Dialysis Den Brings Convenience and Care to VHS Coliseum Nursing and Rehabilitation Center Residents

For nursing home residents, traveling off site to dialysis appointments can be problematic. In such a situation, residents may spend hours a day traveling to and from appointments, and being away so frequently means they might miss out on activities and events hosted by the nursing home.

That’s why Virginia Health Services’ Coliseum Nursing and Rehabilitation Center sought out a way to make dialysis available on site to its residents. The DaVita Dialysis Den, located within the Coliseum Nursing and Rehabilitation Center, was unveiled this August, transforming residents’ experiences in receiving dialysis treatments.

The Decision to Offer Dialysis


Mark Klyczek, president and CEO of Virginia Health Services

Mark Klyczek, president and CEO of Virginia Health Services, explains that plenty of time and effort went into identifying how to offer dialysis. “Like many nursing homes, we’re looking to increase the amount of clinical services we offer,” he says. “Part of the strategic plan was to offer dialysis in one or more buildings.”

While engaged in strategic planning, Virginia Health Services received communication from DaVita Kidney Care indicating that the organization was interested in partnering with nursing homes in the area. “Their data said that our nursing homes were an area where a lot of people needed dialysis service,” he explains.

The next challenge was determining how to incorporate dialysis into the Coliseum facility. Virginia Health Services faced the decision of whether to use existing space, build an addition onto the building, or create a modular type of add-on. “The Dialysis Den is about 1,200 square feet,” says Klyczek. “We landed on using existing interior space.” That planning process was aided by DaVita’s resources, including drawings and an architect who helped to identify what the space should look like. “We used our location and internal area plus the DaVita specifications to build it out,” Klyczek explains.

Building the Dialysis Den

The process of building the Dialysis Den took longer than anticipated. “We had several hangups with getting approval from the city and building department, due to their being short-staffed,” Klyczek explains. “That cost us many months of time.” Additionally, Virginia Health Services ran into some issues with their initial contractor and had to find a second contractor.

Those delays proved to be beneficial, however. DaVita has been creating Dialysis Dens across the country, and as they created more and more facilities, they were able to provide Virginia Health Services with information from their learnings about elements like ideal water pressures and temperatures. “We did have to make some changes as we were building,” says Klyczek, “but if anything, the length of time it took to get it done was helpful. It let us iron out most of the wrinkles.”

The result was a professional, hospital-grade dialysis center. “The final product is probably one of the best in-facility dialysis units that are around,” Klyczek says.

Creating an on-site dialysis center would often mean that the organization then has to staff the center, but partnering with DaVita Kidney Care means that DaVita addresses the staffing needs. “We have a hard enough time finding long-term care and rehab staff,” says Klyczek. “To find someone technically good and experienced in dialysis for one provider would be next to impossible. If they call off or find another position, finding another person would be next to impossible.” DaVita staffs the Dialysis Den with a technician and a nurse, so the Coliseum’s main responsibility is to ensure that the resident gets to their treatment on time.

The Benefits of the Dialysis Den

The Dialysis Den has six chairs and can serve approximately 18 Coliseum patients per week. The Den is currently running two shifts, which can serve about eight patients per day, but can expand to run a third shift to serve more patients.

The Dialysis Den solves several challenges that residents would face if they had to travel elsewhere for services. “We’re primarily focusing on rehabilitation residents who might be more difficult to place from the hospitals, because folks that are on dialysis require transportation three times a week. When you’re in rehabilitation, insurance often doesn’t cover transportation,” explains Klyczek. Facilities that take on dialysis rehabilitation patients often have to pay $150 three times a week, which cuts into reimbursement.

By offering dialysis on site, residents don’t have to worry about accessing transportation. “They get at least 10 hours per week of their life back, because transportation is often delayed,” says Klyczek. “It’s obviously a lot more comfortable than getting into a wheelchair after dialysis. Dialysis is a challenging treatment and it does take some of the strength out of the resident for that day.”

Klyczek notes that one of the residents receiving services from the Dialysis Den remarked that she isn’t missing any of the activities in the facility anymore. She’s excited that she doesn’t have to miss activities or the chance to be with other residents, and that she’s able to participate in living, rather than being transported.

The response to the Dialysis Den has been very positive so far. “We invited the care managers from two of the biggest referral sources we have in the area,” says Klyczek. “They had heard about it and loved the idea, but when they actually came to see it, it was amazing to see how professional it is. It’s a really great place that care managers are comfortable sending patients to.”

Advice for Other Organizations

The success of the Coliseum’s Dialysis Den is partially due to the organization’s partnership with DaVita Kidney Care, which has more than 20 years of experience providing dialysis services. You can learn more about DaVita’s Dialysis Den model and can contact the organization for more information.

Klyczek recommends that organizations interested in starting an on-site dialysis operation of their own start the process early, since the planning and construction processes may take longer than anticipated. “In my opinion, [dialysis] is a differentiator,” he says. “You really want to be the first if you can, and establish that you’re a center of excellence for the community.”

Topics: Executive Leadership , Featured Articles , Leadership , Operations , Rehabilitation