Fresenius Medical Care North America plans to open six new dialysis clinics over the next year or so in rural communities in Eastern Washington and North Idaho through its joint venture with Providence Sacred Heart Medical Center & Children's Hospital.

Through the expansion, Fresenius aims to meet the needs of rural patients and free up space at other clinics here, says Jean Stevens, the Portland-based regional vice president for the company, which has headquarters in Waltham, Mass.

The expansion, which will include adding a total of 44 new dialysis stations to the regional system and include moving four other stations, will offer relief to some Fresenius clinics, such as one in North Spokane, which has been nearing capacity, Stevens says. When a new dialysis clinic opens later this spring in Colville, several patients who have been driving to Spokane several times a week for the procedure likely will use that clinic, freeing up space for patients in the Spokane area.

In addition to the Colville clinic, the joint venture plans dialysis centers in Washington in Newport, Othello, and Ephrata and in Idaho in Ponderay and Moscow. In Omak, Wash., Fresenius will add nine additional dialysis stations to what currently is a six-station clinic. In Moscow, Gritman Medical Center also is a partner.

Sacred Heart opened two dialysis centers, in Spokane and Coeur d'Alene, and collaborated with Renal Care Group Inc., of Nashville, Stevens says. Fresenius and Sacred Heart have been operating the centers together since Fresenius bought Renal Care Group in 2006, she says. Now they operate seven dialysis centers in Spokane, Post Falls, Coeur d'Alene, and Hayden. The partners meet every three months and work together to administer and govern the centers, she says.

The need for kidney dialysis is growing as people live longer with conditions such as heart disease and diabetes that take a toll on the kidneys, Stevens says. In addition to dialysis, the centers provide classes periodically for patients with kidney disease to learn about the treatment, she says.

At the rural clinics, Fresenius will offer onsite dialysis, which can take up to four hours. Because of the extended period of time people spend at the clinics, Fresenius includes amenities such as heated or massaging chairs and entertainment such as video game systems. Also at the clinics, the technicians train some patients to do their own dialysis, called peritoneal dialysis, at home.

Preliminary estimates indicate the Newport Clinic, which is still in the early stages of planning, could cost about $970,000, according to an application Fresenius filed with the state.

In general, the clinics cost between $500,000 and $800,000 to get up and running, but are financed in two different ways, often with the participation of a private developer, Stevens says.

"In Colville, for example, we are paying for the internal renovations" to a building that a developer is constructing, she says. In some other projects, she says, "the developer will pay the upfront costs and we pay them back through lease payments. We look at those two different ways as a way of expanding" without undertaking expensive construction projects outright, she says.

The planned clinics include:

•Fresenius Medical Care Panhandle Dialysis, in Ponderay, a 6,000-square-foot center with 12 stations. It will occupy a building it has leased and remodeled. It will employ five full-time and two part-time staff members initially, Stevens says.

•Fresenius Medical Care Palouse Dialysis Clinic, in Moscow, will occupy about 4,400 square feet of floor space in a building owned by Gritman Medical Center. The joint venture is remodeling the space.

The clinic will have six dialysis stations and about three full-time and three part-time employees when it opens in June, and could be expanded later.

•Fresenius Medical Care Colville Dialysis Clinic, in Colville, is slated to open in June. Fresenius is remodeling the roughly 6,000-square-foot space that center will occupy. Stevens says the clinic will have seven dialysis stations and will be staffed by four full-time employees and three part-time employees.

•Fresenius Medical Care Leah Layne Dialysis, in Othello, will have four stations in a new 5,500-square-foot building constructed by a private developer from Dallas, Texas, and the joint venture will lease it. It's expected to open later this summer.

•In 2010, Fresenius hopes to open a 5,700-square-foot, six-station dialysis center in Newport, but that clinic still is in the planning stages. A contractor hasn't been selected for that project yet, Stevens says.

•Also later, Fresenius plans to open a four-station, 6,500-square-foot clinic in Ephrata. The company will move four stations from its 21-station Moses Lake dialysis center to the new Ephrata site, to free up space and serve rural patients there better, Stevens says.

No contractor has been selected for that project yet, either.