← the access Reviewed as of 14 July 2026
THE ACCESS · WHO'S INVOLVED, AND HOW DOES THE DATA CONNECT THEM?

The Stakeholder Matrix

Rows are stakeholders; columns are the data systems and registries. Every filled cell cites the relationship in the dataset. An empty cell is a finding, not a gap: that stakeholder has no direct line to that system.

TEXT ALTERNATIVE ↓
WIDE DRAWING · SCROLL SIDEWAYS TO READ IT ALL · THE FULL CONTENT IS ALSO IN WORDS BELOW
The seat sends data to the system—the mark points into the machine
The system sends data to the seat—the mark points back out
The system scores the seat—a judgment, not a feed
An accountability line—the seat answers to that system
A silent seat—a flat line across all six systems, drawn because it is the finding
Reviewed as of 14 July 2026 Changelog

The drawing in words

  1. Medicare-certified dialysis facilities—8 of 18 relationships: scored by Care Compare (quarterly) [R56]; feeds EQRS per-event/45-day [R16]; feeds EQRS per-event/14-day [R17]; feeds EQRS annually [R18]; feeds EQRS monthly [R19]; feeds NHSN quarterly [R20]; scored by NHSN quarterly [R61]; feeds USRDS annually [R24]. [1]
  2. Kidney transplant centers—1 of 18: feeds OPTN / UNOS (continuous) [R28]. [1 · 2]
  3. Nephrologists / medical directors—0 of 18. A silent seat: no direct line to any machine. The physician signs, the facility types. The row is genuinely empty, and that emptiness is the finding. [1]
  4. ESRD Networks (18 regional)—1 of 18: feeds EQRS (continuous) [R63]. [1]
  5. State Survey Agencies—0 of 18. A silent seat: no direct line. The surveyor reads, through other doors. The row is genuinely empty, and that emptiness is the finding.—across the six machines drawn here. The survey program’s own system (ASPEN / iQIES) is out of this plate’s scope. [1]
  6. Centers for Medicare & Medicaid Services—1 of 18: is fed by NHSN (quarterly) [R32]. [1]
  7. Centers for Disease Control and Prevention—1 of 18: is reported to by NHSN (continuous) [R42]. [1]
  8. Medicare Administrative Contractors—1 of 18: feeds Medicare claims systems (continuous) [R65]. [1]
  9. U.S. Department of Health & Human Services—1 of 18: is reported to by USRDS (continuous) [R51]. [1]
  10. ESRD patient population—1 of 18: is scored by USRDS (annual) [R60]. [1]
  11. ESRD QIP—3 of 18: is fed by EQRS, by Medicare claims systems, and by NHSN (all payment-year-cycle) [R21, R23, R22]. [1]
  12. The machines, by density: EQRS carries 6 of the 18 relationships (the densest); NHSN 5; USRDS 3; Medicare claims 2; Care Compare 1; OPTN / UNOS 1. [1]
  13. System to system: Medicare claims feeds USRDS annually [R25]; OPTN / UNOS feeds USRDS annually [R29]; EQRS feeds Care Compare quarterly [R31]. [1]
  14. The form layer: the CMS-2728 Medical Evidence Report rides R16 and also populates the USRDS registry [R30]; the CMS-2746 Death Notification rides R17; the CMS-2744 Annual Facility Survey rides R18, and the Network reviews and finalizes 2744s inside EQRS [R63]. [1 · 3]
  15. The census: 11 seats x 6 machines = 66 cells. 14 are filled; 52 are genuinely empty. Two of the eleven seats never touch the machines directly. A silent station is a finding, not a gap in the data. [1]

BRACKETED NUMBERS TRACE EACH LINE TO THE SOURCE LIST BELOW · EVERY SOURCE IS HELD IN THE REFERENCES LEDGER WITH ITS LOCATOR, ITS LAST-CHECKED DATE, AND HOW IT WAS VERIFIED