A ProPublica investigation into the state of dialysis care in the United States found "patients commonly receive treatment in settings that are unsanitary and prone to perilous lapses in care. Regulators have few tools and little will to enforce quality standards. Industry consolidation has left patients with fewer choices of provider. The government has withheld critical data about clinics' performance from patients, the very people who need it most. Meanwhile, the two corporate chains that dominate the dialysis-care system are consistently profitable, together making about $2 billion in operating profits a year." For the investigation, ProPublica spent more than a year reviewing inspection reports and conducting interviews with patients, doctors, advocates, policy makers and other experts.