The Kidney Community Emergency Response (KCER) Program: Lessons Learned and Looking Ahead

The Kidney Community Emergency Response (KCER) Program: Lessons Learned and Looking Ahead

March 4, 2019

March is National Kidney Month, and we are pleased to share a guest blog from KCER, the Kidney Community Emergency Response Program, to celebrate. KCER is the leading authority on disaster preparedness, response, and recovery for dialysis and kidney transplant patients. Healthcare Ready works with KCER year-round, engaging in trainings, sharing information, and partnering to assist patients during emergencies. KCER is a valuable partner during emergencies and during blue skies, and we are happy to share some of their insights from 2018 in this guest blog.

The year 2018 proved to be both hectic and difficult for emergency management in the end stage renal disease (ESRD) community. As you may be aware, KCER is the Centers for Medicare & Medicaid Services (CMS) contracted agency that:

  • Provides technical assistance, tools, and resources for the ESRD community.
  • Monitors the status of emergencies impacting the ESRD community before, during, and after the event to identify patient access to care issues.
  • Coordinates continuing care and access to services for dialysis and transplant patients during emergencies or disasters.
  • Assesses emergency situations to determine the need for federal response and stakeholder assistance and communicates that information to CMS.

During 2018, KCER was at least partially activated in all 12 months, in response to over 35 incidents or emergencies!  From wildfires in California to typhoons in the Mariana Islands, KCER worked to assist the 18 ESRD Networks, dialysis companies, and most importantly, patients, who need to receive lifesaving dialysis treatment. Some of the important lessons learned include:

  • Better evacuation planning is needed with the local governments, especially in the areas that are under pre-storm mandatory evacuation orders, to enable facilities to remain operational as long as possible. This will help to reduce the gap between pre and post incident treatment for patients in evacuation areas.
  • Patient transportation to treatment becomes an issue when transportation companies shut down, especially early pre-incident.
  • Decision makers at the local and state levels need to be better educated on the importance of dialysis and the impact missed treatments have on patients.
  • Duplication of efforts during incidents remains a barrier to effective overall response. Emergency Operation Centers, Healthcare Coalitions, ESF-8, and State Survey Agencies are tracking ESRD facility status. These agencies are unaware that the ESRD Networks and KCER are already compiling this information and could provide it to any agency for response and recovery purposes.
  • Patient tracking was a challenge, especially in the protracted and large-scale incidents. There are many variables that contribute to the issues, including patients evacuating last minute, patients that remain in evacuation areas, and patients that don’t communicate with their providers regarding their evacuation plans. 
  • Better coordination is needed between evacuation shelters/ESF-8, along with dialysis providers, ESRD Networks, and KCER. Networks and KCER can be used as a resource to assist shelter staff with locating and coordinating treatment for housed dialysis patients.

Moving forward into 2019, KCER will be working with all stakeholder partners to overcome the barriers previously encountered and to collaborate on interventions to address the lessons learned.  Another focus for KCER will be promoting year round resilience in dialysis patients, staff, and facilities. We welcome your feedback and participation as we work to support quality improvement in ESRD emergency management! Please take a moment to visit our website and feel free to contact any member of the KCER team!



KCER Hotline: 866.901.3773 

Fax: 855.232.KCER (855.232.5237)

Twitter: @KCERProgram


Beverly Whittet, RN, CDN, CPHQ

Beverly Whittet, RN, CDN, CPHQ, has 18 years of end stage renal disease (ESRD) quality improvement and nursing experience, with over 10 years as a Clinical Nurse Manager in an outpatient dialysis setting. In addition to being a KCER Coordinator, she is the Special Projects Director for HSAG: The Florida ESRD Network (Network 7).