Tier 3 Needs Assessment Facility Details Question Title * 1. Please select your facility name and CCN: ARA - ADELPHI (212622) BMA - BLUE RIDGE (492558) BMA - FARMVILLE (492526) BMA - FRANKLIN COUNTY (492565) BMA - NEW RIVER VALLEY (492532) DaVita Butler Farm Dialysis (492653) DaVita Caroline County Dialysis (212736) DaVita Catonsville North Dialysis (212634) DaVita Dan River (492738) DaVita District Heights Dialysis (212657) DaVita Dundalk Dialysis (212616) DaVita Forestville Dialysis (212695) DaVita Front Royal Dialysis (492573) DaVita Giles County Dialysis (492671) DaVita Glenvar Dialysis (492709) DaVita Grant Park Dialysis (092522) DaVita GWU Southeast Dialysis (092517) DaVita Harrisonburg Dialysis (492507) DaVita Henrico County Dialysis (492598) DaVita Lee Street Dialysis (092510) DaVita Leigh Dialysis Center (492629) DaVita Lexington Dialysis (VA) (492539) DaVita Meherrin Dialysis Center (492551) DaVita Meherrin Home Training (PD) (492708) DaVita Norfolk Dialysis Center (492537) DAVITA PEAKS OF OTTER DIALYSIS (492736) DaVita Petersburg Dialysis (492594) DaVita Renal Care of Seat Pleasant (212640) DaVita Seton Drive Dialysis (212653) DaVita Staunton Dialysis (492528) DaVita Takoma Park Dialysis (212590) DaVita Tidewater Home Dialysis (492669) DaVita Washington County Dialysis (212667) DaVita Washington Nursing Facility (092524) DaVita Whitesquare Dialysis (212523) DaVita Winchester Dialysis (492523) East Henrico Dialysis Center (492702) FMC - ABINGDON (492630) FMC - BLAIRS DIALYSIS (492656) FMC - ELKTON (212573) FMC - FRIENDSHIP MANOR (492610) FMC - HAGERSTOWN (212534) FMC - LOUISA (492677) FMC - MIDDLE RIVER (212676) FMC - NORTH SALISBURY (212664) FMC - OAK HILL (512511) FMC - PRINCESS ANNE (212669) FMC - WESTON (512524) FMC Grafton (512546) Fresenius Kidney Care Laurel Park (492711) Fresenius Kidney Care of Halifax (492725) Fresenius Kidney Care Smyth County (492700) Fresenius Medical Care Braxton County (512549) Fresenius Medical Care Upshur County (512548) Grace Medical Center (212749) GREATER SOUTHEAST COMMUNITY DIALYSIS CENTER (092505) LIBERTY DIALYSIS PETERSBURG (492634) MOUNTAIN RIDGE DIALYSIS (512525) Northpoint Dialysis, LLC (212688) NXSTAGE KIDNEY CARE GREENBELT (212694) QUALITY CARE DIALYSIS - SOUTHERN MARYLAND (212539) RACEWAY DIALYSIS CENTER (492664) RAI - CHESAPEAKE-NEWPORT NEWS (492645) RAI - CHILLUM-HYATTSVILLE (212614) RAI - CHURCHLAND-CHESAPEAKE (492581) RAI - MECHANICSVILLE TRNPK-RICHMOND (492561) RAI - MERCURY BLVD-HAMPTON (492640) RAI - SOUTH CHURCH-SMITHFIELD (492641) Renal Care Silver Hills Dialysis (212536) Salisbury Dialysis Center, LLC (212726) SOUTH LABURNUM DIALYSIS LLC (492648) TAPPAHANNOCK DIALYSIS CENTER (492536) US RENAL CARE - HYATTSVILLE (212620) US RENAL CARE - WEST BALTIMORE (212647) US RENAL CARE OXON HILL DIALYSIS (212566) Question Title * 2. Person completing questionnaire: Name Email Address Question Title * 3. Select the best description/setting of your facility: Free-standing Located in a shopping center Located in a hospital Located in a nursing home Question Title * 4. Does your facility have on-site parking? Yes No Question Title * 5. Is free parking available? Yes No Question Title * 6. What area hospitals do your patients use? Question Title * 7. What is the average amount of time it takes your patients to travel to a hospital? Question Title * 8. How many staff members are in your facility? Question Title * 9. Is your facility currently short staffed? Yes No Next