CMS SOM App. X, Tag X-053

candidate must receive a psychosocial evaluation, if possible.

Guideline §482.90(a)(1)

An evaluation of each candidate’s psychosocial status must be conducted in all situations in

which it is possible to do so in order to determine suitability for transplantation and/or identify

resources that potentially will be needed for the safe care and discharge of the patient post-discharge. The transplant program must conduct and document the psychosocial evaluation

performed on a potential recipient before their placement on the waiting list. It is expected that

in nearly all cases, a psychosocial evaluation is possible and should be conducted as part of the

determination of whether or not someone would be a suitable transplant candidate. There are

rare or emergency situations when a psychosocial evaluation cannot be completed prior to

transplantation due to the transplant candidate’s medical condition. Justification for not

conducting a psychosocial evaluation prior to a potential recipient’s placement on the waiting list

must be documented in the medical record.

While the transplant program has flexibility in the selection of a specific psychosocial evaluation

tool(s) to be used, it is expected that the psychosocial evaluation would be conducted by

transplant program personnel who have the professional qualifications to administer

psychosocial evaluations, make resultant assessments and make recommendations to the

multidisciplinary team. Evaluations should include, at a minimum, the following:

• Social, personal, housing, vocational, financial, and environmental supports;

• Coping abilities and strategies;

• Understanding of the risks and benefits of transplantation;

• Ability to adhere to a therapeutic regimen; and

• Ongoing psychological issues that may impact the success or failure of organ

transplantation.

The transplant program policy should include the following operational guidelines for ensuring

that the psychosocial evaluation is completed, documented, and reflects the patient’s current

psychosocial status:

• The length of time in which the psychosocial evaluation is deemed to be current and/or

frequency of re-evaluation to determine continued appropriateness;

• The type of qualified professional healthcare personnel (MSW, LCSW, psychiatrist or

psychologist) who may complete these evaluations;

• The follow-up and referral procedures if a transplant candidate requires such activities;

and

• The method of communicating the psychosocial evaluation findings into the selection

process.

• X-054

• (Rev. 200, Issued: 02-21-20; Effective: 02-21-20, Implementation: 02-21-20)

•

• §482.90(a)(2) Before a transplant program places a transplant candidate on its waiting list,

the candidate’s medical record must contain documentation that the candidate’s blood type

has been determined.