ManorCare Adds Dialysis Services in Handful of SNFs, With Eye on Expanding

HCR ManorCare and Dialyze Direct on Wednesday announced a cooperation agreement that will bring hemodialysis services to HCR ManorCare’s skilled nursing facilities.

Dialyze Direct currently offers services in two of ManorCare’s Chicago-market SNFs, ManorCare assistant vice president Eric O’Neill told Skilled Nursing News. The skilled nursing giant is looking to expand the services to two additional facilities in the Indianapolis market, while assessing other parts of its footprint where adding dialysis services would be a good fit, he explained.

“Obviously, there are markets where it makes sense, and there are markets where there’s not as much of a need,” he told SNN.


ManorCare is part of the Toledo, Ohio-based health system ProMedica, which has a network of 13 hospitals, 2,600 physicians, a health plan, and 400 skilled nursing and rehabilitation centers. The non-profit acquired the skilled nursing operator last year in a complex deal with the real estate investment trust Welltower Inc. (NYSE: WELL)

The Neptune, N.J.-based Dialyze Direct — with a footprint across Florida, Illinois, Indiana, New Jersey, New York, Ohio, Pennsylvania and Texas — provides equipment, training, and caregivers within SNFs. Under the agreement with ManorCare, patients in the company’s facilities will receive treatment up to five days a week — depending on their medical needs — for about two and a half hours.

Dialyze Direct deals with all billing related to the services, while ManorCare pays “a fair market value fee” to Dialyze Direct on a per-treatment basis. There are no minimum numbers for facilities or patients under the agreement between ManorCare and Dialyze Direct, O’Neill told SNN.


“The term of the agreement is kind of open-ended at this point,” he said.

To assess which SNFs would receive the dialysis services, ManorCare will use demographic information provided by Dialyze Direct, showing the number of patients in the area who need them. An obvious target would be facilities with several patients who require dialysis services, O’Neill said — particularly since SNF patients who have to travel to offsite dialysis centers end up having to go through an all-day round of transportation and treatment.

“There are two parameters: Is there a large need in the community? And the second threshold is: Are we currently serving a lot of dialysis patients that have to leave our facility three days a week for the majority of the day to get care?” he said.

The primary upfront costs were related to identifying the space where the dialysis would be provided, which O’Neill said would vary depending on a SNF’s physical plant. But ManorCare expects to see savings on transportation costs, and adding the service provides the opportunity to market to other patients and hopefully boost census, he added.

That, in his eyes, makes it a worthy return on investment. And even though the Patient-Driven Payment Model is taking effect in a few short months, O’Neill said the addition of this service has nothing to do with the payment system bolstering reimbursements for complex patients.

“The main driver was trying to provide a better experience for our current patients, as well as the opportunity to offer a service that might be able to attract new patients that we haven’t been able to care for at all,” O’Neill said.

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