CMS Memo: QSO 18-24-ESRD: Guidance and Survey Process for Reviewing Home Dialysis Services in a Nursing Home (REVISED 3/22/2023)

Memorandum Summary

  • Dialysis Services in a Long-Term Care (LTC) Facility: In 2018, CMS issued guidance that addressed care at home provisions for nursing home residents that were receiving home dialysis. Since that time, CMS has received questions, comments, and feedback from the state survey agencies, the dialysis provider community, as well as other Federal and non-Federal stakeholders. This memorandum addresses those questions and incorporates the feedback that we received.
  • Survey Process for Evaluation of Home Dialysis in an LTC Facility: The End-Stage Renal Disease (ESRD) Core Survey Process has been updated to include additional survey activities which evaluate dialysis services provided by an ESRD facility to residents in an LTC facility.
  • Attachments: Included as an attachment to this memorandum is an advance copy of the survey procedures for ESRD surveyors reviewing dialysis in nursing homes.

Please see the full memo for complete details at