DaVita’s Top-User Water Efficiency/Management Program


DaVita provides kidney care to patients nationally at 2,600 treatment centers. The dialysis process is extremely water-intensive and water quality is critical to patient care. On average, 153 gallons of water are utilized per dialysis treatment and DaVita performs over 25 million treatments each year. The company set environmental goals in 2016 and updated them in 2021 to include saving 240 million gallons of water through implementation of water efficiency projects by 2025. To help achieve this goal, DaVita created the Top 150 Water Users program. This program is foundational and considered “low hanging fruit” – it is also an iterative project that will be in existence for years to come. DaVita continues to monitor system operations and identifies opportunities to refine use and systematic procedures and technology.

DaVita’s Sustainability Department conducted an analysis of its 2,600 treatment centers and noticed that 11 percent of the total water use could be attributed to 150 facilities. While the average dialysis center uses 153 gallons per treatment, some of the centers in the top 150 were using more than 400. Instituting the Top 150 Water Users program would establish a continuous cycle of working through inefficiencies across DaVita’s portfolio, leading to progress in achieving their water reduction goal. Once it was determined there was a significant value to reduce water usage at these facilities, the Sustainability Department presented the program to their clinical operations team.


The Sustainability Department pulls a monthly list of the top 150 water users and analyzes consumption and cost data to assess data accuracy and pinpoint variances in performance trends. In one instance they found that the top user was being mis-billed for nearly nine years, resulting in a $180,000 refund. By continuously evaluating data quality, DaVita can identify opportunities to control costs, address leaks, and perform preventative maintenance.


The Biomedical team – which is responsible for purifying and treating the water before its use in dialysis treatment – and Sustainability Department then work to develop water use optimization strategies for the targeted 150 facilities. Clinics are evaluated to implement to an optimized frequency and duration of pre-treatment backwashing and regeneration procedures needed for facilities water treatment needs. After the team confirms these centers are following standard operating procedures related to optimizing flow or backwashing, the Biomedical team and Sustainability Department evaluate water performance trends per treatment and assess opportunities to implement water reduction strategies. The primary goal is to make sure that the targeted 150 facilities are reaching the current average of 153 gallons per treatment, in addition to look at all centers to understand why their usage is out of expected range. Once this is achieved, they aim to get these centers to DaVita’s 2020 goal of less than 100 gallons per treatment. This requires ongoing monitoring as water systems change, as do treatments. DaVita will continue to evaluate and examine excess water consumption in processes.

Additional water reduction strategies that have been implemented include the “Water Surge” program, which was kicked off in 2019 across all of DaVita’s centers. This program encourages all centers to report any and all leaks in order to establish a “see something, say something” culture. By addressing leaks, DaVita empowers their facilities to identify areas that are not only wasting water but could possibly be impacting occupant health. To encourage participation in the program, centers that find leaks are entered into a contest to win a “breakroom makeover.” 

Since 2013, DaVita has saved 645 million gallons of water through water optimization projects. As DaVita continues to work towards their 2020 goal of reducing water by 30% per dialysis treatment, they plan to relaunch “Water Optimization 2.0” in efforts to improve the efficiency of water used during the backwashing process. Additionally, the Top 150 water users will be re-assessed and educational strategies will be used to engage on-site staff in creating a culture of responsibility around water reduction. One of our core values is Continuous Improvement and patient safety and impact is our number one priority. With this in mind, DaVita continues to be innovative to reduce water consumption.

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Tool type:

Energy Management Program

Building Type:



Water Efficient Equipment


Needed to optimize water use processes 


Developed program that identifies and optimizes high water users to reduce portfolio-wide dialysis center water consumption.