For most nursing home residents who need dialysis, the routine looks the same: an early morning wake-up, a long ride to an outpatient center, hours in a chair, then an exhausting trip back. By the time they return, half their day is gone — and they’re too drained to do much else.
A small but growing number of facilities are changing that equation. By partnering with specialty dialysis providers to bring treatment directly into the building, they’re keeping residents in familiar surroundings, reducing logistical headaches, and seeing real improvements in care quality.
The model — increasingly called a “dialysis den” — remains rare. Most nursing homes still rely on off-site providers. But for operators who’ve made the move, the benefits are hard to ignore.
A Better Day for Residents
Texas-based Eduro Healthcare runs roughly 40 facilities and has introduced on-site dialysis at one of them through a contract with Rendevor Dialysis. Deanna Truax, Texas area president for Eduro, says the difference in residents’ daily experience has been stark.
“Our residents leave dialysis and are able to continue the rest of their day,” Truax said. “They’re able to eat breakfast, do dialysis, have lunch, participate in activities, have conversations along the way — instead of coming back after five hours and their whole day is gone.”
On-site treatment also means residents stay in surroundings they know. Their nurses are familiar. Their CNAs are there. For someone who just came home from the hospital — or who’s just starting dialysis — that continuity matters more than most people realize.
“I’ve woken up in my home, and I’m still in my home,” Truax described residents saying. “The whole process is much more peaceful and less jarring.”
Fewer Hospital Trips, Better Referral Relationships
On-site dialysis doesn’t just improve daily quality of life — it also reduces hospitalizations, which is the kind of outcome that matters to value-based care models. Residents are less likely to miss treatment appointments when transportation isn’t part of the equation. Staff can monitor and coordinate medications, meals, and therapy without the disruption that off-site visits create.
That improved consistency is also part of why outcomes across the sector have been trending better at facilities that invest in care continuity. Ben Williams, VP of business development at Rendevor, says on-site dialysis dens strengthen relationships with hospital referral partners, too — because facilities can accept newly discharged dialysis patients without scrambling to arrange outside appointments.
“Our referral partners and hospital systems have a hard time if somebody is new to dialysis,” Truax said. “We’re working with Rendevor on chair times and authorizations and we’re able to come back to the hospital and say yes, we can do it.”
What It Takes to Make It Work
Building out an on-site dialysis program isn’t simple. Space, electrical capacity, compliance requirements, and sufficient patient volume all factor in. Not every facility can justify the upfront investment, Truax acknowledged.
Policy plays a role, too. Illinois has added a Medicaid add-on payment for in-facility dialysis, which helps cover the cost of caregivers not typically reimbursed through Medicare. Williams called it a significant policy shift — and there’s hope it becomes a model for other states. Still, uncertainty around payer implementation remains a barrier.
Eduro is exploring whether to expand the model to more of its properties. The interest is there. The question is whether the infrastructure — and the policy environment — will catch up to the demand.
For now, the facilities that have made it work say it’s changed how they think about what a nursing home can actually be for the people living there.
