Beneficiaries will benefit by the following updates in the rule:

· Adopts updated Centers for Disease Prevention and Control (CDC) guidelines for hemodialysis facilities to increase patient infection control procedures.


· Adopts updated American Association for Medical Instrumentation (AAMI) water quality guidelines to promote safer water for dialysis use.

· Requires defibrillators in every dialysis facility, to allow facility staff to respond rapidly to individuals that may be having a heart attack.

· Incorporates sections of the 2000 Life Safety Code, which upgrades fire safety standards.

· Expands patient rights protections, including:

A requirement to inform beneficiaries of their right to have advance directives,

A facility-level grievance process that explains how a facility must respond to a patient's grievance, and

A policy that provides a 30-day written notice to the patient before a facility can involuntarily discharge a patient.

· Requires a comprehensive patient assessment based on current medical practices and the patient's unique needs.

· Requires a personalized patient plan of care, based on current standards of care

· A facility-level quality assurance and performance improvement (QAPI) program to demonstrate how the facility will improve the quality of care it provides to patients.

· Minimum qualifications and training requirements for patient care technicians.

· Increases Medical Director involvement in the outcomes of the QAPI program and involuntary transfers or discharges.

The final rule meets CMS's overall goal of protecting patient safety, enhancing ongoing quality improvement, and improving patients' experience receiving dialysis services. CMS continues to work to improve the quality of health care by measuring and improving outcomes of care, educating health care providers about quality improvement opportunities, and educating beneficiaries to make good health care choices.

The final rule is displayed at: www.cms.hhs.gov/CFCsAndCoPs/downloads/ESRDdisplayfinalrule.pdf



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