CMS SOM App. H, Tag V770

provide inpatient care, routine and emergency dialysis and other hospital services, and

emergency medical care which is available 24 hours a day, 7 days a week. The agreement

must:

(i) Ensure that hospital services are available promptly to the dialysis facility’s patients

when needed.

(ii) Include reasonable assurances that patients from the dialysis facility are accepted and

treated in emergencies.

Interpretive Guidance § 494.180(g)(3)(i) and (ii):

In order to protect dialysis patients who may need emergent hospital services, there must be an

agreement with a hospital that can provide inpatient dialysis care, furnish emergency dialysis

services, as well as routine care. This could be in the form of a letter from the hospital

acknowledging their agreement to this requirement, or a more formal document signed by

representatives of both the dialysis facility and the hospital. The hospital does not have to be

certified as an ESRD provider, but must be able to provide inpatient dialysis treatment as well as

emergency care and other hospital services to meet the patient’s needs.

It is not required or expected that every patient admission would be to the hospital with whom

the agreement is signed.