CMS-2744 Annual ESRD Facility Survey Completion Process

February 5, 2024

Each calendar year, the Centers for Medicare & Medicaid Services (CMS) requires all Medicare-certified dialysis and transplant facilities to complete Form CMS-2744, also known as the End Stage Renal Disease (ESRD) Medical Information System ESRD Facility Survey. This survey provides a final count of all patients and treatments provided by a dialysis or transplant facility during the prior calendar year. It also includes important facility and patient demographic information, such as Medicare status, vocational rehabilitation, and facility staff counts.

Please note:

Before initiating the 2744 survey in the ESRD Quality Reporting System (EQRS), please follow the guidance provided by your organization, as some organizations complete their surveys at the corporate level. Additionally, facilities are required to submit the completed survey by the deadline established by their ESRD Network.

Facility representatives can begin the Form CMS-2744 survey completion process in EQRS by generating a Form CMS-2744 and submitting it to their ESRD Network for review. Before submitting the survey to the Network, facilities must review all survey information for accuracy and correct any identified errors. To verify auto-populated data on the survey, dialysis facilities can download four reports and transplant facilities can download one report from the View Facility Form 2744 screen (Figure 1a (dialysis facilities) and Figure 1b (transplant facilities)) in EQRS. Lastly, once a facility submits the completed survey to their ESRD Network for review, they must monitor their forms’ status in EQRS and work with their ESRD Network to finalize the form.

Figure 1a: Downloadable reports on View Facility Form 2744 screen for dialysis facilities

Figure 1b: Downloadable reports on View Facility Form 2744 screen for transplant facilities

For instructions on completing the CMS-2744 survey, view or download the Form CMS-2744 from the CMS.gov website: https://www.cms.gov/Medicare/CMS-Forms/CMS-Forms/CMS-Forms-Items/CMS009579. For additional information on completing the CMS-2744 survey, refer to the 2023 CMS-2744 Training Aid, available on the Education page on www.MyCROWNWeb.org.

For assistance with completing the CMS-2744 survey, please contact your ESRD Network. Use this link to find the contact information for your local ESRD Network: https://esrdncc.org/en/ESRD-network-map/.

For assistance with EQRS technical issues, please contact the Center for Clinical Standards and Quality (CCSQ) Service Center. The CCSQ Service Center is open Monday-Friday 8 a.m. to 8 p.m. Eastern Time and can be reached via phone at 866-288-8912, email at qnetsupport-esrd@cms.hhs.gov or online at the CCSQ Support Center.