CMS issued QSO-18-24-ESRD REVISED 3/22/2023 clarifying care delivery flexibilities and responsibilities for home dialysis services in nursing facilities (NFs).

• The memo was effective as of its issue date, March 22, 2023.
• AHCA has prepared a member-only summary of the guidance.

Why it matters: CMS notes that the characteristics of persons residing in NFs who need 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 NF residents addresses certain disadvantages of in-center dialysis, such as transportation times and disruption of the resident’s daily activities.

The survey guidance is directed at assuring the dialysis provider responsible for the home dialysis furnished in the NF meets their regulatory responsibilities.

• However, NFs that arrange for dialysis providers to furnish these services in the NF should become familiar with the guidance due to the increased emphasis on care coordination between the dialysis provider and the NF.

Questions may be directed to ESRDQuestions@cms.hhs.gov.