RCG acquires NNA

Specialties Urology

Published

To all Renal Care Group Associates:

From Gary Brukardt, President and CEO

This morning, we announced that Renal Care Group has entered into an agreement to acquire National Nephrology Associates, Inc., (NNA). We expect to complete the acquisition on or before March 31, 2004. Over the next few days and weeks, our companies will work together under the direction of Renal Care Group's transition and integration teams, and we will communicate with you about the details of the transition plan.

The red and blue "swoosh" image in our logo is, by now, very familiar to you. It represents the exchange of blood that occurs in the dialysis process and it is also a fitting symbol of Renal Care Group's corporate culture, where we continually exchange ideas and information in fulfilling our mission to provide optimal care to ESRD patients. We listen to each other, learn from one another and, through this exchange, identify and implement best practices for our clinical and operational initiatives.

In the transition period and beyond, as we exchange ideas and information with NNA's associates, our primary objective is to stay focused on providing optimal care to our patients that we serve on a daily basis.

When the acquisition is complete, our combined company will serve almost 28,000 patients in more than 370 owned outpatient facilities, in addition to providing acute dialysis services at approximately 175 hospitals. Over 8,000 associates will provide services across our 30-state network.

This is an exciting time in our company's history and development. Thank you in advance for your patience and flexibility. We have always believed that everyone benefits when we stay true to our mission of providing optimal care for our patients. I know I can count on you to extend a warm welcome to the NNA associates.

It will be interesting. As usual many many LPN's are very good and can assess but unfortunately there has to be protocols and rules etc..

JMHO and some facts thrown in for good measure.

ESRD:kiss

Hi, I'm new to this forum and found it interesting to see all the different things that LPNs can and cannot do in the various states. I am an LPN in Oregon. I worked for RCG from Aug. thru Dec. of last year in Portland. I also worked for Gambro. I liked RCG but the intense negativity/rudeness of some of the techs toward patients and staff alike drove me away. The commute had some to do with it too--45mins-an hour or more at times. With both companies the benefits were great(pay and PTO were better with RCG); my duties were "team leader"(charge), meds, EPO, working with pts who had catheters(the techs were able to put on those with caths too which was a plus since Gambro prohibited techs from putting on cath pts.) With Gambro I pre-assessed and post-assessed pts. With RCG, I assessed within 45mins-1 hr of put-on time--that was permitted. I understand the statement of thinking that only the RN could "assess". I was always taught that too. LPNs can only "gather data". t's a shady area. I got the feeling when I worked for ea. company that the LPNs might be on their way out ---or relegated to being "high-priced techs", and wondered if I just worked as a tech if I would lose out on earning nursing hours toward license renewal--never got a real straight answer on that. I really enjoyed my expereince in the field--really liked RCG and the RNs I worked with, but too many techs and nurses were afraid to speak up about/document in writing the frustration with the techs' misbehavior.

From reading some of the posts, it sounds like RCG is well-thought-of. What company is FMC short for? I checked out hte Davita site and it looks like they aren't in Oregon though I hear rumors they may be coming to this state. Does anyone have an opinion on that company or any others?

Thanks for any input.

FMC= Fresenius Medical Care. The largest dialyzer in the world..

http://www.fmcna.com Fresenius Medical Care North America.

This business is very competitive. ESRD is the only chronic illness in the country that is totally funded by Medicare....A big big push now I see is towards daily home hemo....Interesting how the pedulum swings..

ESRD :)

Specializes in Hemodialysis, Home Health.

Intersting read on the "assessment/observation" issue. Here in Va., LPNs do assess... all the time. However, the RN still has to cosign (kinda dumb, if the RN didn't actually asess, right?).

But............. something interesting is happening now with FMC. Curious to see if any other companies are going to go this way... we just had a staff inservice where the company (and I don't know if this is just "regional", or according to the governiong body, the clinic's medical director.. or what? Or will it be a nationwide FMC policy... remains to be seen.)

At any rate, we are no longer required to do the pre and post tx. assessments !!! :eek: So NOW.. instead of "assessments", the term used will be "observation".. which means the licensed ppl will no longer have to sign behind the unlicenced. We will continue to ask the pt. how they feel, whether or not they are SOB, etc., but do not do lung sounds unless c/o SOB.

The RNs won't have to cosign behind the LPNs that way, as we are all now merely doing "observations" . There is no longer a place on the flowsheets for pre and post assessments.

I'm not sure what to make of this... or where they are going with this....???

And I can't speak from experience, but I've never heard too much good about Davita.

Any thoughts?

Intersting read on the "assessment/observation" issue. Here in Va., LPNs do assess... all the time. However, the RN still has to cosign (kinda dumb, if the RN didn't actually asess, right?).

But............. something interesting is happening now with FMC. Curious to see if any other companies are going to go this way... we just had a staff inservice where the company (and I don't know if this is just "regional", or according to the governiong body, the clinic's medical director.. or what? Or will it be a nationwide FMC policy... remains to be seen.)

At any rate, we are no longer required to do the pre and post tx. assessments !!! :eek: So NOW.. instead of "assessments", the term used will be "observation".. which means the licensed ppl will no longer have to sign behind the unlicenced. We will continue to ask the pt. how they feel, whether or not they are SOB, etc., but do not do lung sounds unless c/o SOB.

The RNs won't have to cosign behind the LPNs that way, as we are all now merely doing "observations" . There is no longer a place on the flowsheets for pre and post assessments.

