Archive for January, 2014

Appointment of Representative form from HHS

Tuesday, January 14, 2014 | By Scott | No Comments

It appears that this is the new Appointment of Representative form that the Department of Health and Human Services Centers for Medicare & Medicaid Services has finally decided to use.  

For both Spanish and English versions, go to:

It has taken almost 40 years to have a form for an advocate to fill out and submit…Go figure.

Medicare ESRD Network Is Still At It – They’re Supposed to Help

Monday, January 13, 2014 | By Scott | No Comments

If you want to get a headache, read through the official
Medicare ESRD Network Organizations Chapter 7 – ESRD Complaints and Grievances
here is a copy.

A couple of highlights are below. You may want to consult a lawyer to guide you through this legalize document with cross references that no normal reader, let alone someone who is distress from poor and sometimes humiliating treatment, can truly understand. Will someone in the ESRD please translate this document so it is useful to anyone seeking help!?

It is the responsibility of the Medicare ESRD Network to assure that an impartial review of grievances by Network staff and the MRB occurs without conflict of interest.

But we’ve seen so many instances where the ESRD is creating documents and forms to protect their interests.

Is this guidance or a roadmap for confusion?

Is this guidance or a roadmap for confusion?

The Network shall assume a proactive role in the prevention, facilitation, and resolution of complaints and grievances, including implementing educational programs that will assist facility staff in handling difficult situations.

Why doesn’t the Medicare ESRD Network implement programs to dismiss dialysis providers who practice unethical procedures?

The Network advises anonymous complainants or grievants that their complaints/grievances will be investigated but the Network will be unable to report back to them without their name and address.

So with the fear of blacklisting or undue retribution, if it is anonymous, how do we know any action has been taken?

170 – Personal Representative
A personal representative is an individual designated by a court of competent jurisdiction or by the beneficiary, as evidenced by a document signed by such beneficiary, to act on his/her behalf. An individual/patient/beneficiary may designate whomever he/she chooses as his/her personal representative by executing a Power of Attorney, a Durable Power of Attorney, or a witnessed, signed, and dated proxy statement. The patient representative may act for the person they represent in any capacity that is authorized. The personal representative can be authorized to conduct a single transaction or to assume ongoing responsibility for an identified purpose such as a financial transaction(s), healthcare decision(s), ….


180 – Conflict of Interest
The Network ensures that a conflict of interest or potential conflict of interest does not exist among members of a complaint/grievance committee, a MRB committee, or a board of directors handling a grievance. Any individual who has direct involvement with the complainant/grievant or the provider under investigation, whether it is a financial, professional or personal relationship, should be excluded from participation in the investigation and resolution of the complaint/grievance.

See Above!

If you really want to see the complete document, download the entire document, good luck.

Medicare ESRD Network Organizations, Chapter 7 –ESRD Complaints and Grievances

A GREAT BUSINESS MODEL – Profit From The Suffering of Others!

Wednesday, January 8, 2014 | By Scott | No Comments


“There’s an underlying growth in the population of patients that need dialysis. That population growth is roughly four percent,” said Jim Hilger, DaVita’s chief accounting officer.

DaVita operates in 44 states, has 53,000 employees and pulled in more than $12 billion in revenue last year. This is up from operating in 42 states with 32,500 employees and $5.7 billion in revenue in 2008. DaVita has been opening about 75 new clinics each year across the country.

“For our dialysis business, we weren’t really affected by the downturn of the economy and that’s because of our patients. The healthcare service we provide these patients is life sustaining,” Hilger said. “It’s a very stable business.”

Long story short: patients will show up for treatment regardless of the state of the economy — good or bad.

Recession, recovery haven’t dampened DaVita’s growth
Company officials excited about future of employer-focused Paladina system

Looking Back on DaVita, Fresenius and GranuFlo Side Effects in 2013.

Wednesday, January 8, 2014 | By Scott | No Comments

. By Gordon Gibb


DaVita Healthcare Clinics (DaVita) is one of two players in the GranuFlo and NaturaLyte portfolio. The other is Fresenius Medical Care, the manufacturer of the two dialysis products and a competitor with DaVita in the dialysis market. Both operate scores of dialysis clinics and are competing for market share.

DaVita is also the target of a GranuFlo class-action lawsuit for its role in allegedly putting dialysis patients at risk with regard to alkali dosing errors inherent with GranuFlo and NaturaLyte. DaVita, it should be noted, was also the subject of a federal investigation with regard to an alleged doctor kickback scheme – and the firm has also faced allegations of wage improprieties involving its employees.