With the ever changing world of reimbursement, it is becoming more difficult to make ends meet in caring for the ESRD population. I am wondering what other hospital based dialysis units are doing in regard to staffing of their chronic HD units? What are the nurse:patient ratio? What are the HDT:patient ratios? Do staff work every other weekend or 3 out of 4 weekends? How are vacations and LOAs covered? If more than 1 unit in your network of facilties, are staff expected to cover in more than 1 unit?