June 1 marks the beginning of hurricane season. Natural disasters - earthquakes, hurricanes, tornadoes, snow storms - often occur without warning. Long before any storm season begins, preparations to educate dialysis patients and the teams who care for them are already underway.

People with end stage kidney disease receive life-sustaining dialysis treatment three times per week. Any missed appointments, lack of access to clean water or missing medications could endanger their health. That’s why having a highly-coordinated disaster management plan is critical.

DaVita follows a six-step process to help its 2,772 U.S. outpatient dialysis centers prepare for natural disasters: 1) identify, (2) assess, (3) communicate, (4) prepare, (5) respond and (6) recover.

Safety is always top priority. Each dialysis center will post emergency signs informing patients of inclement weather as it approaches. During the last week of May, centers will also create and distribute patient emergency preparedness packets containing information related to:

• Patient demographics
• Dialysis orders
• Medication list
• Copies of insurance cards
• Curfew letter from the facility
• Letter for the center’s corresponding ESRD network (Example: Florida Network 7)
• Emergency phone numbers
• List of shelters and phone numbers
• List of supplies to include in an emergency kit, along with instructions on how to disinfect water (should a boil requirement go into effect)
• Current laboratory results, medical history and physical exam
• Emergency diet plans

Dialysis patients may not be able to access treatment for a couple of days when a disaster strikes. Reverting to a 3-day emergency diet will provide them with adequate nutrition as well as limit fluid and waste buildup.

If a natural disaster is imminent, patients may be proactively dialyzed in case they are temporarily unable to receive treatment. Emergency supplies, including generators, water tankers and fuel, may also be staged at a dialysis center to ensure continuous operations. The center will remind patients to:

1. Stay home, call your center—if you have phone service—to find out if it is open.
2. Call family members and let them know that you are alive and how you are doing.
3. Listen to public announcements with a battery operated radio. It is recommended you pack one in your emergency kit.

Because dialysis is not optional, patients need to let someone know where they are at all times. If they evacuate to an emergency medical shelter, they need to let the staff know that they are a dialysis patient and where they dialyze.

Dialysis center teams will determine the status of the center and its ability to administer treatment as well as approve emergency dialysis orders during the response phase. Depending on the disaster, the center may open for any patient to receive dialysis – regardless of where they normally receive treatment.

The final phase, recovery, involves updating patients on a timeline to resume treatment, assessing damage and developing a plan for re-establishing normal operations.