Dialysis

The Survey and Certification Program certifies ESRD facilities for inclusion in the Medicare Program by validating that the care and services of each facility meet specified safety and quality standards, called "Conditions for Coverage." The Survey and Certification Program provides initial certification of each dialysis facility and ongoing monitoring to ensure that these facilities continue to meet these basic requirements.

This page provides basic information related to survey and certification of dialysis facilities for ESRD surveyors and dialysis providers. It includes links to applicable laws and regulations, and provides resources to support and assess compliance with Federal regulations.

1. ESRD Program Interpretive Guidance Manual Version 1.1 (10/08) is formatted as a three column table: a computer identifier tag (“V tag”); the text of the regulation; and the guidance for interpreting the regulation. For ease of navigating the Interpretive Guidance, the Conditions are hyperlinked so you can click on the page number for the Condition in the Table of Contents to navigate to that page.

2. CMS 3427 ESRD Application/Notification and Survey/Certification Report (Expiration date 10-31-2019): is completed by facility and reviewed by the surveyor for Medicare certification/recertification for a new facility, existing facility, expansion of stations/services, relocation, or change of ownership

3. ESRD Core Survey Field Manual Version 1.9 and Individual Tools & Worksheets: contains the full ESRD Core Survey Field Manual plus individual tools and worksheets,including the ESRD Core Survey Process task descriptions (REV), copies of key survey laminates (REV), FY2017 Core Survey Data Worksheet, CMS 3427, a sign to announce the survey, Entrance Conference Questions, Observations of Hemodialysis Care and Infection Control Practices checklists, Patient Roster, Water Treatment and Dialysate Review Observation & Interview worksheet, Reuse: Observation/Interview Review worksheet, Machine/Equipment Maintenance Technician worksheet, patient and personnel interview worksheets, Medical Record Review worksheets (3 REV), Personnel Record Review worksheet, and the Quality Assessment and Performance Improvement Review Worksheet (REV), that can be used by surveyors and providers to monitor care REVISED

4. FY2018 ESRD Core Survey Data Worksheet should be used for all recertification surveys in FY2018 and includes updates to the thresholds table (Version 1.8)

5. ESRD Surveyor “Laminates” are abbreviated survey guidance