The Access — An Atlas of the U.S. Dialysis System

AN ATLAS OF THE U.S. DIALYSIS SYSTEMFIELD NOTES 2011–2026

42 CFR 494.80 — CONDITION: PATIENT ASSESSMENT

The facility’s interdisciplinary team consists of, at a minimum, the patient or the patient’s designee (if the patient chooses), a registered nurse, a physician treating the patient for kidney failure, a social worker, and a dietitian. The interdisciplinary team is responsible for providing each patient with an individualized and comprehensive assessment of his or her needs. The comprehensive assessment must be used to develop the patient’s treatment plan and expectations for care.

AN ATLAS OF THE U.S. DIALYSIS SYSTEMFRONTISPIECEPLATE 0

TERRA INCOGNITA — STATE LICENSURE LAYER

UNGOVERNED — PAYMENT RULES, SEE PLATE IV

THE ACCESS — FRONTISPIECE

THE TERRAIN

42 CFR Part 494, the Conditions for Coverage, read as landscape.

ELEVATION = REGULATORY TEXT DENSITY
SRC: eCFR, 42 CFR PART 494 · AS OF 2026-07-01

08001,600 WORDS

START HERE — PLATE I: THE LOOP

GENERATED FROM 42 CFR PART 494 —
AWAITING THE AUTHOR’S PASS · 07|2026 ELEVATION: TEXT DENSITY
SRC: eCFR · 42 CFR PART 494

Enter the atlas — Plate I: The Loop

.terrain-wrap{display:none} .terrain-passage{display:block}THE TERRAIN — 42 CFR PART 494 AS LANDSCAPE · MOTION REQUIRES JAVASCRIPT

01 — THE PLATESTHE CHROMA STAYS INSIDE THE WORKS

02 — THE ESSAYTHE CORNERSTONE

03 — THE CARTOGRAPHERDRAWN FROM THE SEATS, NOT THE ALTITUDE

JOHN CRUZ, RN
TECHNICIAN → NURSE
→ CHARGE → MANAGER
→ DEVICE CLINICAL SALES
→ QUALITY & SAFETY
FIELD NOTES 2011–2026

“I’ve spent 15 years in dialysis. I started as a technician mixing acid and bicarb at 4 AM. I became a nurse, then a manager, then a clinical sales specialist walking into boardrooms at Ivy League academic medical centers, and now I sit in quality and safety at a major academic institution. At every level, I saw a different piece of the system. At no level did anyone show me how the pieces connected.”

Why I’m drawing the map