End-stage renal disease facility
An end-stage renal disease facility (ESRD facility, dialysis facility, or dialysis center) is a medical facility that operates to assist people with irreversible loss of kidney function (stage five), requiring a regular course of dialysis or a kidney transplant to survive. The facility may operate independently, as part of a hospital-based unit, or as a self-care unit that furnishes only self-dialysis services.
ESRD facilities in the United States
In 1972 the United States Congress passed legislation authorizing the End Stage Renal Disease Program (ESRD) under Medicare. Section 299I of Public Law 92-603, passed on October 30, 1972, extended Medicare coverage to Americans if they had stage five chronic kidney disease (CKD) and were otherwise qualified under Medicare's work history requirements. The program officially launched on July 1, 1973. Previously only those over 65 could qualify for Medicare benefits. This entitlement is nearly universal, covering over 90% of all U.S. citizens with severe CKD.
- Renal transplantation center - "a hospital unit which is approved to furnish, directly, transplantation and other medical and surgical specialty services required for the care of ESRD transplant patients"
- Renal dialysis center - "a hospital unit that is approved to furnish the full spectrum of diagnostic, therapeutic, and rehabilitative services required for the care of ESRD dialysis patients"
- Renal dialysis facility - "a unit that is approved to furnish dialysis service(s) directly to ESRD patients"
- Self-dialysis unit - "a unit that is part of an approved renal transplantation center, renal dialysis center, or renal dialysis facility, and which furnishes self-dialysis services"
Patients undergoing dialysis at these facilities require two important documentation steps: the patient assessment and the patient plan of care. U.S. Federal regulation requires a comprehensive 13-point assessment, including current health status, laboratory profile, and nutritional status. Additionally, a comprehensive plan of care must be written, detailing "the services necessary to address the patient's needs" per the previously mentioned patient assessment.
For a more global look at dialysis centers:
- Hinkfuss, A.; Sherwin, A.; Hu, C.; Kirac, I.; Murray, M. (2006). "Dialysis in Emerging Economies". Brown University Division of Biology and Medicine. http://biomed.brown.edu/Courses/BI108/2006-108websites/group04emergingeconomies/esrd.html.
- Peden, Ann H. (2011). "Chapter 5: Dialysis". Comparative Health Information Management. Cengage Learning. pp. 147–176. ISBN 9781133708124. http://books.google.de/books?id=aXAJAAAAQBAJ&pg=PA147. Retrieved 29 March 2014.
- "P.L. 92–603, Approved October 30, 1972 (86 Stat. 1329)". Compilation of the Social Security Laws. Social Security Administration. http://www.socialsecurity.gov/OP_Home/comp2/F092-603.html. Retrieved 29 March 2014.
- "Outpatient Dialysis Services Payment System" (PDF). MedPAC. September 2006. Archived from the original on 21 July 2007. https://web.archive.org/web/20070721144509/http://www.medpac.gov/publications/other_reports/Sept06_MedPAC_Payment_Basics_dialysis.pdf. Retrieved 29 March 2014.
- "End Stage Renal Disease Facility Providers". Centers for Medicare and Medicaid Services. 9 April 2013. http://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/CertificationandComplianc/DialysisProviders.html. Retrieved 29 March 2014.
- "ESRD Quality Incentive Program". Centers for Medicare and Medicaid Services. 5 March 2014. http://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/ESRDQIP/index.html. Retrieved 29 March 2014.