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US · guidance

CMS SOM App. H, Tag V270

§ 494.40(b)(2)(ii) - If the test results from the last component or carbon tank are greater

activein force · 2026-07-22 – presentas-observed

than the parameters for chlorine or chloramine specified in paragraph (b)(2)(i) of this

section the facility must—

(A) Immediately take corrective action to bring chlorine or chloramine levels into

compliance with paragraph (b)(2)(i) of this section and confirm through testing that the

corrective action has been effective, or terminate dialysis treatment to protect patients

from exposure to chlorine/chloramine;]\

Interpretive Guidance § 494.40(b)(2)(ii)(A)

“Corrective action” here could include backwashing carbon tanks, rebedding or replacement of

the tanks, or addition of an adjunct system such as chemical injection to address an extremely

high chlorine or chloramine load from the municipal supplier. In any case, testing must confirm

acceptable levels of chlorine/chloramine before dialysis treatments can resume. It could be

necessary to reschedule patient treatments, or for patients to be transferred to another facility

for one or more treatments.

History

Rev.

Provenance

Source
cms.gov
Retrieved
2026-07-22
Edition
som-2026-07-22
Content hash
4945d21242d7367360562cefe63fda0726b464f46824581b6a3ea69d650263d2
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