Sales and Marketing
Xentel
Expanding call center. New Hiring Bonus! Driver/Transportation
CPC Southwest Materials
Drivers Trades/Construction
Pioneer Landscaping
Yard Person/Loader Operator Mechanical
Pioneer Landscaping
Diesel Fleet Mechanic General
Grocery/Market Mgr-Cafe/Restaurant Mgr Engineering
Knight Piesold & Co
Engineer General
The Graham Group
Assistant to the Building Manager

Patients at dialysis centers can expect an individualized plan, electronic health records and defibrillators in every unit under new Medicare rules.

The rules aren't expected to cost dialysis centers more because other provisions will be eliminated, including requirements for a long-term care plan, Barry Straube, Medicare's chief medical officer, said in a telephone news conference Thursday.

Medicare, the federal health-insurance program for the elderly and disabled, paid about $7.9 billion for dialysis and related drugs in 2005 for patients with kidney disease, according to a report by the Medicare Payment Advisory Commission, an independent group that advises Congress.

The new regulations incorporate developments in standards of treatment and care since the rules were last set in 1976, the agency said.

"We've worked very carefully with many, many stakeholders," Straube said. "I don't think there will be major surprises about the conditions, and I think they are going to be very much on board with most of them."

Because of the scope of the changes, dialysis facilities will have 180 days to come into compliance instead of the normal 60 days, Straube said.

Medicare will assume the 4,700 centers it previously certified are in compliance pending new surveys, he said. Fresenius Medical Care AG, the world's biggest provider of kidney dialysis, and DaVita Inc. are among center operators treating the 336,000 Medicare-qualified patients in the United States.

Dialysis cleans the blood in people with chronic kidney failure. Kidney failure can cause uremia, a toxic condition resulting from the buildup of waste products usually excreted in urine.

The Medicare changes reflect the agency's efforts to boost the quality of care, including promoting broader use of computerized records to track patient care and encouraging providers to follow nationally recognized standards.

"We will be holding people's feet to the fire to ensure that each individual facility is implementing all conditions for coverage," Straube said.

LeAnne Zumwalt, spokeswoman for El Segundo, Calif.-based DaVita, didn't immediately return a call for comment. U.S. spokesmen for Germany-based Fresenius didn't immediately respond to a voice-mail message.