Archive for the ‘Termination of patient care’ Category

Involuntary discharge from dialysis: A health care practice like no other

Wednesday, January 11, 2017 | By arlene | No Comments

Involuntary discharge from dialysis — a life-sustaining treatment — is a uniquely American phenomenon.

Source: Involuntary discharge from dialysis: A health care practice like no other


Wednesday, December 28, 2016 | By arlene | 1 Comment

With the end of the year fast approaching there has been an alarming increase in the number of patients terminated from dialysis care. One has to wonder if these terminations are tied to the implementation of the Star Program by CMS as a way to grade care centers on results of patient care along with clinic reviews. Payments to the Dialysis providers for patient care are tied to this star program….more stars…..more money. Continue reading “IS THE CMS STAR PROGRAM RESPONSIBLE FOR RECORD NUMBER YEAR-END DIALYSIS PATIENTS TERMINATED FROM CARE” »

Internationally Known Doctor and Author Robert Bear joins Board of Directors at Dialysis Advocates

Thursday, September 22, 2016 | By William Tinker | No Comments

Dr. Robert Bear has a long history in Health Care Management in Canada and the U.S.


Practiced Medicine (Nephrology) and was a Professor of Medicine at two Canadian Academic Health Science Centers, University of Toronto & University of Alberta (Edmonton). Held a number of senior positions in both academic and health care administration in each Centre. Established successful health care consulting company (Fresnel Management Ltd), that for over 14 years has engaged in health care management consulting projects independently or with other companies in most Canadian provinces.

Author of “Sorrows Reward”. a medical novel. Invited speaker on health care in Canada and the U.S. Guest blogger on multiple sites. Currently working on a second novel. Dr. Bear’s novel shows his great concern and care for the present state of care for patients, families and the many care givers who are coping with the present RENAL system.

Continue reading “Internationally Known Doctor and Author Robert Bear joins Board of Directors at Dialysis Advocates” »

CMS 5 Star Rating System Misleading- Not Good for Patients, Clinics or Nephrologist

Saturday, May 7, 2016 | By William Tinker | No Comments

Several recent studies and papers point to problems in the much heralded CMS/Medicare 5 Star rating system which is meant to rate the quality of patient care and overall clinic standing using a Star Rating System with ratings from 1 to 5 stars. Articles written by Medical Staff, Administrators point to this system being generally ineffective in  giving real, workable numbers. The results are used by CMS in determining payments for care and are suppose to allow patients to rate overall care at their clinic using Dialysis Facility Compare.

The problem is that it only takes few wrongly or under or overstated figures to skew the results making them fairly unusable.

Additional stars in the rating system for dialysis facilities may not reflect increases in quality of care, according to an analysis presented at the National Kidney Foundation 2016 Spring Clinical Meetings

A concern of patients and those advocating for them is that clinics may feel pressure to rid themselves of those patient who are lowering their star rating.


Rebroadcast of “How To Ask For What You Want” with John Rider….. A Patient Guide

Tuesday, March 24, 2015 | By William Tinker | No Comments

John Rider will discuss how patients can empower themselves and take charge of their own treatment. His insight will help listeners and callers process the difficulties faced by Dialysis Patients and their family. He presently works with Out Patients at High Point Treatment Center in Brockton, Boston.

John is a past National Advocate for the Committee of Ten Thousand which deals with the hemophilia community, living with HIV/AIDS and HCV. He helped get national legislation passed and supported litigants in a national class lawsuit.

Show will be on Thursday March 26 at 9:00 PM Eastern, 8:00 Central and 6:00 PM Pacific

You can listen on line at: or call into the show no earlier than 10 minutes before airtime at: 347-857-3961

Dialysis Talk is supported by Dialysis Advocates

Radio show with Dr. Robert Bear-Author of “Sorrow’s Reward”

Sunday, March 15, 2015 | By William Tinker | No Comments

Portrait (1 of 1)Dr. Robert A. Bear, is the author of “Sorrow’s Reward” -interrelated tales from a fictional dialysis unit. While fictional, the stories are too close to the real day to day, lives of patients, Doctors and families. Dr. Bear, author of over 150 medical articles will discuss his reasons for these compelling stories told through the eyes and thoughts of his fictional characters.


