New Facilities

Opening a new ESRD Facility in Virginia, West Virginia, Maryland, or District of Columbia


Prior to CMS Certification

  1. Complete and submit this form  
  2. Print confirmation for the State Surveyor visit

After CMS Certification

  1. Your facility will receive a letter from the State Survey Department containing your facility’s CMS Certification Number (CCN). 
  2. Obtain access to the following national data systems:
  3. Hang Network 5 Grievance Posters (English or Spanish) in area visible by patients. Facilities can order more by contacting the Network office at

Important Resources

Conditions for Coverage

Interpretive Guidelines


Involuntary Transfers & Discharges

Emergency Preparedness

Network 5 Staff

Email Alison Crittenden at the Network office at or call Alison at 804-320-0004, Ext. 2707, with any questions.