CMS SOM App. H, Tag V764

The governing body is responsible for ensuring

that the dialysis facility furnishes services directly on its main premises or on other

premises that are contiguous with the main premises and are under the direction of the

same professional staff and governing body as the main premises (except for services

provided under § 494.100).

Interpretive Guidance § 494.180(d)

Each separate physical location for dialysis services must be certified separately, and all

approved services for a particular facility must be provided on the premises of that location

(with the exception of dialysis care at home). Hospital-based facilities may be located on the

same campus of the hospital, with various services (e.g., home training vs. in-center dialysis)

being provided in different rooms or areas, but sharing the same address on that campus.

All services provided by the facility must be under the direction of the same professional staff

and governing body. Training and support for home dialysis must be provided by a facility

certified for those services. On occasion, some home training may be provided in the patient’s

home to meet the needs of the patient and/or caregiver.

Training for care at home is discussed at V582 through V585. Home patients may see their

physicians or a non-physician practitioner (i.e., advanced practice registered nurse or physician

assistant) in their offices instead of seeing these practitioners at their dialysis clinics. In-center

patients may, on occasion, see their practitioner in their offices, while periodically seeing their

practitioner during treatment at the dialysis facility. This requirement can be found under the

Condition for patient plan of care at V560.