After many years in Nephrology as a Physician, Educator and Administrator he began to have questions about how Dialysis Care has evolved. Now that many clinics are run by large “For Profit” companies; are the patients, nursing staff and Doctors better off? What can and should be done to improve dialysis care. What are the responsibilities of patients in their care?

This book is a must read for anyone involved with Dialysis from Doctors, Technicians, Counselors, Patient and their families.

Show is on live Thursday March 19, at 9:00 Eastern, 8:00 Central and 6:00 Pacific.

Listen live on line at:

Call in at:  (347) 857-3961  Thursday March 19,2015.




Widespread Bullying and Terminations of Dialysis Patients

Saturday, December 13, 2014 | By William Tinker | 1 Comment

This is report 1 of 3 sent to CMS/MEDICARE detailing the problems patients are having with harassment, retaliation and termination of care after questioning their level of care or reporting staff abuse at clinics. Termination of Dialysis care is undertaken with no hearing, or appeal. These reports are also sent to the corporate office of the clinics involved.

As reported by patients to Dialysis Advocates

Case # Clinic/Doctor Reported Problem   Present Status
21 FreseniusNorth Carolina Clinic care was questioned by patient. After that bullying was order of the day. Claims they treated her mean. She just got tired of the NP complaining about her husband straying. She told the NP that she should not take it out on the patients. She was terminated for that. Patient has had no help relocating to a new clinic and has been denied by everyone. Terminated and blackballed from other clinicsLetter was given to her by CAN Capital Nephrology and Fresenius. Letter stated that they cannot give her dialysis without a Physician and of course no one will take her as she is written up in her charts that Hannibal Lector is a better risk.
31 DaVitaMaryland Bullied and terminated by worker. All she wanted was to be able to dialyze safely. She was terminated as the worker got into her face. Two witness said she did nothing. Is now in the Emergency room situation, being harassed at the hospital and told to come in and then denied her after waiting for hours. Terminated and blackballed by any clinic in the area.
41 DaVita Patient complained about worker to DaVita Corporate, they did nothing. Worker retaliated had patient terminated for violence against another patient even though she knew it was horse play with a strawberry. ESRD Networks talked to the other patient, who admitted he did it first and they were kidding around. Patient tried to get information on their investigation but was denied a copy. Terminated and blackballed from nearby clinics. Has to travel hour and a half for treatment
61 DaVitaMinnesota Retaliated against for complaining about a worker. Clinic retaliated by changing his dialysis hours so he could not work. After contact by Dialysis Advocates and made aware of rules on dialysis hours patient got original dialysis schedule back. Patient is able to work and has original dialysis hours back.
71 Rubin DialysisNew York Terminated from Home Hemo, Patient is afraid that the doctor will stop a transfer to another clinic and he will be blackballed with nowhere to go.
81 DaVitaDallas, TX Complaining about poor care and the fact that they ignored an infection, almost bled out at home and was hospitalized almost dying needed 4 or 5 units of blood.Infection and poor care/ does not want to lodge a complaint now. Hoping they will listen to her when she has a need or infection No action needs to be taken at this time. She will call back if things get worse.
91 DaVitaIllinois  Patient and family complain of verbal abuse. Staff calls him names. Taking off too much fluid causing dehydration and cramps. Has begged to have settings lowered on machine, after they do, this nurse walks behind him and changes it back.Dr. has called them several times and staff told my dad he was a liar. Doctor never called? The main RN who is spiteful and verbally abusive, as are other staff. During several treatments the nurses have been talking about male private parts and who they have been sleeping with.Clinic out of control; harassment, retaliation, is escalating after any complaint.


