Hospital Conditions of Participation
March 30, 2007 -- 42 CFR Parts 405, 482, 488 and 498 -- Medicare Program; Hospital Conditions of Participation: Requirements for Approval and Re-Approval of Transplant Centers to Perform Organ Transplants; Final Rule (format: PDF, size: 467 kb)
ESRD Conditions for Coverage
Below are some helpful resource materials in understanding and applying the recently released Conditions for Coverage of ESRD Facilities.
April 15, 2008 -- revised ESRD Conditions for Coverage final fule issued in the Federal Register
October 14, 2008 -- effective date of most conditions
CMS Memo: Phasing Implementation of Life Safety Code (LSC) Surveys in End Stage Renal Disease Facilities for Calendar Year 2010
|Patient Care Tech Certification Rules Go Into Effect April 15, 2010
Here are Web Sites Offer Training/Certification Options
April 15 is the effective date for technician certification requirements from the Centers for Medicare and Medicaid Services (CMS). As mandated in the Conditions for Coverage for End-Stage Renal Disease Facilities, patient care techs (PCT) must meet specifications for training and certification. These PCT requirements are listed in §494.140(e), and they are also included in the ESRD Interpretive Guidance, under Subpart D: Administration, §494.140 Condition: Personnel Qualifications.
The ESRD Interpretive Guidance is a guideline for surveyors. Listed below are some of the PCT requirements from the ESRD Interpretive Guidance, along with its corresponding V-tag:
Patient Care Technician Definition – V 692
Any person who provides direct patient care or sets up machines for patient use and is not classified as another professional (i.e., nurse or social worker).
Educational Requirements – V 692
PCTs must have a high school diploma or equivalency.
PCTs with more than four years work experience in dialysis as of October 14, 2008, and who lack a high school diploma or its equivalency, may use work experience in lieu of the diploma/equivalency requirement.
Required Training in the Facility – V 693
PCTs must successfully complete the approved training program offered by their facility or company.
PCTs must demonstrate competency in knowledge and skills by successfully completing a written exam and skills checklists, which are then signed by a registered nurse (RN).
Certification “Required by “dates – V 695
PCTs working on October 14, 2008 must be certified by April 15, 2010.
PCTs hired after October 14, 2008 must be certified within 18 months of their hire date.
Note: If an uncertified PCT moves from one facility to another, the time they were employed in the first facility will count toward their 18 month deadline for certification, unless there is a gap of 18 months in employment as a PCT.
Approved Federal Certifications – V 695
Check these organizations and their Web sites for information on approved certification training and examinations:
- Certified Clinical Hemodialysis Technician (CCHT) exam – offered by the Nephrology Nursing Certification Commission (NNCC), www.nncc-exam.org.
- Certified Hemodialysis Technologists/Technician (CHT) exam – offered by the Board of Nephrology Examiners for Nursing and Technology (BONENT), www.bonent.org.
- Certification Examination in Clinical Nephrology Technology offered by the National Nephrology Certification Organization (NNCO), www.ptcny.com.
For a download of Core Curriculum for the Dialysis Technician, A Comprehensive Review of Hemodialysis (Fourth Edition), got to the Medical Education Institute (MEI), http://www.meiresearch.org/core_curriculum.php
CMS Memorandum -- April 23, 2010 -- Regarding: ESRD Program Survey Guidance on Patient Care Dialysis Technicians Certification
The following information and resources were provided by CMS in a Memorandum to State Survey Agency Directors (format: PDF, size: 875 kb). The summary to the memoradum is supplied below:
- PCT Certification Deadline: April 15, 2010: Centers for Medicare & Medicaid Services (CMS) regulations require certification of PCTs by April 15, 2010, who have been employed in dialysis facilities since October 14, 2008.
- Ongoing Certification Dates: PCTs hired after October 14, 2008, must be certified within 18 months of their date of hire.
- Surveys conducted after April 15, 2010: Surveyors are expected to assess the certification status of the PCTs employed at ESRD facilities for determination of compliance with this requirement.
- Condition level non-compliance: Facilities should be cited at the Condition level if most of their PCTs are not certified as required. Standard or Condition level deficiencies may be cited under the Condition for Quality Assessment and Performance Improvement depending on the extent of the deficient practice. CMS will use administrative sources to verify that a plan of correction will be implemented.
- Attachments to Memo: Two appendices are attached to this memorandum. Appendix A (format: PDF, size: 21 kb) is a compilation of the Frequently Asked Questions (FAQs) about PCT certification which have been received at the ESRDSurvey@cms.hhs.gov mailbox since the publication of the new ESRD Conditions for Coverage. These FAQs provide additional guidance which should be used in making survey decisions. Appendix B (format: PDF, size: 21 kb) is an optional Surveyor Worksheet which may be used by surveyors to collect the information about the certification status of the PCTs.
(format: PDF, size: 157 kb)
Final Rule -- Conditions for Coverage
(format: PDF, size: 1.3 mb)
UPDATE March 2011: Frequently Asked Questions (FAQs)
(format: PDF, size: 723 kb)
Thank you to all of our colleagues in the renal care community who submitted questions to the Centers for Medicare & Medicaid Services (CMS) about our recently released ESRD Conditions for Coverage final rule. In response to these inquires, we have already provided many of you with individual responses to your questions; however, to share the benefit of these questions with the entire community, CMS has developed a "Frequently Asked Questions" document that condenses many of the questions we received from you.
Crosswalk: Former Conditions versus Revised Conditions
(format: PDF, size: 349 kb)
As another tool to help you understand the new Conditions for Coverage, CMS has developed a crosswalk that compares the former conditions to the final revised conditions. The crosswalk will help you navigate the new organization structure of each conditions as well as some revised provisions on the conditions themselves.
Interpretive Guidance: Part 494 -- Conditions for Coverage for End-State Renal Disease Facilities
(format: MS Word, size: 1.1 mb)
Comprehensive Multidisciplinary Patient Assessment (CMPA) Example Questions
(format: PDF, size: 2.3 mb)
UPDATE October 2011: Measures Assessment Tool (MAT)
(format: PDF, size: 94 kb)
Version 1.9, Released October 25, 2011
End Stage Renal Disease Facilities V-Tags & Identifiers
(format: PDF, size: 141 kb)
Version 1.4, Released May 19, 2010
Infection Control and Requirements for Isolation Room/Area
(format: PDF, size: 95 kb)
Patient Assessment and Plan of Care Correlation Grid/Timelines
(format: PDF, size: 80 kb)
Version 1.3, Released May 19, 2010
Chemical Contaminant Levels in Water Used to Prepare Dialysate/Water System Flow Diagram
(format: PDF, size: 144 kb)
Personnel Requirements/National Commercial Dialysis Technician Certification Organization (as of September 2008)
(format: PDF, size: 109 kb)
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