Kidney failure presents physical and psychosocial challenges for patients owing to a high symptom burden, multiple comorbid conditions, demanding treatment schedules, and potentially adverse effects on employment, quality of life, socioeconomic status, relationships, and mental health.1 The Centers for Medicare & Medicaid Services (CMS) has long acknowledged—in word, policy, and funding2—that kidney failure has a pervasive and far-reaching impact on patients’ lives. In their 1976 Conditions for Coverage for End-Stage Renal Disease Facilities,2 CMS uniquely mandated that all U.S.