CMS SOM App. H, Tag V757

The governing

body or designated person responsible must ensure that— (1) An adequate number of

qualified personnel are present whenever patients are undergoing dialysis so that the

patient/staff ratio is appropriate to the level of dialysis care given and meets the needs of

patients; and . . .

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Interpretive Guidance § 494.180(b)(1):

There must be sufficient numbers of qualified and trained staff on duty while patients are on

dialysis in-center to meet the individualized needs of the patients. Consideration should be given

to the acuity and care needs of patients, staff experience and areas of expertise when evaluating

the adequacy of staffing. Sufficient numbers of staff must be present in the treatment area to be

able to see every patient during treatment (including lunch breaks, shift change, etc.[refer to

V407]); to deliver routine care, patient assessment and monitoring per facility policy; and to

promptly respond to and address patient needs (such as changes in physical or mental condition)

and machine alarms. Staffing assignments and schedules should demonstrate a pattern of

sufficient staff coverage to ensure safe patient care.

Facilities are expected to meet any applicable State regulations that identify specific patient-to-staff ratio requirements. Failure to comply with those State patient-to-staff requirements may be

cited at this tag.