Quality Improvement Overview

A primary goal of the ESRD Networks is to improve the quality of health care services provided to ESRD beneficiaries. Network 14 utilizes various strategies to achieve this goal, such as development and coordination of quality improvement projects, provision of data feedback reports, offer of technical assistance by Network 14 QI staff and Medical Review Board, and provision of educational opportunities and materials.

Areas in need of improvement in Network 14 are identified by:

  • CMS direction
  • Patient and facility communications
  • Various data collections and reports
  • State surveyor and QIO collaborations
  • Input from renal community and Network 14 boards advisory council

These areas may be addressed through general measures for all facilities, such as posting educational materials on the website, or by specific Network intervention with targeted facilities, practitioners or regions.

The CMS Conditions for Coverage require each facility to participate in the Network CQI activities, as well as establish their own Quality Assessment and Performance Improvement (QAPI) program to include, as described in the Interpretive Guidance:

  • Monitoring data/information
  • Prioritizing areas for improvement
  • Determining potential root causes
  • Developing, implementing, evaluating and revising plans that result in improvements in care

Quality of care issues to be addressed by facilities include, but are not limited to, dialysis adequacy, nutritional status, mineral metabolism and renal bone disease, anemia management, vascular access, medical injuries and identification of medical errors, hemodialysis reuse program (if applicable), patient satisfaction and grievances, and infection control issues.

Additional information and assistance with QAPI activities may be obtained by contacting the QI staff at the Network office.


Current Network 14 Quality Improvement Projects

  1. Home Modality QIA
  2. Transplant QIA
  3. Facility and Patient Engagement QIA
  4. Behavioral Health
  5. Vaccinations
  6. Hospitalizations
  7. ESRD Facility Monthly Report Card Measure Specifications

To book an appointment related to any Quality Improvement, click here.


Health Equity and CLAS

Click here to access the Health Equity and CLAS webpage. 


QI Overview, Goals for Clinical Performance Measures/Quality Indicators

Network 14 endorses the CMS Quality Incentive Program Performance Standards in lieu of setting additional Network-specific goals.

Payment Year 2026 Performance Standards


Calendar Year 2024 Measure Technical Specifications

Calendar Year 2024 Measure Technical Specifications can be accessed here.


Quality Incentive Program Information

The ESRD QIP is designed to provide better care to patients with ESRD. CMS will pay your facility based on the care that it provides to you. It is possible that your facility will receive a payment reduction if it does not perform well enough. You will not be impacted financially by the ESRD QIP.

You can use the ESRD QIP to see how your facility’s performance under the ESRD QIP compares to the performance of facilities nationwide in the same program. CMS requires facilities to post certificates describing how they performed on the ESRD QIP. You can also find this information on Dialysis Facility Compare, available for free at Medicare.gov. You can ask your facility about its ESRD QIP scores, including its Total Performance Score. This information can be used as one tool among many when making choices about your care. It is important to note that the ESRD QIP is not the sole method for evaluating quality care at a facility; you should consider other factors as well.