CMS SOM App. H, Tag V589

§ 494.100(c) Standard: Support services. (1) …Services include, but are not limited to, the

following: (i) Periodic monitoring of the patient’s home adaptation, including visits to the

patient’s home by facility personnel in accordance with the patient’s plan of care.

Interpretive Guidance § 494.100(c)(1)(i):

To assess a patient’s home dialysis environment, a home visit should be conducted at the

initiation of home therapy and whenever a problem is identified with either patient health or

equipment that could be related to treatment at home. Periodic routine replacement of equipment

would not necessarily require a home visit be scheduled. The IDT may designate the most

appropriate staff member(s) to make the home visit(s).

Documentation of home visits should be included in the medical record. The number, timing, and

frequency of home visits should be based on individual patient need as indicated in the patient’s

plan of care. Distance from the facility or concerns about staff safety should not preclude home

visits. If a patient refuses a home visit, the IDT must evaluate their refusal and the potential

impact it may have on achieving the goals identified in the patient’s plan of care as well as

discuss alternative ways to ensure the patient’s health and safety at home.