CMS SOM App. H, Tag V587

The dialysis facility must – (2) Retrieve

and review complete self-monitoring data and other information from self-care patients or

their designated caregiver(s) at least every 2 months; and

(3) Maintain this information in the patient’s medical record.

Interpretive Guidance § 494.100(b)(2) and (3):

Page 232 of 420

The dialysis facility must obtain and maintain records on all home patients including at a

minimum, treatment records, flow sheets, medications administered, and, equipment and water

treatment system checks, if applicable. The facility is responsible to ensure that records of

dialysis treatments in the home setting are retrieved and reviewed by the appropriate personnel

at least every 2 months. Such review assists staff in monitoring home patients’ status by

determining if patients are following their treatment plans and/or having problems with their

dialysis at home. When home hemodialysis or peritoneal dialysis machines have the capacity for

interactive electronic documentation of the treatment data, the facility may obtain these data

electronically, if the security of the electronic submission is in accordance with HIPAA privacy

regulations, or from the patient, through a disc/card brought to the facility.

Home dialysis patients’ medical records must include dialysis treatment records and evidence of

their timely review by home dialysis personnel. If the patient or caregiver has not provided the

appropriate records at least every 2 months, reasonable efforts by facility staff to obtain these

records must be made and documented. The patient’s plan of care should address any problem

with adherence to this requirement. The applicable facility staff member (generally either the

nurse responsible for home training, the attending physician, or a non-physician practitioner

[i.e., advanced practice registered nurse, or physician assistant]) is responsible for review upon

receipt of such time sensitive information as hospitalization data and radiology, pathology, and

laboratory results that cannot wait 2 months for review.