Anyone out there been part of an independant clinc that went into a joint venture with one of the "big guys" (DaVita, Fresinius, etc)? Just wondering how it has affected everyone and what kind of changes were implemented. Thanks for any insight.

I work for three hospital owned clinics that became DaVita affiliates about 9 years ago. DaVita(TRC at the time)owned a percentage of the units and had an option to buy after 5 years. All the employees were going to become TRC employees. There was a huge protest. The employees remained hospital employees, but the managers worked for TRC.

TRC was going through a very difficult period in their history. Their stock was around $2 a share, and I think they were under investigation for Medicare fraud. Having the managers work for one company and the employees work for another is not good.

DaVita took over billing, purchasing,labs and QA. We went through a number of facility administrators.

At the end of the five years, the hospital ended the relationship with DaVita. The hospital administration felt they could run the place themselves and not pay DaVita a management fee.

We had one DaVita facility administrator who was outstanding. One did not have a California RN license and was terminated. Some were just OK.

I liked and respected most of the DaVita employees with whom I had contact.

It could happen to us again.