How to Choose a Dialysis Center: 7 Things That Matter Most

Location, schedule, outcomes, home dialysis options and how the staff treat you. A practical way to compare dialysis centers before you commit.

Updated 2026-09-29. Sources: CMS, Medicare and federal regulations, linked inline.

If you are starting dialysis, you will likely spend 12 or more hours a week at your center, three days a week, for years. Few health care choices touch daily life as much. The good news: you have a choice. Medicare lets you use any certified dialysis center that has an opening and accepts you, and you can transfer later if it is not working out.

Here is how to compare centers in a way that fits both your health and your life.

1. Start with the drive and the schedule

In-center hemodialysis usually runs three times a week (Monday-Wednesday-Friday or Tuesday-Thursday-Saturday), for three to four hours plus setup. A center 10 minutes closer saves you hours of travel every month, and missed or shortened treatments are linked to more hospital stays.

• Ask which shifts have openings right now, not just which shifts exist.
• If you work, look for a center with a shift that starts after 5 pm. Only about one in seven centers offers one; every listing on this site says whether it does, and city pages let you filter for it.
• Ask how the center handles holidays, bad weather and transportation. Many patients rely on Medicaid transport or paratransit, which can add waiting time on both ends.

2. Compare outcomes, not just stars

The CMS star rating is a useful first screen, but it groups thousands of centers into five buckets. Look under the hood at the measures that matter most to you:

• Deaths and hospital admissions (risk-adjusted). These reflect how well the whole care team manages fluid, blood pressure, anemia, infections and other problems between treatments.
• Bloodstream infections. Infections are one of the main reasons dialysis patients end up in the hospital, and they are largely preventable with good technique.
• Fistula and long-term catheter use. A fistula (a surgically joined artery and vein) is the safest long-term access. Centers with high catheter use tend to have more infections.
• Transplant waitlisting. If a transplant is a possibility for you, a center that gets its patients evaluated and listed is a big advantage.

Every center page on this site shows these next to state and national averages, and our 0–100 score combines them. How to read dialysis star ratings.

3. Read what patients say

The ICH-CAHPS survey asks in-center patients about their kidney doctors, the staff, the information they get and the center overall. CMS only publishes results for centers with at least 30 completed interviews, so smaller centers may not have them. Where they exist, they are one of the best windows into daily life at the center.

4. Ask about home dialysis, even if you are not ready

Peritoneal dialysis (PD) and home hemodialysis give many people more control over their schedule, fewer dietary limits and no commute. Not every center trains patients for home dialysis, and switching later is easier if your center already has a home program. In-center vs. home dialysis.

5. Check who runs it

Two companies, DaVita and Fresenius Medical Care, run about three out of four US dialysis centers. Chain ownership is not good or bad in itself; quality varies widely between centers of the same company. But it is useful to know, since policies, supply contracts and transfer options often follow the chain.

6. Visit before you decide

Ask for a tour during a treatment shift. Notice whether the floor looks clean and calm, whether staff respond quickly to machine alarms, and whether patients seem comfortable asking questions. Bring our list of questions to ask.

7. Know that you can change your mind

If your center is not working out, you can ask your nephrologist and social worker to help you transfer. If you have a complaint you cannot resolve with the center, your regional ESRD Network (listed on every center page) handles grievances and can help you find another center. You cannot be discharged for filing a complaint.

The short version

1. Search your ZIP code for the nearest centers.
2. Shortlist the ones with a shift that works for you.
3. Compare their scores, stars, infection and hospitalization rates.
4. Tour your top two, ask the hard questions, and trust what you see.

Sources: Medicare: Choosing a dialysis facility, CMS ESRD Conditions for Coverage (42 CFR Part 494), National Kidney Foundation: Choosing a treatment.