Dialysis in Nursing Homes

The Department of Health (DOH) has issued Dear Administrator Letter (DAL) 18-11 regarding providing dialysis in nursing homes. In 2017, the Centers for Medicare and Medicaid Services (CMS) recognized a new modality of dialysis therapy, Nursing Home Hemodialysis. This service was previously allowed by CMS under Home Dialysis and approved by DOH on a limited basis under the State operating certificate service category of Home Hemodialysis Training and Support. CMS has yet to finalize guidance for federal requirements for the dialysis providers.

A new CMS State Operations Manual (SOM) released in November 2017 includes more detailed requirements for nursing home surveys related to expectations for the performance of dialysis in nursing homes. Based on a review of this recently released SOM for surveys of nursing home hemodialysis, and a further review of the State regulations and the draft CMS guidance for the dialysis providers, DOH is assessing the appropriate process for allowing dialysis in nursing homes. There are currently two models of service delivery being considered by providers: (1) delivery of dialysis at the resident’s bedside, and (2) delivery of dialysis in a dedicated space in the nursing home, also known as a den.

The DAL outlines the two service models and the approval process.

Contact: Elliott Frost, efrost@leadingageny.org, 518-867-8832