Treatment Barriers

Prevent treatment barriers before they become an access to care problem. If a patient is at risk of IVD, IVT, or F2P, please contact the Network immediately

It is important for patients to understand their rights and responsibilities when it comes to access to dialysis. There are many factors that influence a person’s choice of dialysis unit: Location, Insurance, Availability and medical needs to name a few. If you are having difficulty finding a dialysis facility to begin treatment, or if you have been discharged from your dialysis facility, it is important that you contact the Network so that our trained staff can assist you in finding care.

Access to care cases include those involving involuntary discharge, involuntary transfer, and failure to place.

Involuntary Discharge (IVD)

An involuntary discharge is a discharge initiated by the treating dialysis facility without the patient’s agreement.

Involuntary Transfer (IVT)

An involuntary transfer occurs when the transferring facility temporarily or permanently closes due to a merger, or due to an emergency or disaster situation, or due to other circumstances, and the patient is dissatisfied with the transfer to another facility.

Failure to Place (F2P)

A failure to place is defined as a situation in which no outpatient dialysis facility can be located that will accept an ESRD patient for routine dialysis treatment.

ABOUT PATIENT INVOLUNTARY DISCHARGE: It is the medical director’s responsibility to make sure “that no patient is discharged or transferred from the facility unless
1. The patient or payer no longer reimburses the facility for the ordered services;
2. The facility ceases to operate;
3. The transfer is necessary for the patient’s welfare because the facility can no longer meet the patient’s documented
medical needs; or

4. The facility has reassessed the patient and determined that the patient’s behavior is disruptive and abusive to the
extent that the delivery of care to the patient or the ability of the facility to operate effectively is seriously impaired…”
(§494.180 (f) Standard: Involuntary discharge and transfer policies and procedures; Conditions for Coverage for End Stage Renal Disease Facilities)