CMS SOM App. H, Tag V685

§ 494.140(b)(2) Self-care and home dialysis training nurse. The nurse responsible for self-care and/or home care training must—

(i) Be a registered nurse; and

(ii) Have at least 12 months experience in providing nursing care and an additional 3

months of experience in the specific modality for which the nurse will provide self-care

training.

Interpretive Guidance § 494.140(b)(2)(i) and (ii):

The requirement at §494.100(a)(2) requires the home training to be conducted by a registered

nurse. “Responsible for …training” means that the registered nurse must be in charge of and

provide self-care and home dialysis training for dialysis patients and/or their caregivers. A staff

member, other than the registered nurse responsible for home training, may re-educate the

patient on certain portions of the training program. In these situations, delegated tasks may not

be new material and the delegated task(s) must be consistent with the scope of practice laws and

limitations set by the State in which they practice. For example, due to the specialized training

that a PCT receives in the operations of a dialysis machine, they may provide the home dialysis

patient additional education for cleaning the machine and how to respond to alarms.

Additionally, the registered nurse that is responsible for the home training program must

maintain oversight of any delegated portions of the training program to ensure training activities

are consistent with facility policies.

For example, the home training nurse

The registered nurse responsible for self-care and the home dialysis training must have at least

12 months experience as a registered nurse, plus 3 months experience as a registered nurse in

the specific modality of hemodialysis (HD) and/or peritoneal dialysis (PD). If one registered

nurse is responsible for both the HD and PD programs, that nurse must have 12 months

experience as a nurse plus at least three months experience in each respective modality.