I'm not sure what to make of this... or where they are going with this....???

And I can't speak from experience, but I've never heard too much good about Davita.

Any thoughts?

First off don't take this wrong..It's my opinion.. I don't sign behind anyone as to someone's assessment. I listen and feel for myself.. Too many times I have heard rales or found pedal edema and would have been brought up short by the nephrologist if I had missed those things. I am signing that chart and I better be sure it's accurate.. Heck, in Maine at FMC we never listened to lungs.. Might touch an ankle now and then.. We always signed behind the tech..Not my ultimate way of doing things.. But then again I was never in charge there.. I had my own patients and assignment.

Davita staffs very lean license wise. I have worked in two facilities for a year now as a traveler.. California and now NC..

I'm ready for a change. CT has a staffing law for dialysis units..They must be 50% licensed staff on and I loved Gambro in Norwalk just because of that.

ESRD :)

As charge I will continue to listen to lungs, heart, and feel ankles.. Just my way of doing things. I make rounds even if I am not giving meds.. I check every patient in the place. I check goals, sodium modeling, UF profiles, hep infusion and asses EDW and adjust as neccesary..

Specializes in Hemodialysis, Home Health.

Well, we have only ONE tech, so we're all licenced but for one. Our LPNs were there LOOOOOOOOONG before I ever came.. the same two. They've been there 10-12 years now. Before they made changes a couple years ago, the only RN in the bldg. was our NM... the LPNs did charge, blood, the works.

They've since stripped some of these responsibilities from the LPNs, but only a few.. charge, taking orders, and blood. They still give all the meds and change dosages according to lab results weekly, etc.

I've never felt I had to "double check" behind them, as they have pretty much taught me everything I know, and they are impeccable. I wish I knew half as much as they !

Two years ago, FMC attempted to do away with all LPNs, and replace them with techs. The LPNs nationwide rose up and created such a fuss (justifiably) that they backed down. Some of these LPNs had been there 10-15 years or more, and were on the verge of retiring... that would have really sukked !

At any rate.. I just wondered if this sudden change about not having to do assessments had any alterior motive to it... somehow it just doesn't set right with me. Guess we'll find out....

Thanx for your input ! :)

Well, we have only ONE tech, so we're all licenced but for one. Our LPNs were there LOOOOOOOOONG before I ever came.. the same two. They've been there 10-12 years now. Before they made changes a couple years ago, the only RN in the bldg. was our NM... the LPNs did charge, blood, the works.

They've since stripped some of these responsibilities from the LPNs, but only a few.. charge, taking orders, and blood. They still give all the meds and change dosages according to lab results weekly, etc.

I've never felt I had to "double check" behind them, as they have pretty much taught me everything I know, and they are impeccable. I wish I knew half as much as they !

Two years ago, FMC attempted to do away with all LPNs, and replace them with techs. The LPNs nationwide rose up and created such a fuss (justifiably) that they backed down. Some of these LPNs had been there 10-15 years or more, and were on the verge of retiring... that would have really sukked !

At any rate.. I just wondered if this sudden change about not having to do assessments had any alterior motive to it... somehow it just doesn't set right with me. Guess we'll find out....

Thanx for your input ! :)

There are NO LPN's in dialysis units in Maine that I know of cuz they can't give meds.. Fresenius is the only dialyzer there except for one DCI clinic and some in the hospitals..I was an LPN when EPO came out and they drove me out just by the way they treated me.. It was BMA actually at the time.. We were just overpriced techs.. Heck, Maine's BON comes out with an edict almost evey year that LPN's can't give heparin as a bolus at the initiation of dialysis and every year they rescind that.. I bet Fresenius reminds them that techs are doing it...LPN's can't give heparin as a bolus in the hospitals except to flush a hep lock...We could hang the bag of heparin though....

I still will do my own assessments to CMA .. (cover my a**).. As far as charge I had heard ( maybe here) that Medicare has just come out with a rule that LPN's can't be in charge in a dialysis unit.

Don't know if that is gospel or not..

ESRD

Specializes in Hemodialysis, Home Health.
There are NO LPN's in dialysis units in Maine that I know of cuz they can't give meds.. Fresenius is the only dialyzer there except for one DCI clinic and some in the hospitals..I was an LPN when EPO came out and they drove me out just by the way they treated me.. It was BMA actually at the time.. We were just overpriced techs.. Heck, Maine's BON comes out with an edict almost evey year that LPN's can't give heparin as a bolus at the initiation of dialysis and every year they rescind that.. I bet Fresenius reminds them that techs are doing it...LPN's can't give heparin as a bolus in the hospitals except to flush a hep lock...We could hang the bag of heparin though....

I still will do my own assessments to CMA .. (cover my a**).. As far as charge I had heard ( maybe here) that Medicare has just come out with a rule that LPN's can't be in charge in a dialysis unit.

Don't know if that is gospel or not..

ESRD

Wow. True here as far as LPNs doing charge anymore... they USED to.. up 'til two years ago, but no more. And can't take orders.. but everything else is still the same.

Isn't it wild how each state varies ? I started with FMC immediately after they purchased BMA.. like a wek or two after.

Specializes in Acute/Chronic hemodialysis.

Working as Travel RN in Texas. RCG company. Tech's and LPN's assess, including lung sounds. Go figure.

Juanay

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