Is Your Dialysis Clinic ESRD Survey-Ready?

Is Your Dialysis Clinic ESRD Survey-Ready?

In order to receive Medicare reimbursement, dialysis facilities must comply with ESRD facility certification requirements. State agencies survey all Medicare-certified facilities for ESRD Conditions for Coverage compliance to ensure that the facility provides quality care to all patients.

Being ESRD Survey-Ready means that all functions of your dialysis facility are performing day-to-day activities while maintaining compliance standards and a high quality of care for the patients. Because of changing trends and extensive ESRD survey requirements, preparing properly for the survey could seem like a daunting task for your dialysis team. Understand and apply these helpful tips in order to eradicate doubts and create an effective survey:

  • Create a culture of safety by defining specific behaviors that the dialysis team and patients can practice daily. Contact us for a free review if you would like expert advice
  • Conduct a mock survey annually (at a minimum) and flag items not in compliance
  • Assign a staff member to each item not in compliance in order to take charge of improvements. For example: assign your dietitian for infection control, your nurse for patient care process, another staff member for P&P adherence, etc
  • Work with your team to define action steps and a timeline for changing noncompliant ESRD practices For example: if the infection rate among patients is trending negatively, identify root causes (e.g. low rates of hand washing among staff or inadequate cleaning of chairs between patients)
  • Conduct regular meetings with your team to discuss all areas in noncompliance and their progress to meet the standards
  • Track clinic process and document. For example: track the number of hand washing audits and show that the process is improved.
  • Evaluate the new processes monthly and change those that didn’t work
  • Inform your whole team about the changes and updates in real time and seek their input
  • Keep your patients updated on all of the positive changes
  • Sign up with CMS communications to stay up-to-date with changes and updates

Important elements of the ESRD survey include:

  • Policies and Procedures compliance
  • Patient care process ensuring safety
  • Clinical measures outcomes confirming high quality service
  • Water treatment management
  • Employees orientation and competency management process
  • DFR and QIP review

For more information on dialysis facility survey process, click here. If you are interested in our FREE survey checklist, please complete the contact form below.


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