Administrators need a game plan for crisis management in dialysis care
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The profession of renal health care is evolving, with breakthroughs in research and innovative treatments that improve the lives of millions of patients with kidney disease.
In this context, administrators who manage dialysis clinics face many challenges.
State of emergency
In the wake of enduring reimbursement deficiencies under the Prospective Payment System, dramatic supply and labor cost increases and insurmountable staffing challenges, we have a state of emergency in the dialysis provider community. Members of the Renal Healthcare Association (RHA) are reporting record-high losses, and dialysis facilities are closing at an astounding rate. Between January 2020 and January 2023, 383 dialysis facilities ceased operations, affecting an estimated 21,000 patients with end-stage kidney disease. Without immediate intervention, these alarming trends of revenue losses and facility closures will persist, further disrupting care of patients on dialysis in the years ahead.
With dialysis facility staffing models in crisis, the support needed for recruitment, onboarding and retention is lacking. Independent and mid-sized facilities typically do not have a dedicated staff educator to oversee new hire training or the ability to support experienced professionals in their development.
Membership in the RHA includes many independent dialysis providers – the companies hardest hit by changes in reimbursement and when staff shortages become acute.
Central resource
In 2021, RHA conducted a job analysis survey of those in dialysis administrator/leadership roles. The results confirmed the need for a centralized body of knowledge for the profession that includes leadership and renal-specific administration skills.
The RHA advocated that having a central resource to help facility leaders keep abreast of the knowledge needed to run dialysis facilities effectively amid the challenges of increasing regulations was needed. Released this month, the first edition of Core Curriculum for the Renal Healthcare Administrator, edited by Helen Currier, MA, BSN, CENP, CNN, includes experts sharing ideas and forming consensus on best practices for clinic management. The resulting curriculum provides the guidance required for renal health care leaders that is essential for providing safe, effective care of patients with kidney disease.
Curriculum
The curriculum is presented in 20 sections and covers a range of topics relevant to the industry, including:
- patient experience;
- chronic kidney disease and its treatment;
- jurisprudence and case law;
- advocacy and health care policy;
- quality and safety;
- operations;
- governance;
- infection prevention;
- finance;
- emergency preparedness;
- water for hemodialysis;
- regulatory and accreditation;
- research; and
- practical tools.
The curriculum is the work of nearly 100 volunteer contributors inclusive of all renal health care settings, organizational size and across the continuum of care. The Core Curriculum for Renal Healthcare Administrators is available for pre-order at www.renalhealthcare.org. A digital version will also be offered.
- References:
- Analysis of Medicare’s Dialysis Facility Care Compare (DFCC) database between 2020 and 2022 by Prima Health Analytics, Weymouth, Massachusetts. February 2023.
- Medicare Provider Reimbursement Manual Part 2, Provider Cost Reporting Forms and Instructions, Chapter 11, Form CMS-339 https:// www.cms.gov/Regulations-and-GuidanceR5P211.pdf.
- MedPAC meeting, December 2022. https://www.medpac.gov/wp-content/uploads/2021/Dialysis-Updates-8-Dec-2022.pdf.
- For more information:
- Caprice Vanderkolk, RN, BS, MS, BC-NE, is president of the Renal Healthcare Association.
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