End Stage Renal disease

End‑Stage Renal Disease (ESRD) facilities are places where people with kidney failure receive dialysis care. Dialysis helps do the job your kidneys can’t, and these facilities are designed to support patients who need this ongoing treatment.

About the Medicare ESRD Program
Medicare has a special program just for individuals with ESRD. It helps cover the cost of dialysis and kidney transplants, encourages patients who want to manage some aspects of their care at home, and makes sure services are provided in a cost‑effective way.

Most dialysis centers are certified to take part in Medicare by meeting important federal quality and safety standards.

How DHSS Helps Keep Patients Safe
Here in Missouri, the Department of Health and Senior Services (DHSS) works with the Centers for Medicare & Medicaid Services (CMS) to help protect patients. DHSS:

• Visits ESRD facilities for routine inspections
• Checks that centers are meeting federal requirements
• Look into complaints about patient care

All of this is done to help ensure people receiving dialysis get safe, high‑quality care.

Please find required forms.

CMS 3427 ESRD Application, Survey, and Certification Report 

ESRD Change of Administrator Form

Life Safety Code (LSC) Attestation Form

Licensing and Regulations

Dialysis centers in the United States must follow federal regulations set by the Centers for Medicare & Medicaid Services (CMS) to ensure safe, high‑quality care. These rules require facilities to protect patient rights, provide individualized care plans, maintain strict infection‑control and safety practices, monitor quality, support home dialysis when offered, employ qualified clinical staff, and keep accurate medical records. All dialysis centers must also follow federal safety and emergency‑preparedness standards and comply with all applicable laws under the Medicare Conditions for Coverage (42 CFR Part 494). 

Learn more about federal regulations

How to Report a Complaint

If you have concerns about patient care, infection control, or any other issue involving an End Stage Renal Disease Facility, you can report them to the Missouri Department of Health and Senior Services (DHSS) using any of the options below:

• Call the State Hotline toll‑free at (800) 392‑0210

• Call the Bureau of Ambulatory Care at (573) 751‑1588

• Email the Bureau of Ambulatory Care at BAC@health.mo.gov

Please note: Calls and emails received after normal business hours will be returned the next business day.