The Star Beacon; Ashtabula, Ohio

April 12, 2013

Dialysis center to open soon

Star Beacon

KINGSVILLE TOWNSHIP —  It only took a few seconds for Bob Alessi to pick out the spot where he will spend 1/14th of the rest of his life.

“I think I want that one in the corner,” Alessi said, pointing to a big blue chair with a dialysis machine next to it. “These are nice, really looking good.”

Alessi and his wife, Justine, were among the steady stream of dialysis patients and curious public who attended an open house at DaVita’s new center in the Ashtabula County Nursing Home on Dibble Road. The center, announced nearly two years ago, has been treating a private-pay patient since January and is undergoing its final state inspection this week. John Steen, manager of the Kingsville and Ashtabula DaVita sites, said the final licensing hurdles should be cleared by early May, allowing the center to open its doors to both nursing home residents and outpatients like Alessi.

“He lives in North Kingsville, so this will be nice for us,” Justine Alessi said. Her husband drives 11 miles for his thrice-weekly treatment in Ashtabula; transferring to the nursing home site will cut that drive to about three miles.

Steen said Alessi is exactly the kind of patient that DaVita wants to serve with its Kingsville location. He said there are many patients from the Conneaut, Kingsville and Monroe Township areas who must drive to Andover or Ashtabula for their treatments. The partnership with the county will allow DaVita to cut drive time off a very time-consuming therapy.

Many patients who require dialysis while undergoing rehabilitation service or long-term care in a nursing facility have to be transported by ambulance to a dialysis center, exposing them to the elements, plus the risks and stress of the journey. There are at least four residents of the nursing home that require dialysis. Commissioners hope that having the center based at the nursing home will bolster the census while sparing the dialysis patients the inconvenience and expense of transportation.

Justine Alessi said that when her husband was in the nursing home last year, they had to pay $150 for each trip to the dialysis center. Because he was in a wheel chair and not a bed, the transportation costs were ineligible for Medicare reimbursement.

“It was a lot of money,” Justine Alessi said. “But we had to pay it.”

Commissioners lease the 2,600-square-foot space to DaVita, which invested more than $500,000 on remodeling the former daycare area and equipping it with six stations. Steen said the center initially will operate on a Monday, Wednesday, Friday schedule.

When fully operational, the center will be able to treat 18 patients a day and carry a full caseload of 36 patients. Treatments are typically four hours in length.

Dr. Orlando D’Silva, medical director for the center, said the dialysis process can’t be hurried because the few hours spent on a machine every-other-day must replace the 24-hour-a-day function of the kidneys.

To help patients pass the time, the center offers wireless Internet connection for browsing and email, plus television monitors at each station. An upbeat, fun atmosphere is maintained at the centers to help combat the boredom and malaise, as well.

“These people are amazing,” Justine Alessi said. “Every time he comes here, they are always upbeat.”

Steen estimates that there are at least 150 dialysis patients in the county, and the numbers increase annually. DaVita’s Ashtabula center on Carpenter Road can handle up to 96 patients and has a census of 83. DaVita also has a center in Miller Memorial in Andover. Outpatient therapy also is offered at a center in Jefferson that is not owned by DaVita.

The leading illnesses that cause kidney failure are diabetes, high blood pressure and hereditary factors.

“We see a lot of fathers-sons, mothers-daughters getting treatment,” Steen says. “We even had a couple, husband and wife, who got treatment together.”

The average age of a dialysis patient at the Ashtabula center is 62; the center has treated teenagers as well as patients in their 90s. One patient was on dialysis 37 years.

“We have many who have been receiving dialysis for over 10 years,” D’Silva said. “It is much safer, more efficient ... we have come a long way with it. We understand the physiology of it and why we do what we do much better now.”

Some of the patients are on waiting lists for a transplant; D’Silva they’ve had patients on a list for just a few weeks before an organ became available; for others, it has been decades.

“Our job is to keep them in the best possible health until they can get a transplant,” Steen said.

Stephen Gates of DaVita said that for people with kidney failure, dialysis is simply a matter of life and death. It’s also a substantial chunk of the spending by Medicare and Medicaid; while only 1 percent of that population receives dialysis, it accounts for 8 percent of the total spent by the programs.