Reported to CMS/Medicare-no response
92 Neomy DialysisBrooklyn, NY Terminated due to conduct. Family believes it was a set up and unable to locate another center. No one will take her. Feels like she was blackballed. Another patient was involved and nothing was done is my understanding. Terminated
93 No clinic named Terminated since July and has been turned down by every local clinic Terminated blackballed from other clinics has to go to E.R.
94 DaVitaHarlan, CO The patients has a trained Seizure dog. The dog was not allowed to be with her during dialysis even though she provided the staff with the name of the trainer. There is no certificate in Colorado. After contacting ADA and getting certified letter stating dog is trained for seizures dog is allowed with her during dialysis
95 St. Peter’s HospitalAlbany, NY He states he has been terminated and blackballed for “Behavioral issues” but no one will give him information or records of the evidence or information on what they terminated him for.Turned down by 8 emergency rooms.  No clinic will take him; but they will not tell him what the reason is other than a statement of behavioral. He has not been allowed to see the reason.
96 DaVitaSan Antonio, TX Claims DaVita said the PD was a privilege which can be taken away if he doesn’t cooperate or stop complaining. He wanted to transfer to another company, but the new clinic decided not to take him citing no chairs. Forcing him back to DaVita. He is constantly harassed and retaliated against and stuck. Harassed, Intimidated and told he is not going anywhere. He feels stuck and to keep his mouth shut and does not complain.



Tuesday, December 9, 2014 | By William Tinker | No Comments

This is report 2 of 3 sent to CMS/MEDICARE detailing the problems patients are having with harassment, retaliation and termination of care after questioning their level of care or reporting staff abuse at clinics. Termination of Dialysis care is undertaken with no hearing, or appeal. These reports are also sent to the Corporate office of the clinics involved.

Case # Date Clinic/Doctor Reported Problem Present Status
Case#118 B Nov/14 DAVITAPhoenix, AZ DaVita staff rarely communicate, and are inconsistent with what they tell this patient. Written up for ripping up a paper, his days for dialysis that he was promised were never honored. His wife needs to be his transportation, he never has gotten a dialysis starting time. They call him in early and the days they don’t call him and he goes in early, they get angry. No one has addressed this. He would like to have a starting time that is consistent. DAVITAHarassed intimidated for complaining.
Case#119 Nov/14 DaVita-CA Patient had contacted DaVita Corporation and CMS. Complained about a nurse, the nurse retaliated by getting the son banned from floor. Tech calls her Ghetto Nurse and not a real nurse. Son wanted to have us advocate since it was a forced meeting, Manager gave son letter that he was banned from the floor. Mother is constantly harassed and they hurt her, she fell due to taking off to much fluid and broke her tooth. Nurse threatened son and mother that she would have him off the floor. Mother is left alone and continues to have no say. Even though the Nurse is not to go near her, she continues and is allowed to do as she pleases. DavitaCase closed.
