A: We were seeing the same challenge across multiple admissions: patients who were otherwise appropriate for skilled rehab couldn’t come to us because of their dialysis needs. Coordinating transportation three times a week—especially in Erie, where winters can be brutal—wasn’t just logistically difficult, it was unsafe. We had patients getting sick, missing appointments, or suffering injuries just trying to get to outpatient dialysis centers. We knew the only sustainable solution was bringing the service in-house.

So, we built a dedicated on-site HD unit in partnership with DaVita, one of the nation’s leading dialysis providers. Our unit offers seamless care coordination between nephrologists, nursing staff, and rehab therapists—all under one roof. The response from families and hospitals has been overwhelmingly positive.

A: It reduces stress immediately. Imagine being discharged from a hospital to recover in a nursing facility, only to be loaded into an ambulette in 10-degree weather three times a week for dialysis. It's exhausting for the patient and frustrating for families.

By integrating dialysis into the care plan on-site, our patients can rest more, rehab harder, and recover faster. We also eliminate the handoff errors that can happen when care is fragmented between facilities. Our teams are all in one loop.

A: We’ve seen a marked improvement in length of stay, patient satisfaction, and even skilled mix. Patients who once would have been discharged to hospitals or long-term care facilities due to complex dialysis needs are now safely managed in our subacute setting.

We’re also a more attractive partner to hospitals looking to discharge high-acuity patients quickly. Being able to say, “Yes, we can take them—even with dialysis needs,” is powerful.

A: Sure. Skilled mix is the percentage of Medicare or high-acuity rehab patients in your census. The higher the mix, the better your reimbursement and clinical outcomes tend to be.

When you offer services like on-site dialysis, you’re signaling to hospitals and families that you can handle complex cases. That naturally draws more short-term rehab admissions, which builds skilled mix. It’s not just good for business—it’s a smarter way to allocate healthcare resources in a post-acute setting.

Answer: We want to be known as a clinical destination, not just a step-down option. Our dialysis unit is one piece of that, but it’s part of a larger philosophy: invest in infrastructure, recruit excellent staff, and build care models that truly serve patient needs. If we do that consistently, we’ll earn the trust of hospitals, doctors, and families—and we’ll be able to deliver care that’s both compassionate and cutting-edge.

A: Start by listening to your referral partners and your patients. What do they need that you’re not providing? For us, dialysis was the loudest ask. Once we heard it clearly, we made it a strategic priority.

The investment was significant, but the return—in terms of patient care, skilled census, and reputation—has been more than worth it.