DOH Unveils New Licensure Model for Dialysis Delivery in Nursing Homes
The Department of Health (DOH) held a webinar on June 19th to discuss their proposed model for licensing dialysis services in nursing homes. LeadingAge NY participated in the discussion, which may be of interest to several members.
By way of background, in August 2018, the Centers for Medicare and Medicaid Services (CMS) released guidance for a new modality, Home Hemodialysis in Long Term Care, to allow dialysis to be provided in nursing homes. This service was previously allowed by CMS under Home Dialysis and was licensed by DOH on a limited basis under the State operating certificate service category of Home Hemodialysis Training and Support. A new CMS State Operations Manual (SOM) update released in November 2017 includes more detailed requirements for federal long term care surveys in nursing homes performing dialysis on-site. The SOM for surveys of End Stage Renal Dialysis (ESRD) was also updated to include a review of any care provided in nursing homes.
There are currently two new 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 treatment room. Both require the involvement of a certified dialysis provider. To date, one dialysis provider has been approved to provide hemodialysis in dedicated spaces in four nursing homes. Applications for performing dialysis at the resident’s bedside have continued to be accepted and approved, pending development of the new DOH licensure model.
DOH’s proposed licensure process will require nursing homes seeking to offer services on-site to submit a Limited Review Application (LRA) through NYSE-CON, the State’s electronic Certificate of Need submission system. The process will allow the two categories of service noted above – bedside and/or dedicated treatment space – to be provided in nursing homes. Each nursing home at which services will be provided will need to submit an LRA to add the appropriate hemodialysis service to its operating certificate.
More details are provided in the webinar slides. DOH plans to provide a detailed communication, together with frequently asked questions, to providers when it launches the program in the fall.
Contact: Dan Heim, dheim@leadingageny.org, 518-867-8866