Conditions for Coverage, State Survey & Certification

The ESRD CfCs are the minimum health and safety rules that all Medicare and Medicaid participating dialysis facilities must meet.

The April 15, 2008 ESRD Conditions Final Rule modernizes Medicare's ESRD health and safety conditions for coverage and updates CMS standards for delivering safe, high-quality care to dialysis patients. The revised regulations are patient-centered; reflect improvements in clinical standards of care, the use of more advanced technology, and, most notably, a framework to incorporate performance measures viewed by the scientific and medical community to be related to the quality of care provided to dialysis patients.

• CMS Survey & Certification - Guidance To Laws & Regulations for Dialysis
• Conditons for Coverage
• Medicare ESRD Center
• Chemical Contaminant Levels In Water Used To Prepare Dialysate And Water Flow Diagram
• CDC Guidelines for the prevention of intravascular catheter-related infections
• Clinical Staff Responsibilities (RN, LPN, PCT)
• Conditions for Coverage and Involuntary Patient Discharge/Transfer
• Dialysis Lab Tests At a Glance
  
• End Stage Renal Disease Facilities V-Tags & Identifiers
• ESRD Final rule 4/15/08
• Infection Control and Requirements for Isolation Room/Area
• Interpretive GLs
• Involuntary Discharge Letter from the DOH
  
• Measures Assessment Tool (MAT 2.0 Updated 05/01/2012)
  
• Outline of the Basic ESRD Survey Process
  
• Patient Care Technician Certification Information

Survey & Certification: CMS Guidance to State Surveyors on Laws & Regulations for Dialysis Facilities

It includes links to applicable laws and regulations, and provides resources to support and assess compliance with Federal regulations.

This page provides basic information related to survey and certification of dialysis facilities for ESRD surveyors.

Including current documents on:

1. ESRD Program Interpretive Guidance Manual is in three parts: a computer identifier tag ("V tag"); the wording of the regulation; and the guidance in interpreting the regulation. For ease of navigating the Interpretive Guidance, the Conditions are hyperlinked so you can click on the page number for the Condition in the Table of Contents to navigate to that page.
2. ESRD State Operations Manual (under construction)
3. Surveyor Optional Worksheets & Tools: Acronyms & Abbreviations, CMS 2567 blank form and interview guides and worksheets
4. Surveyor "Laminates" are abbreviated survey guidance
   • Measures Assessment Tool (MAT): 2-page summary of the standards used in assessing compliance with requirements used throughout the regulations formatted in 5 columns to include the referenced V tag, the measure, the expected value(s), reference for the value(s), and where the surveyor should find the information during a survey Helpful Web Sites for ESRD Surveyors: 2-page listing of recommended Web sites inside and outside CMS
   • Outline of the Basic ESRD Survey Process: 4-page list of tasks in the survey process End Stage Renal Disease Facilities V-Tags & Identifiers: 3-page list of V-Tags and Aspen identifiers along with Condition statements from the Interpretive Guidance
   • Infection Control/Requirements for Isolation Room or Area: 2-page description of V-tags and descriptors plus requirements for all facilities, existing facilities and new facilities
   • AAMI RD52 Table 4/Water Chart Decision Tree: Two documents adapted from AAMI RD 52, Table 4 and Figure 1, to include the V-tag, the item to monitor, what to look for, how often to monitor, special interval, normal interval and specification
   • Chemical Contaminant Levels in Water Used to Prepare Dialysate/Water System Flow Diagram: 2-page summary of the ANSI/AAMI RD 62 water levels and a diagram of a typical water system
   • Correlation Grid of Patient Assessment & Plan of Care/Timelines for Patient Assessment & Plan of Care: 2-page summary showing the relationship between patient assessment and plan of care requirements plus expected frequency of patient assessments and plans of care based on whether the patient is on in-center or home dialysis, new, transferred/transient, changing modality, stable or unstable
   • Personnel Requirements/National Commercial PCT Certification Organizations: 2-page summary of requirements for staff of a dialysis facility plus information on national commercial dialysis technician certification organizations
   • Principles of Documentation Overview: 2-page adaptation of the Principles of Documentation, the guidance surveyors must use in writing deficiency statements adapted from (Exhibit 7A), in the CMS State Operations Manual
   • Dialysis Lab Tests At a Glance: 2-page listing of common blood tests for people on dialysis, to include normal values, expected values in someone with kidney disease, and signs/symptoms if values are too high or too low
5. Survey & Certification Letters related to dialysis: PureFlow, initial survey, waivers and phase in, Life Safety Code