Management LLC

Create The Right Alliance &
Achieve Regulatory Success


Debra Punch, MBA, RN, CDN

Debra Punch is Founder and President of Alliance Management, LLC, an End Stage Renal Disease (ESRD) consulting firm.  Alliance Management, LLC, founded in the year 2000, specializes in Mock Department of Public Health (DPH) inspections, new facility start-ups and administrative recommendations for improving the quality of care and financial performance.

Debra's wide ranging experience includes large integrated hospital healthcare systems, independent dialysis corporations and renal management projects. Her expert familiarity with federal and state regulatory requirements takes Debra all over the country in her consulting role.

Ms. Punch is a nephrology nurse who is a featured speaker and has published several articles for ESRD trade publications.  Ms. Punch has served on the California Dialysis Council (CDC) Board of Director’s since 1990 and has served as the President-Treasurer for the council.  She has been the CDC’s Chairperson for the PCT State Exam since 2008.  Ms. Punch was the grant recipient for the American Nephrology Nurses Association for the “Nurse in Washington” program and has served on the Quality Committee for National Renal Administrators Association since 2007.

Our Process


We begin by assessing the current  working environment.


We develop goals and plans for achieving those strategic outcomes.

Implement Plans

Following our strategic goals, we set-up clear and organized processes.

Project Completed

A collaborative process, with achievable outcomes.

Got Problems?

We Have Solutions!

Frequently Asked Questions

These are just a few of the questions we get frequently.

Please let us know if other questions come up for you. You are welcome to us our Contact Form below.

  •  Nephrologist Medical Director
  •  Business Corporation or Limited Liability Company established
  •  Potential facility location
  •  Dialysis experienced construction company
  •  Dialysis Project Manager, for example, Alliance Management.

There is no set timeline that has been established by state or federal licensing.

Each project is a unique situation and timeline.  Currently in California, the average timeline is 2 years from construction to state licensing.

Yes, Alliance Management has vast experience with post DPH inspections.

Alliance Management works with staff to improve compliance, processes and writing the response report.

  • Alliance Management has a program to mentor new Clinical Manager’s with learning the Conditions for Coverage, Quality Assessment Performance Improvement, Water Safety, HIPAA, Infection Control, Quality Incentive Program and Staff Management.

Alliance Management has an hourly fee for consulting time and established set pricing for support material services, ie., manuals. For more information, send us a message.

our Solutions for you

Alliance Management, LLC realizes that each project is unique.  
The services listed below are the popular and most requested dialysis services.  
Please feel free to discuss with us other renal projects.

Facility Development

Dialysis Facility Services

DPH & CMS 855 Applications
Policy & Procedure Manuals

  • In-Center & Home Hemodialysis
  • Peritoneal Dialysis
  • Hospital Acute Dialysis Services
  • Chronic Kidney Disease Clinic

    Clinical/Operational Management Review

  • Financial Viability
  • Revenue Enhancement Review
  • Quality Incentive Program
  • Expense Management

    Strategic Business Planning

    Mentorship Program
  • Administrator
  • Nurse Manager
  • QAPI Nurse

Mock DPH Inspections

Mock Inspection Services

  • Clinical Best Practice Standards
  • Regulatory Compliance Audits
  • Conditions for Coverage
  • Compliance Checklist
  • V codes vs Internal policy
  • Life Safety Codes

    Infection Control Compliance Program

    CIPA/Plan of Care

    QAPI Program

    Technical/Water System Reviews
  • Daily Water Check Logs
  • MonthlyTechnical Audit

  • Medical Director Orientation

Get in touch

When You Have Questions, We Have Answers. Let us know what your individual concerns are and we will respond in a timely manner. If It’s Important To You, It’s Important To Us!