Facility Network Affiliation Sign Up

Welcome to our Network:

We welcome your facility to HealthInsight ESRD Network 18, and look forward to working with you and the rest of your staff. As you may already know, the mission of the Network is to promote optimal dialysis and transplant care for kidney patients in California located throughout Imperial, Inyo, Kern, King, Los Angeles, Orange, Riverside, San Bernardino, San Diego, San Luis Obispo, Santa Barbara, Tulare, and Ventura counties.

Please see the information below to learn more about the process of joining your facility with our Network.

1. Complete the New Facility Application
   • After you submit your request, the Network will email you a signed Memorandum of Understanding (MOU)
2. Sign the MOU and return to the Network via
   • Fax: (888) 280-8669 OR
   • Email: Network18@nw18.esrd.net
3. Sign up for NHSN
4. Keep the Network updated on certification status

1. Submit the following documents to the Network immediately upon receipt of your CMS Certification letter:
   • A copy of the CMS Certification Letter
   • Updated MOU with CCN sign and fax/email to the Network, we will return it with the signature of the Executive Director
   • Facility Information Form-New Facilities
   • Facility Personnel Update Form
     The Network cannot add your facility to CROWNWeb until we receive these documents.
2. The Network will send a welcome email to the listed Facility Administrator that includes:
   • Link to the Facility Orientation and Resource Packet (Zipped Download)

   The Network will also mail the Grievance Poster (English and Spanish versions). These must be posted in your facility where patients and State Surveyors can easily see them.

3. Sign up for our ESRD Network Blog Posts. The blog provides information for ESRD facilities including important dates, product recalls, and CROWNWeb information.
4. Contact the Network with any questions. Please also review our Network website, which has valuable resources for providers and patients.