Another non-profit, hospital-owned dialysis dinosaur, eaten by the Corporate Big Dogs

[Guttercat, ASN, RN]

My hospital-owned unit is the latest to fall prey (to one of the Big Two). Our hospital fought tooth and nail in three years of litigation, after a major player snuck in through the front back door.

These national "McDialysis Chains" as I call them, have been trying to get into our little slice of dialysis nirvana for years...and one of them, due to some sneaky maneuvering involving changing state regulations with CON's finally managed to pull it off. We are now undergoing shall we say...a hostile sale.

Dialysis as a business, has experienced exponential changes over the last 20 years. Some good, some bad. It began when people realized there was cash to made on the backs of renal failure patients, and Corporate America took notice.

The last twenty years (the last four especially) has seen times of rapidly changing regulations and reimbursement requirements, and those that rise to the top and survive are these cut-throat corporations with enough money to pay the right people playing the right people, at the state and federal levels. Indeed, these corporate entities are imo, the very ones controlling the changes.

I moved here ten years ago and took the position in large part, because it was a not-for-profit. Best position I've ever had.

I've researched a bit about the company taking over, including a recent whistleblower lawsuit against it for medicare fraud brought on by a nephrologist and an RN. It was imho egregious and obvious, but the suit was...swept under the rug and dismissed: it pays to have certain "Health Czars" on your side (my speculation only of course, based upon playing connect-the-dots).

The moral is, change faster than everyone else, or be eaten.

[traumaRUs, MSN, APRN]

I think as the Medicare dollars are cut deeper and deeper that there will be fewer and fewer dialysis units owned by anyone but the top two.

[Guttercat, ASN, RN]

I think as the Medicare dollars are cut deeper and deeper that there will be fewer and fewer dialysis units owned by anyone but the top two.

The politics of how health care has become politics, is fascinating.

And not just health care...think Monsanto. "That guy" is now the head of the FDA.

Interesting stuff.

[madwife2002, BSN, RN]

I think as the Medicare dollars are cut deeper and deeper that there will be fewer and fewer dialysis units owned by anyone but the top two.

I couldn't agree more, it is just a matter of time

[Guttercat, ASN, RN]

I couldn't agree more, it is just a matter of time

But that "time" was fifteen or more years ago.

What we see now is not the result of recent Medicare cutbacks. We're seeing the end result of those that had their heads in the game a long time ago, and planned accordingly.

My hats off to them for their wileyness.

[Joni's Mom]

Good luck on your take over, and be prepared to be VolunTold to do alot of unpaid added jobs with big titles. Oh, and by the way, there won't be any increase in salary for at least one year after take over, and that could be more then the actual year.

No sense applying for a dialysis job in a not for profit position since they too will soon be gobbled up.

Sorry I sound negative, but I'm still reeling from our take over.

[traumaRUs, MSN, APRN]

Liberty was recently purchased by FMC.

[Guttercat, ASN, RN]

Good luck on your take over, and be prepared to be VolunTold to do alot of unpaid added jobs with big titles. Oh, and by the way, there won't be any increase in salary for at least one year after take over, and that could be more then the actual year.

No sense applying for a dialysis job in a not for profit position since they too will soon be gobbled up.

Sorry I sound negative, but I'm still reeling from our take over.

Sorry Joni.

If you've been in dialysis for any length of time, perhaps you can remember the days when there was one tech and one RN to every 5-7 patients.

Funny thing is, is we were also very busy back then in the early 90's, but... we were busy managing treatments, and making sure all the best care possible was delivered to the patients in every aspect. A far cry from the "cattle call" it is today. Increasing regulations (not necesarily a bad thing) pared with decreasing reimbursement and add to it For-Profits struggling to meet shareholder dividends = perfect storm.

In fact, dialysis itself is an interesting example and precursor to what the medical field and what those on the front lines in general, will be and are facing.

Dialyisis technology, and renal medical advances have come a long way since then, but I'd be interested in seeing some comparisons of morbidity/mortality from 20 years ago (not that this would be a necessarily accurate marker as demographics, patient-type and volume have also changed significantly).

Follow the money...

(right now, it's being bundled up in a very few people's golden parachutes).

[Guttercat, ASN, RN]

Liberty was recently purchased by FMC.

Yes. There's been a whole lot of shuffling going on in the for-profit world. :)

[Marisette, BSN, RN]

I loved working dialysis prior to the "Mcdialysis Chains" taking over. Now we don't have stock people. We count each syringe, and bandaid, and boxes of gloves remaining at the end of the month. We deliver care for the many based on medication algorithms instead of the individual patient's needs. We have five managers for every RN. Many of the managers are not registered nurses, but MBA's. The physicians fear "McDialysis" and seldom speak up for their patients. Most times they go along with corporate goals so they will have dialysis chairs where they can refer their patients. No more raises, but bonuses are given to managers who meet corporate for profit goals. Patients are "the numbers" we provide to agencies to build more clinics, and meet medicare requirements for payment of ESRD services.

How did this all change? How is this legal?

[CocoaGirl]

I have always been curious WHY FMC is not considered a Monopoly in the industry. FMC has the market in its back pocket since it manufactures their own machines, dialyzers, saline. They own Phoslo, Venofer & want us to push our patients to utilize the FMC pharmacy for their meds. The company acquires hundreds of independant dialysis facilities & now they are jumping into the vascular access business.

[Guttercat, ASN, RN]

They own Phoslo, Venofer & want us to push our patients to utilize the FMC pharmacy for their meds. The company acquires hundreds of independant dialysis facilities & now they are jumping into the vascular access business.

Ding ding ding! Weener!

FMC would be a monopoly, excepting for state laws that "placate" the obvious attempts at corporate monopolies within a given area. These laws often do nothing however, to prevent takeovers and buy-outs of non-profits or regionally owned units by the Big Two. And imho, they are in cahoots with state and federal regulatory bodies.

He who has the most gold, can buy out anyone who makes the most law. :)