February - Long Term Catheter Use Reduction QIA - Track 1: Surgeon Focus
Facility Name and CMS Certification Number:
Select your unit's name and CCN from the drop down list below.
162501 - Central Des Moines Dialysis
162516 - Cedar Valley Dialysis Center
162526 - West Union Dialysis Center
162527 - Shenandoah Dialysis
162528 - Harlan Dialysis
162533 - East Des Moines Dialysis
162534 - Perry Dialysis
162539 - Council Bluffs Dialysis Center
162541 - Black Hawk Dialysis
162544 - Buchanan County Dialysis
162548 - Marshalltown Mary Greeley Dialysis
162552 - Cedar Rapids Dialysis
162554 - Green Country Dialysis
162557 - Ankeny Dialysis
162558 - Five Seasons Dialysis
162559 - E.A. Motto Dialysis
172524 - Lawrence Dialysis
172537 - Pratt Dialysis Center
262534 - Hope Again Dialysis Center
262536 - Rolla Dialysis
262580 - Chillicothe Dialysis
262585 - Saint Louis West PD Dialysis
262607 - RTC - Hampton Avenue Dialysis
262611 - RTC Columbia Dialysis
262625 - North Saint Louis County Dialysis
262628 - Eureka Dialysis Center
262634 - Timberlake Dialysis
262637 - Hannibal Dialysis
262648 - Town and Country West Dialysis
262663 - Kansas Avenue Dialysis
262673 - North County Kidney Care Dialysis
282503 - Capital City Dialysis
282517 - McCook Dialysis Center
282518 - Cornhusker Dialysis
282526 - South Lincoln Dialysis
Use the drop down box to select the month you want to report your data.
Form Submitted By:
Enter the name of the person completing this form.
Enter the email address of the person completing this form.
Enter the phone number for the person completing the form (in case the Network has any questions on your data)
Reduce the use rate of long term catheters in select dialysis facilities by focusing on surgeon interventions.
A "long term catheter" is defined as a catheter in use as a hemodialysis patient's access for 90 days or more.
Monthly Surveillance Questions
the number of patients using a catheter as their vascular access (for 90 or more days) as of the patient's last hemodialysis treatment of the month
total number of hemodialysis patients receiving treatment at the dialysis facility as of the last hemodialysis treatment of the month (total facility hemodialysis patient census)
#3) Share with us your participation with the kick off of this project in February
select one from the options below
Attended one of Kick Off Webinars held in February
Downloaded and reviewed the Kick Off Webinar PowerPoint Slides
Watched / Reviewed the Kick Off Webinar recording (online)
Send me a copy of my responses
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