How On-Site Dialysis in SNFs Could Improve Patient Outcomes

Improving patient outcomes remains a top priority for skilled nursing providers, and some have begun to see the potential benefits of offering specialized on-site services such as dialysis.

Shelley Matthes, director of quality improvement at Ecumen, believes delivering hemodialysis treatments on site eases the overall process for the patient who would otherwise be required to travel to receive treatment.

“Currently, SNF residents are typically picked up early in the morning and sent via transport van with a bag lunch to the dialysis center, where they spend the greater part of the day [for] three days a week,” Matthes told Skilled Nursing News. “I imagine it’s a lonely time for them, and certainly interferes with their social life within the facility.”


The New Jersey-based Dialyze Direct, a provider of on-site hemodalysis recently announced plans to begin offering its services at SNFs in Ohio; the company also operates in the Northeast and South. Dialyze Direct uses a portable device, the NxStage System One, to bring treatment to seniors both at home and in SNFs.

The device’s portability could be considered as a big draw for skilled nursing operators and professionals, including Matthes. Ecumen, a Shoreview, Minn.-based senior housing provider, operates more than 40 senior housing communities across Minnesota, as we all as in Idaho, Nebraska, North Dakota, Tennessee, Michigan and Wisconsin.

The elimination of transportation not only ensures that patients are receiving continual care, but also knocks out the often costly expenses associated with busing patients from facility to facility, according to Joseph E. Turk, president of the Lawrence, Mass.-based NxStage Medical, which manufactures the portable units.


“The transportation costs can be higher than the actual dialysis treatment itself,” Turk told Skilled Nursing News. “The patients are in the SNF for a reason …  Breaking the schedule to be transported to a dialysis center is not ideal for the nursing home patient.”

Turk also noted that dialysis can be administered more frequently with portable devices, resulting in lower mortality rates among patients, according to a study conducted by the Chronic Disease Research Group and the Minneapolis Medical Research Foundation.

Though the system has various benefits, it may not be a practical choice for some SNFs. Dialysis patients in SNFs can have numerous co-morbidities and health issues, but they represent only about 10% of the patient population in SNFs at any given time, according to Turk.

Matthes acknowledged this, questioning the system’s cost-effectiveness for her own facility.

“Typically, there are only one or two residents on hemodialysis at any given time within a SNF, at least in our organization of 13 skilled nursing facilities, so I’m not sure how truly economical it would be,” said Matthes. But she also noted that the benefits could extend beyond financial considerations.

“Obviously the time to dialyze is necessary for life, but if efficiencies could be developed in how hemodialysis is delivered, it would give patients more time to live their life the way they want to,” Matthes said.

Overall, Turk said the industry has potentially overlooked the needs of dialysis patients.

“[On-site hemodialysis is] an area that not enough attention has been placed on it over time,” he said.

Written by Carlo Calma

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