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New Facility Information

The Southeastern Kidney Council staff would like to welcome you as a new facility in our Network 6 area.  As an organization, Network 6 promotes the quality of care for all patients.  We support renal care providers and dialysis and transplant patients by providing helpful information and technical assistance as directed by the Centers for Medicare & Medicaid Services (CMS). 

As part of our Network, you will need to complete the New Facility Form below and return a copy to Network 6.  Below are the links to important documents and information, that your facility will use for future reference.  Please review and utilize the following information provided below.  If you need additional assistance, please contact Melodye Aben at our Network office at (919) 855-0882, ext 31.

• New Facility Form (Complete and Return to SKC)
• CROWNWeb QIPS Registration Form Flyer
• CMS Data Forms (Blank Copies)
  • 2728 Form
  • 2746 Form
  • Network Patient Activity Report
  • Vascular Access (FF) Forms
• 2728/2746 Release Authorization Form
• What Can I Do If I Have a Complaint? (English)
• What Can I Do If I Have a Complaint? (Spanish)
• 2011 Education Calendar & Monthly Mailings
• Decreasing Dialysis Patient-Provider Conflict (DPC) Toolbox
• Annual Report Notification

Network 6 will be mailing your facility a few other resources that are not available on our website.  The following resources/documents will be mailed to your facility, to help get you started:

1. Facility Specific Dialysis Outcomes Report Binder
2. Quality of Care Commitment
3. Network 6 All Hazards Series: Disaster Preparedness Packet
4. Southeastern Kidney Council/State Surveyor Poster
5. ESRD Education “Get Hooked”! Poster (small version and large version)
6. Vascular Access Stop Light Poster
7. Decreasing Dialysis Patient-Provider Conflict (DPC) Toolbox and Poster
8. Dialysis Facility Compare Poster
9. Transplant Poster
10. CMS Flu Poster
11. Emergency Preparedness Guides in English and Spanish
12. Catheter Brochures
13. Patient and Family Guide to Vascular Access brochures
14. DVDs:  Dialysis Patients Speak (Vascular Access), Exercise and Live Well; and Because I Count

**Please research the Network 6 website for other helpful references regarding Data Forms, Patient Services, and Educational Resources.**