CMS Updates Guidance for Home Dialysis Furnished in Nursing Facilities and Clarifies Care Delivery Flexibilities and Responsibilities

CMS; Clinical Practice

On March 22, the Centers for Medicare and Medicaid Services (CMS) Center for Clinical Standards and Quality/Quality Safety Oversight Group issued a long-awaited revised 21-page Guidance and Survey Process for Reviewing Home Dialysis Services in a Nursing Home (Rev QSO-18-24-ESRD) to State Survey Agency Directors. The effective date is immediately. 

CMS notes that the characteristics of persons residing in nursing facilities requiring dialysis, such as age and multiple comorbidities, increase their risk of experiencing adverse health and safety events, such as hospitalization, infection, and death. Offering home dialysis as a treatment option for nursing home residents that addresses certain disadvantages of in-center dialysis, such as transportation times and disruption of the resident’s daily activities.  

While the survey guidance is directed at assuring the dialysis provider responsible for the home dialysis furnished in the nursing facility is meeting their regulatory responsibilities, nursing facilities that arrange for dialysis providers to furnish these services in the nursing facility should become familiar with this updated guidance due to the increased emphasis on care coordination between the dialysis provider and the nursing facility.

AHCA is grateful to several members that provided significant insights to CMS about challenges and opportunities that were incorporated into this updated guidance.​ AHCA has compiled a member-only detailed summary of this updated guidance.