Per the CDC, the prevalence of CKD in adults aged 30 years or older is expected to increase from 14.4% in 2020 to 16.7% in 2030. For those progressing to End-Stage Renal Disease (ESRD), dialysis is a crucial intervention to prolong life. While you may already be providing care and services to this demographic, it can be inferred that the number of individuals in need of dialysis will continue to rise.

In FY 2019, 6.6% of SNF/NF providers were cited for deficient practice at F698 – Dialysis. Common areas of concern included weight measurements, access site care, and pre- and post-treatment monitoring.

F698 deficiencies for FY2021 have included:

      • 107 citations nationally
      • 86 D level
      • 14 E level
      • 2 Harm (Gs)
      • 5 IJs (4 J & 1 K)
      • IJs=1 IL, 2 OH, 1 OK, 1 CA

Examples of IJ citations include:

      • IJ cited related to a resident going 9 days without dialysis after testing + for COVID due to the facility’s failure to communicate and coordinate continuity of care with the dialysis center; as well as the failure to notify the physician & family that the resident did not receive ordered treatments, in addition to the failure to transport the resident to dialysis treatments. The resident was transferred to the hospital and subsequently passed away
      • IJ cited related to failing to ensure dialysis services were provided consistent with professional standards of practice for two residents when a licensed nurse performed peritoneal dialysis (PD) without written orders from a Nephrologist, performed PD without having been trained by nurses from a certified dialysis center, and failed to perform adequate pre & post PD assessments. In addition, the facility did not have approved, specific PD policies and procedures based on current standards of practice.

Whether providing dialysis services on-site, or otherwise caring for those who receive dialysis elsewhere, providers are expected to ensure that residents who require dialysis receive such services, consistent with professional standards of practice, the comprehensive person-centered care plan, and the residents’ goals and preferences. Navigating the clinical complexities, documentation demands, and regulatory requirements can seem daunting.

Would your team benefit from advancing skills and facility systems related dialysis? Join Proactive Medical Review on April 20th or 21st for Care of the Dialysis Recipient. This session will review regulatory requirements and best practices specific to the resident receiving in-house or offsite dialysis with guidance on pre- and post-treatment monitoring protocols. Through lecture and case study analysis we will identify critical nursing assessment and documentation principles to apply in your daily practical operations to promote resident well-being and minimize potential risks.

Join Proactive for the Care of the Dialysis Recipient webinar in April. 

Review requirements specific to residents receiving in-house or offsite dialysis with guidance on pre and post treatment monitoring protocols.

Blog by Eleisha Wilkes, RN, RAC-CTA, RAC-CT, DNS-CT, Proactive Medical Review

Click here to learn more about Eleisha and the rest of the Proactive team.