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US · guidance

CMS SOM App. H, Tag V759

§ 494.180(b)(2) A registered nurse, who is responsible for the nursing care provided, is

activein force · 2026-07-22 – presentas-observed

present in the facility at all times that in-center dialysis patients are being treated;

Interpretive Guidance § 494.180(b)(2):

Page 285 of 420

There must be a registered nurse (RN) on duty and available at all times when in-center dialysis

patients are being treated. This requirement is based upon data in the nursing literature which

demonstrates a positive correlation between the availability of professional nursing service and

patient outcomes.

If only one RN is on duty, that RN is expected to spend the majority of their time on the treatment

floor. Short personal breaks away from the treatment floor are acceptable. A RN must be on-duty

whenever patients are present, including the beginning and end of the treatment day.

In some cases, the RN who is on duty may not be qualified under these regulations as a “charge

nurse” See V686-V687. In those instances, if allowed under the applicable State nurse practice

acts, a qualified licensed practical nurse or qualified licensed vocational nurse may function in

the charge role.

History

Rev.

Provenance

Source
cms.gov
Retrieved
2026-07-22
Edition
som-2026-07-22
Content hash
cde405378b0069d0549bb6aa74ebf066b1068294de37721511f332ccfcfe6292
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