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.

Additional Resources
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.