CMS SOM App. H, Tag V584

nurse who meets the requirements of § 494.140(b)(2); and

Interpretive Guidance § 494.100(a)(2):

The nurse responsible for home dialysis training must: be a registered nurse who meets the

practice requirements of the State in which he or she is employed; have at least 12 months

experience in providing nursing care; and, have an additional 3 months of experience working

as a nurse in the specific modality (hemodialysis or peritoneal dialysis) for which the nurse will

provide patient/caregiver training. Refer to V685.

The self-care and home dialysis training nurse position may be filled by an employee or a

contracted nurse who is a registered nurse and meets the clinical experience requirements at

§ 494.140(b)(2). This position is not required to be full-time. However, if the position is part-time, the facility should have qualified personnel assigned for all approved home modalities to

answer questions, respond to patients’ concerns and to troubleshoot problems when the home

training nurse is unavailable.

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While the qualified home training RN(s) is expected to be the primary staff member providing

training and support whether training occurs in the dialysis facility or in the patient’s home,

other members of the clinical dialysis staff may assist in providing the home training, within the

scope of practice and expertise/competencies of those staff members. For example, another nurse

might reinforce earlier training done by the qualified home training RN; the dietitian might

educate the patient about food and fluid limits based on the type of home dialysis treatment; the

social worker might offer suggestions for keeping one’s job or coping with any stress potentially

created by home treatment; and, the biomed staff might coach the patient/caregiver in

troubleshooting equipment. The qualified home training RN is responsible to ensure that allof

the training is in accordance with the requirements listed in this Condition.

Use V685 for the failure to have a qualified nurse; use this tag if the qualified nurse is not

primarily responsible for conducting the training.