How we score dialysis centers
Every number on this site comes from the Centers for Medicare & Medicaid Services (CMS) Provider Data Catalog: the Dialysis Facility Compare file and the In-Center Hemodialysis CAHPS patient survey, refreshed 2026-09-29. We add one thing: a single 0–100 score that ranks each center against all others nationally.
The score in one paragraph
For each measure a center has, we compute its percentile rank among all US dialysis centers (0 = worst, 100 = best), flipping the direction where lower is better (deaths, hospital admissions, infections, catheter use and so on). We average those percentiles, then rank that average against every other center, so the score is simply the percentage of US dialysis centers this one outperforms: 50 is the national median, 80+ is the top 20%. A center needs at least 5 measures to receive a score. Scores based on fewer than 8 measures are marked Limited data: with so few numbers, one unusually good or bad result moves the score a lot. They are ranked after full-data scores and left out of the state "best" lists.
Outcome and care measures (15)
- Patient deaths (risk-adjusted rate) (lower is better)
- Hospital admissions (risk-adjusted rate) (lower is better)
- Readmitted within 30 days of a hospital stay (lower is better)
- Blood transfusions (risk-adjusted rate) (lower is better)
- Bloodstream infections (ratio to expected) (lower is better)
- Emergency room visits (ratio to expected) (lower is better)
- ER visits within 30 days of a hospital stay (ratio to expected) (lower is better)
- Patients dialyzing through an AV fistula
- Patients with a long-term catheter (90+ days) (lower is better)
- Hemodialysis patients getting adequate dialysis (Kt/V ≥ 1.2)
- Peritoneal dialysis patients getting adequate dialysis (Kt/V ≥ 1.7)
- Patients with high blood calcium (over 10.2 mg/dL) (lower is better)
- Patients with very high phosphorus (over 7.0 mg/dL) (lower is better)
- New patients put on the transplant waitlist (ratio to expected)
- Patients on the kidney transplant waitlist
Death, hospitalization, readmission, transfusion, infection and ER measures are risk-adjusted by CMS for age, other illnesses and other patient factors. The ratio measures compare the center to what CMS would expect for its patients: 1.00 means as expected, 0.80 means 20% fewer events than expected.
Patient survey measures (6)
- Kidney doctors' communication and caring
- Quality of dialysis center care and operations
- Providing information to patients
- Rating of the kidney doctor
- Rating of the dialysis center staff
- Rating of the dialysis center
These come from the ICH-CAHPS survey of in-center hemodialysis patients, reported as 0–100 linearized scores. CMS only publishes them for centers with at least 30 completed interviews, so about a third of centers have them; the rest are scored on outcomes alone.
How this differs from the CMS star rating
- The CMS five-star rating is shown on every page because it is the official rating. It groups centers into five buckets on a curve, so hundreds of centers share each star level.
- Our score adds the patient survey, emergency room use and transplant waitlisting, and places every center on one 0–100 scale so you can tell apart two 3-star centers.
Score bands
| Score | Label |
|---|---|
| 80–100 | Excellent |
| 60–79 | Above average |
| 40–59 | Average |
| 20–39 | Below average |
| 0–19 | Poor |
Limits you should know
- Measures are weighted equally. We do not claim a clinical basis for weighting survival over fistula use.
- Small centers have wide uncertainty. CMS's own "better / as expected / worse than expected" verdict, shown under each measure, accounts for that; a small center can look extreme on a rate yet be "as expected".
- Data windows range from one to four years and lag by up to a year. Recent changes in staff or ownership will not show yet.
- Home-only programs and pediatric units treat very different patients; compare them with care.
- A score is a starting point for questions, not a substitute for touring the center and talking with your nephrologist.
Data sources
- CMS Provider Data Catalog: Dialysis facilities (listing by facility, state and national averages, ICH-CAHPS)
- Addresses are geocoded with the US Census Bureau geocoder; the few it cannot place use their ZIP code center and the page says so.
Counts in this release: 7,490 dialysis centers, CMS data dated 2026-06-16.