streetsboro Kidney Center 94.10% 142530 FMC – West Suburban Dialysis Center 92.10%
362503 FMC – Akron 94% 142521 FMC – Neomedica – Cumberland 91.90%
182501 Univ of Louisville Kidney Disease Prog 94.00% 142533 RCG – Berwyn 91.80%
152576 RCG-Dupont 93.80% 140108 Highland Park Hospital 91.70%
182505 Bowling Green Kidney Center 93.70% 142592 Quad Cities Kidney Center – Geneseo 91.70%
362636 RCG – Elyria Renal Care – Amherst 93.60% 142595 FMC – Duquoin 91.30%
362640 Community Dialysis Unit – Mercy 93.50% 142581 Jacksonville Dialysis 91.30%
362623 NRI – Summit Renal Care West 93.50% 140148 Memorial Medical Center 90.90%
362653 Kidney Center of Columbus East 93.40% 142620 Rushville Dialysis 90.90%
362567 CDC – Cleveland West 93.30% 142531 FMC – Neomedica – East Belmont 90.50%
152502 RCG – Indianapolis – East 93.30% 142628 RCG – Northwest Kidney Ctr 90.40%
18005F VA Med Center – Lexington 93.30% 142528 DaVita – Lincoln Park Nephrology Assn, SC 90.30%
362559 RCG Youngstown 93% 142586 DaVita – Springfield Central Dialysis 90.30%
152533 NRI – South Anthony Dialysis Center 92.90% 143523 University of Chicago – Lakepark 90.20%
362563 Marietta Dialysis 92.60% 140119 Rush – University-St Lukes Med Ctr 90%
362597 RCG Sidney 92.50%
362558 Renal Care Group – Warren 92.50%
362554 Ashtabula Dialysis 92.30%
182557 Kentucky Nephrology 92.30%
150089 Ball Memorial Hospital 92.20%
362598 FMC – Akron East 92%
182508 DCI – Corbin 91.90%
362607 RCG – Toledo Central Dialysis 91.90%
180017 T.J. Samson Kidney Care 91.90%
153518 Ball Dialysis – Winchester 91.70%
360084 Aultman Hospital Dialysis Unit 91.30%
182555 FMC – Mt. Sterling 91.30%
152550 RCG-Northeast Indiana Kidney Center-Auburn 91.20%
362679 Elyria Renal Care Group – Heritage 91.10%
182534 FMC – Suburban 91.10%
360099 Fostoria Community Dialysis Center 90.90%
182519 Hopkinsville Dialysis 90.90%
362675 RCG – Washington Courthouse 90.90%
362652 Kidney Center of Columbus North 90.70%
36007F VA Medical Center – Dayton 90.70%
362583 FMC – Crawford County Kidney Center 90.50%
182523 FMC – South Lousville 90.20%
360053 St John Dialysis Center 90.10%
362587 DaVita – Toledo Dialysis 90%
362654 Defiance Dialysis Center 90%
362521 FMC – Akron Canton Kidney Center 90%
362520 FMC – Central Ohio East 90%
362604 RCG – Arrowhead Dialysis Center 90%
360066 St Rita’s Medical Center ESRD Unit 90%

 

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