Final Rule to Increase Quality of Care for Individuals with End-Stage Renal Disease

Earlier this month, the Centers for Medicare and Medicaid Services announced a “final rule” to increase care of Medicare recipients with End-Stage Renal Disease.  The rule, according to CMS, “will modernize the Medicare conditions for coverage for the nation’s dialysis centers and promote a higher quality of care for patients receiving dialysis”.  It is intended to impact over 4700 renal dialysis amenities throughout the country. 

The new rule will diminish the some of the redundant, time consuming previous requirements of dialysis facilities and instead focus on improving patient care.  The safety and rights of patients, as well as their participation in their health care plans, are all outcomes of the rule.

 Each facility will be responsible for creating a QAPI program, or “quality assessment and performance improvement” program in order to assure improvement in patient care. They will all also be required to have defibrillators on hand, upgrade fire safety standards, increase patient infection control procedures, promote safer water for dialysis, and implement minimum qualifications for patient care technicians.  In order to protect patient rights, it will be mandatory to inform recipients of their right to have advance directives, to apply a clear and standardized grievance process, to create a personalized patient plan of care, and to give a 30 day written notice before discharging a patient involuntarily. Facilities will need to complete a comprehensive patient assessment for each patient, based both on the patient’s needs and the advances in current medical practices. 

 Adherence to the new rule will be necessary for dialysis facilities to continue to be certified by Medicare.   It will improve the quality of life and the standard of care for over 336,000 Medicare recipients who have End-State Renal Disease.