How to choose a dialysis center
What the Medicare star rating and facility facts on our dialysis pages mean, questions to ask, who pays, and how to complain about a dialysis center.
Who this guide is for
For people whose kidneys have failed (end-stage kidney disease) and their families. Most people go to a center for hemodialysis about three times a week, so the place you choose is part of your routine for a long time. Ask your kidney doctor about every option, including home dialysis and a kidney transplant.
What the official data on our pages means
- Medicare star rating
- 1 to 5 stars that compare results such as survival, hospital admissions and readmissions, blood transfusions and infections with what is expected for each facility’s patients.
- Dialysis stations, shifts and services
- The number of dialysis stations (chairs), whether there is an evening shift, and whether the center offers home dialysis training, as reported to Medicare.
- Ownership and chain
- Who owns the center and whether it belongs to a larger dialysis company, from the Medicare file.
Questions to ask when you call or visit
- Which treatment times are open (morning, afternoon, evening shift)? Can the schedule fit your work or transport?
- Does the center offer home dialysis (peritoneal or home hemodialysis) or training for it?
- Which kidney doctors (nephrologists) see patients here, and how often?
- How many patients does each nurse or technician care for during a treatment?
- Is there a dietitian and a social worker? How do they help with diet, insurance and transport?
- Can the center help you get on a kidney transplant waiting list?
- What happens if you need to travel, or if the center closes because of bad weather?
- Are there staff or interpreters who speak your language?
Warning signs
- Treatments often start late or are cut short, or the center is often short of staff.
- Staff do not wash their hands or change gloves between patients, or the area around your access site is not cleaned.
- No one explains home dialysis or the transplant waiting list when you ask.
- You are told you will be discharged from the center after you raise a concern. Ask how the center’s grievance process works and call your ESRD Network.
Costs and who pays
Medicare covers people of any age with permanent kidney failure who need regular dialysis or a transplant, if they (or a spouse or parent) meet the work history rules. Part B covers outpatient and home dialysis, usually with 20% coinsurance after the yearly deductible.
Medicaid is run by each state with federal rules, for people with limited income and savings. Rules, covered services and waiting lists differ by state: ask your state Medicaid agency.
Employer insurance can pay first for a limited period after you become eligible for Medicare because of kidney failure. Ask the center’s social worker to help you understand your coverage.
In general terms only. Deductibles, coinsurance and other amounts change every year, and Medicaid rules differ by state: check Medicare.gov, call 1-800-MEDICARE or your state Medicaid agency, and ask your plan.
How to complain or get help
- Talk to the charge nurse, the social worker or the center’s manager first. Every center must have a grievance process and tell you about it.
- ESRD Network: every dialysis center belongs to an End-Stage Renal Disease (ESRD) Network, a group that works for Medicare in your region and helps patients with concerns and grievances. The center must give you its phone number.
- State survey agency: the state agency that inspects dialysis centers for Medicare takes complaints about safety and care.
- Medicare: 1-800-MEDICARE (1-800-633-4227), TTY 1-877-486-2048, free, with help in Spanish and other languages.
Find care on US Patient Guide
Common questions
Can I do dialysis at home?
Many people can, with peritoneal dialysis or home hemodialysis, after training. Our pages show which centers report offering home dialysis training; ask your kidney doctor whether home dialysis is right for you.
Can I change dialysis centers?
Yes, if the new center has a chair open at a time that works for you and accepts your coverage. Your kidney doctor may need to work at the new center or send your records. The center’s social worker can help.
What can I do when I travel?
Ask your center several weeks ahead to arrange treatments at a center where you are going; Medicare covers dialysis at Medicare-certified centers anywhere in the United States.
Sources
- Medicare Care Compare (Medicare.gov)
- Medicare Coverage of Kidney Dialysis & Kidney Transplant Services (Medicare booklet 10128, PDF)
- In-Center Hemodialysis CAHPS patient survey (CMS)
- Choosing a treatment for kidney failure (NIDDK, National Institutes of Health)
- Medicare.gov in Spanish
Written in plain language by US Patient Guide from the official sources above, November 2, 2026. The facts on each provider page come from the official data shown on that page, with its date. Not medical advice.