Although an in-center hemodialysis facility is primarily perceived as a provider of health care, it is also a business that requires a leader. Analogous to the “Triple Aim” of the health care system envisioned by the Centers for Medicare & Medicaid Services (CMS), each hemodialysis facility has its own triple aim: (1) providing each patient with a safe, high-quality, pleasing experience of care; (2) complying with CMS’s certification requirements; and (3) ensuring that the facility remains financially viable.