THE ACCESS — AN ATLAS OF THE U.S. DIALYSIS SYSTEMPLATE II — FIRST STATE — 07|2026

The Border

A DRAWN MAP · THE SAME CHAIR, THREE RULEBOOKS

The Crossroads’ crash start, zoomed in: how a person moves through the hospital — and the one place this atlas’s own law does not reach. Dialysis at the bedside answers to the hospital’s rulebook, 42 CFR 482, which contains no dialysis condition at all; it is paid inside the admission and surveyed by the hospital’s accreditor. Down the hall, a chronic unit holding its own certification number answers to everything this atlas maps. Same building, same machine — the certification decides which country you are standing in.

HOW TO READ · HAIRLINE REGION = A JURISDICTION — WHOSE LAW RUNS THERE · BOX = A PLACE OR A REGIME · DIAMOND = THE DISCHARGE GATE · ARROW = THE PATIENT MOVES · PLAIN LINE = GOVERNED / PAID / SURVEYED AS · DASHED = THE UNCOMMON ROUTE · LAST VERIFIED 2026-07-10
AN ATLAS OF THE U.S. DIALYSIS SYSTEMWIDE GRAMMAR — THREE RULEBOOKSPLATE II
The BorderFIRST STATE · ED. 001 · 07|2026
THE HOSPITAL'S WALLS I — THE HOSPITAL FLOOR · 42 CFR 482 — THE HOSPITAL’S OWN LAW II — THE CERTIFIED UNIT · 42 CFR 494 — INSIDE THE HOSPITAL’S WALLS III — THE COMMUNITY · 42 CFR 494 — WHERE THE CHRONIC MAP RUNS THE BORDER CROSSING THE CMS-2728 OPENS THE FEDERAL RECORD THE DATA SYSTEM BEGINS HERE THE CRASH START ED, THEN ADMITTED AKI OR NEW KIDNEY FAILURE ACUTE INPATIENT HD BEDSIDE OR INPATIENT SUITE NO DIALYSIS-SPECIFIC CONDITION EXISTS HERE NURSING 482.23 · PHARMACY 482.25 INFECTION 482.42 · ENVIRONMENT 482.41 QAPI 482.21 PAID INSIDE THE MS-DRG THE STAY, NOT THE TREATMENT NO ESRD PPS · NO V-TAGS · NO EQRS SURVEYED AS A HOSPITAL ACCREDITOR WITH DEEMED STATUS OR THE STATE AGENCY · NEVER APPENDIX H OFF THE MAP KIDNEYS RECOVER — NO 2728 EVER FILED THE AKI BRIDGE — SINCE 2017 A CERTIFIED CLINIC MAY DIALYZE ACUTE KIDNEY INJURY PAID AT THE PPS BASE RATE — NO 2728 FILED THE COMMUNITY CLINIC THE COUNTRY THE REST OF THIS ATLAS MAPS INVOLUNTARY DISCHARGE 494.180(f) 30-DAY NOTICE TO PATIENT AND NETWORK MEDICAL DIRECTOR + ATTENDING SIGN · STATE AGENCY NOTIFIED HOSPITAL-BASED CHRONIC UNIT ITS OWN CCN — THE 2300 BLOCK CORPORATE CONTROL, NOT THE ADDRESS, MAKES IT HOSPITAL-BASED THE FULL 494 MACHINERY APPLIES V-TAGS · APPENDIX H SURVEY EQRS · QIP · NETWORK THE QUIET CENSUS A LICENSE HELD AS A CATCH THREE SESSIONS A WEEK UNTIL PLACEMENT GOVERNED BY PAID AS SURVEYED AS KIDNEYS RECOVER DISCHARGED STILL NEEDING DIALYSIS — NOT YET CHRONIC CHRONIC — THE MAP BEGINS RECOVERS DOES NOT RECOVER ANY ADMISSION — THE RULEBOOK FLIPS AT THE DOOR THE CLINIC MOVES TO DISCHARGE PLACEMENT FOUND NO CLINIC WILL TAKE THEM PLACED — BACK TO THE COMMUNITY GOVERNED BY AN ATLAS OF THE U.S. DIALYSIS SYSTEM · PLATE II — THE BORDER, COMPOSED PLATE II KEY DRAWN, NOT BOXED HAIRLINE REGION = A JURISDICTION — WHOSE LAW RUNS THERE BOX = A PLACE OR A REGIME DIAMOND = THE DISCHARGE GATE — 494.180(f) ARROW = THE PATIENT MOVES PLAIN LINE = GOVERNED / PAID / SURVEYED AS DASHED = THE UNCOMMON ROUTE CYANOTYPE = THE SYSTEM'S MACHINERY · THE 2728 THE ROUTE — N=1 · VENOUS AT CROSSINGS INDEX OF JURISDICTIONS I — THE HOSPITAL FLOOR 42 CFR 482 — THE HOSPITAL'S OWN LAW II — THE CERTIFIED UNIT 42 CFR 494 — INSIDE THE HOSPITAL'S WALLS III — THE COMMUNITY 42 CFR 494 — WHERE THE CHRONIC MAP RUNS THE ACCESS — AN ATLAS OF THE U.S. DIALYSIS SYSTEM THE BORDER The same chair, three rulebooks. PLATE II · COMPOSED AND WALKED · ED. 001 · 07|2026 SRC: RIG/THE-BORDER.RIG.JSON LEDGER: CERTIFICATION-SPLIT-V1-VERIFICATION.MD
KEY
A JURISDICTION — WHOSE LAW RUNS THERE
A PLACE OR A REGIME
THE DISCHARGE GATE — 494.180(f)
THE PATIENT MOVES
THE UNCOMMON ROUTE
CYANOTYPE = THE SYSTEM'S MACHINERY · THE 2728
THE ACCESS · 07|2026
ED. 001 · DRAWN MAP SRC: 42 CFR PART 482 / PART 494 (eCFR) · 42 CFR 413.174 · 494.180(f) · TPEA §808 — AKI (2017) · LAST VERIFIED 2026-07-10
PLATE II · FIRST STATE DRAWN UNDER THE AUTHOR’S DIRECTION · VERIFIED AGAINST THE ATLAS DATASET
AWAITING THE AUTHOR’S PASS PLATE III
THE ATLAS CONTINUES PLATE III — THE TRANSPLANT MAP NEXT →