Case#120 Nov/14 DAVITAAR Family states clinic is unsanitary and neglected. Having trouble with staff harassing. Has complained and they will not help her out when needed, do not chart complaints. She is about to give up. She was vomiting and nurse sat at desk and would not help. It is getting worse and needs to be addressed. DAVITA/Retaliation,Harassment and care is ignored.
Case#121 Nov/14 Sentara Norfolk General Hospital VA Terminated had to sign a contract with North General Hospital/Receiving care at Hospital, but cannot have a transplant as he has no clinic. Had to sign a contract to find him a place. Did not happen TERMINATEDBlackballed not allowed on transplant list.
Case#122 Nov/14 FRESENIUS /Hampton, VA Physically assaulted by LPN. LPN was written up for the assault by another RN. Fresenius was aware of this and the worker still is on floor harassing. She has been tormenting him and others in the clinic it appears. Have heard from many patients, as they witnessed the assault. Patient is once again in the hospital by ambulance. The day he was assaulted, had to have surgery that is unrelated. Day of incident he had to go to Urgent care,Another patient had missed two treatments in center for her antibiotics. Nurse never ordered them.Other patient that was going to give us a formal complaint died. FRESENIUS/Patient assaulted by LPN. LPN has since been fired, she is taking the patient to court for him assaulting her. Which will allow this patient to file suit as she this is well documented.
Case#123 Nov/14 FRESENIUSSalem, OR Patient concerned about care and fistula. Lots of laughing, chatting, staff standing around and joking. Not taking care of patients. Questions by MD not answered. Just a few of the complaints FRESENIUS/ Poor care and needs not met.
Case#124 Nov/14 DAVITASan Jose, CA Patient has put in complaint about care and is ignored. Patient had new tech work on her and her proctor allowed her to change settings on her machine, patient started cramping and new tech went to raise her legs and needles came out; she was bleeding out and BP went to 50. Tech and proctor clueless on what to do. DAVITA/ Training issues and leaving untrained staff unattended.
Case#125 Nov/14 DCI/ Albany, NY Patient felt he is receiving poor care; applied to go to another clinic. Example: No catheter caps put on. Nurse that he complained about told the other clinic something bad about him, and even though Fresenius had already accepted him, they were then told that he had threatened the same nurse he complained about. No police report. Fresenius declined to take him on hearsay and from the nurse that this patient complained about. TERMINATED and rejected by Fresenius. Patient not allowed to see the evidence.No Police report again/ hearsay.
Case#126 Nov/14 FRESENIUSJACKSONVILLE TX Patient legally blind. Patient and wife have been played with. They have not addressed the ADA Title ll.Wife has seen too many bleed outs and unsanitary conditions in clinic. The staff do as they please, and due to complaining, the staff banned her from the treatment floor. She is his eyes. Constant violation of their HIPPA Rights. FRESENIUS/ ADA AND HIPPA VIOLATIONS.
Case#127 Nov/14 DAVITAColumbia, TN Patient had failed in this clinic. He wanted to go back to the clinic he was at before and they said yes. Then out of the blue they claimed he was disruptive. Blackballed and Fresenius had said yes, then after talking with Davita they said no. Not able to see what was written about him. Denied the information. Patients not allowed to see records or complaints DAVITA/Blackballed from other clinics after already being accepted by Fresenius, then denied by them after talking to Davita.


