By Karin Hicks, J.D.
Newly released guidance includes instructions for dialysis facilities that treat vulnerable patients with End-Stage Renal Disease.
CMS is committed to helping the U.S. health care system keep patients and health care workers safe during the COVID-19 pandemic. CMS has issued new guidance documents that focus on infection control in a variety of care settings. The updated guidance, based on Centers for Disease Control and Prevention (CDC) guidelines, provides local hospitals and health care systems with infection control instructions and recommendations to prevent the spread of COVID-19 in their facilities. Of particular importance is the new guidance prepared for dialysis centers that will help to protect the vulnerable and immunocompromised patients with End-Stage Renal Disease (ESRD).
Dialysis Facilities. These facilities care for patients who are among the most vulnerable in the U.S. health care system. Patients at dialysis facilities require regular dialysis treatments and are more susceptible to complications from COVID-19. The new CMS guidance includes the option for providing home dialysis services for patients. Additionally, the guidance provides for the establishment of Special Purpose Renal Dialysis Facilities (SPRDFs) which will allow for the isolation of vulnerable or infected patients. The temporary SPRDFs will treat COVID-19 positive dialysis patients in separate locations.
Inpatient Settings. The CMS-issued guidance for hospitals, psychiatric facilities, and Critical Access Hospitals (CAHs) provides new and expanded recommendations on screening patients and staff. The guidance also addresses visitation restrictions, discharge to secondary care locations for patients with COVID-19, and return-to-work policies for COVID-19 positive staff.
CMS guidance also touches upon the Emergency Medical Labor and Treatment Act (EMTALA). Specifically, the guidance addresses the issues of patient triage, medical screening and treatment, the use of alternate testing sites, and telehealth. Medical screening examinations performed at alternate screening locations will not be subject to EMTALA as long as the national emergency remains in place. This allows the facilities to screen for COVID-19 offsite and will prevent further spread of the virus.
Outpatient Settings. The new CMS guidance documents also deliver recommendations to outpatient care centers. The recommended strategies to mitigate transmission of the virus include screening, restricting visitors, and cleaning and disinfection. The documents also address FDA recommendations and encourages the sharing of critical resources during the pandemic.
CMS is committed to monitoring and reviewing the COVID-19 pandemic and will update regulations and guidance as needed.
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