CMS SOM App. H, Tag V666

The facility must contact the patient’s physician,

if possible, prior to initiating dialysis in the special purpose renal dialysis facility, to discuss

the patient’s current condition to assure care provided in the special purpose renal dialysis

facility is consistent with the patient plan of care (described in § 494.90).

Interpretive Guidance § 494.120(d):

The facility must contact the patient’s physician prior to initiating care in the SPRDF to update

that physician on the status of the patient and to coordinate the patient’s plan of treatment. In the

event of a natural disaster, the facility must make every effort to contact the patient’s physician;

however, when it is impossible to contact or communicate with that physician, emergency

dialysis care must be provided. In this situation, the SPRDF should have standard orders for

dialysis, diet/fluids, and medications that the medical director of the SPRDF could prescribe

until they communicate with the patient’s attending physician.