CMS Notified of Abuse, Harassment and Retaliation at Dialysis Centers

Friday, December 5, 2014 | By William Tinker | No Comments

This is report 3 of 3 sent to CMS detailing the problems patients are having with harassment, retaliation and termination of care after questioning their level of care or reporting staff abuse at clinics. Termination of Dialysis care is undertaken with no hearing, or appeal.

Case # Date Clinic/Doctor Reported Problem Present Status
Case#109 9/9/14 Fresenius   3918 Montclair Rd. Suite 110 Birmingham, Al Patient moved and was set up to go to another Fresenius unit. The new clinic refused dialysis after the move, stating she was written the previous clinic for panhandling for transportation expenses from other patients, which other patients said was not true. Her insurance paid for transportation. Feel this is in retaliation from the Social worker, as she had ask her for help. TERMINATED. HAS NO WHERE TO GO EXCEPT HOSPITAL ER.
Case#110 9/9/14 Davita 9210 E. Vancouver Dr. Vancouver, WA Patient transferred from a Fresenius to DaVita. He was dialyzed several times and then told that there were some behavioral issues from past clinic. Director called him into a meeting to sign a “Behavioral Contract” on the hearsay of the other clinic after nothing appeared to be there when accepted. TERMINATED.
Case#111 9/9/14 DAVITA and Milwaukee Nephrology Group Family complained of having no say in parents care. Dr. O. and others going outside of family that had the Power of Attorney. The Nephrologist stated patient will be doing hospice and an army can’t save her.Fresenius refused to take her. TERMINATED FROM CARE FORCING INTO HOSPICE AGAINST PATIENTS FAMILY.
Case#112 9/9/14 Hospital Was in hospital and no one was taking her. Closed
Case#113 9/14 North Ridge Reseda Bld. Northridge, CA Patient has had to go to Emergency Room due to high blood pressure after treatments, multiple times
Case#114 9/9/14 Davita Minnesota Feels he is being paid back for complaining about care.
Case#115 9/9/14 Davita /Maryland University of Maryland Medical Center has treated her poorly. Her crime for complaining about care. Wrote on chart she is not to be treated if she comes back distressed. TERMINATED BY DAVITA/ University of Maryland stated in her records not to treat her when she comes back
Case#116 9/9/14 Davita Illinois Forcing medications on patient, he will be turned away if he does not take the medication. Family has been refused a meeting to discuss care. They have taken any decision away from family. FORCED MEDICATION WITHOUT FAMILY INPUT.
Case#117 9/9/14 Neomy DialysisBrooklyn, NY Patient was terminated from care after another patient went ballistic and attacked her. They claimed she started it; when in fact it was the other way around as the patient was on a machine and being dialyzed. She now is forced to live in a Nursing home and has not been able to be placed, nor was any investigation done. TERMINATED AND FORCED TO LIVE IN A NURSING HOME.
  1. Patient used DaVita complaint line that promises there will be no retaliation for bringing up care and staff issues. The patient was harassed and intimidated by the staff as soon as it was learned he had filed a complaint on the complaint line. The patient went back to the complaint line notifying the clinic of the retaliation; no one from Davita stepped in to stop this harassment. He went to Fresenius as DaVita was unbearable. Then several workers from Davita working at this clinic spread false rumors. They stated that he was violent, gave two different stories with no Police Report. Fresenius terminated him on the spot on hearsay with no conference or taking his statement.


Patient went to St. Josephs Campus Medical Center, where the Davita staff in the hospital denied him care until he stripped down naked, and his clothes patted down. This happened even after the ER Staff assured them nothing was found. Continue.

Case #118



  1. He has been harassed, bullied and has not had the right, as many others, to face their accuser, there is no appeal. ESRD Network stated that they could not help.


  1. When he was again denied care, this time because he had not signed the proper paper work of which they had changed forms three times. Stating they did not have the forms anymore and could not help him. They would not return until Monday. Dr. Russell of CMS would not help and stated the Network was not to talk with his advocate, as the Network gave him the wrong paperwork and we had faxed in the one that CMS wanted, but they lost it, patient is in crisis. Patient had been waiting for 12 hours in Emergency Room only to be denied.


  1. Waited 3 hours for DaVita to dialyze him only to be told in the 3rd hour that the dialysis staff had left two hours earlier.


  1. After getting him back to a unit for dialysis 3 days a week in the hospital, then DaVita terminated him unless he saw their Psychiatrist or he would go back to the ER emergency only. He stated he has done nothing wrong; he has a hard time trusting DaVita; with good reason. DaVita has the dialysis contract with the hospital. One would think his Nephrologist would support him, as he is ultimately responsible for his care.


No Police report has been submitted for the rumors at all.






Case#114 11/14 DCI New Orleans/Ochsner Health System,Jefferson LA
  1. Patient has had to dialysis in Emergency rooms due to termination by DCI taking pictures of deplorable conditions. She has been blackballed and patient has had creative reports written about her.
  2. The hospital Dialyzed her and kept her for 2 weeks, and then released her in a wheelchair it appears she had broken bone that were not set. She was promised home care but never received any. One statement was apparently made she is dying anyway.

Record Number of Dialysis Patients Being Terminated From Clinics

Friday, October 31, 2014 | By William Tinker | 4 Comments

There was a time when we here at Dialysis Advocates would only handle a few patient terminations each month, sadly that is no longer the case. We’ve seen a significant increase in terminations of care from the largest “For Profit” Dialysis companies. Many of these terminations seem to be on trumped up behavioral contracts many of which were not signed by the patient. It appears that many of these terminations have come after patients have reported quality of care issues with a clinic or complained about abuse from a dialysis worker.

Continue reading “Record Number of Dialysis Patients Being Terminated From Clinics” »