Salem Kidney Center, based in Winston-Salem, N.C., is operated by Health Systems Management, an institution that operates a number of outpatient and acute dialysis facilities. Health Systems Management offers in-center hemodialysis at all its clinics. It also offers a home training program at some of its facilities where individuals are trained to perform continuous ambulatory peritoneal dialysis, continuous cycling peritoneal dialysis, home hemodialysis and nocturnal hemodialysis. The individuals are trained for a period of up to six weeks depending on the modality they choose. The center also provides operational and financial management through a cooperative effort between clinical staff, internal and external auditors, accounts receivable and accounts payable personnel and on-site inventory control agents.