The Centers for Medicare and Medicaid Services’ (CMS) mandates that dialysis centers inform patients of their transplant options and report progress of this within 45 days of dialysis initiation for each patient using Form CMS-2728 (Form-2728). To understand the transplant education practices occurring in dialysis centers in four states, we compared reported evidence of transplant education for new dialysis patients on Form-2728 with their educators’ self-reported transplant educational practices. We also investigated educator and center factors associated with rates of transplant wait-listing at the center level. From April-October 2009, we surveyed dialysis educators from 179 centers on their transplant educational practices (e.g., having detailed discussions about transplant). We linked this data with patient data submitted to CMS on Form-2728 for 1378 patients from these centers. Form-2728 data alone indicated that 77% of new patients (n=1056) had been informed of their transplant options, with only 9% not being assessed. The “informed” patients received different forms of education, most commonly recommendations to be evaluated for transplant (887 patients educated, 80% of centers using this strategy), referrals to external transplant education programs (846 patients, 79% of centers), and recommendations to learn more about transplant (786 patients educated, 71% of centers). Only 680 patients (61% of centers) received transplant brochures, 265 patients (18% of centers) had detailed transplant discussions with educators, and 148 patients (17% of centers) received educational resources to share with prospective living donors. Linear regression found that dialysis centers that provided transplant education annually, non-profit dialysis centers, and dialysis centers with ≤50% Black patients had higher wait-listing rates. While most dialysis educators are generally informing patients that transplant is a treatment option, dissemination of educational resources is inconsistent and discussion about the risks and benefits of transplant is minimal. Standardized transplant education in all dialysis centers would help to ensure that more dialysis patients are making informed transplant choices and increase pursuit of transplant.

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