Home Dialysis in Nursing Homes

Nursing homes and dialysis facilities seeking approval to provide hemodialysis in a nursing home, including in a “dialysis den” setting, must first submit the special project form developed by the Department and receive approval from the Department.

Nursing Home Hemodialysis Special Project Form

A dialysis facility providing home dialysis services to nursing home residents must do so under a written agreement with the nursing home. The dialysis facility must maintain direct responsibility for the dialysis related care and services provided to the nursing home residents. A dialysis facility seeking an initial license must complete the health care facility initial licensure process, including suitability review, in order to obtain special project approval.

The nursing home is responsible for providing a safe environment for the dialysis treatments, monitoring the resident before, during, and after dialysis treatments for complications possibly related to dialysis, and providing all non-dialysis related care. Nursing home staff must be prepared to appropriately address and respond to dialysis related complications, and provide emergency interventions as needed.

Prior to initiating home hemodialysis in a nursing home in Massachusetts:

The Nursing Home is responsible for:

  • Submitting plans and obtaining plan approval prior to beginning any new construction or the alteration of existing space;
  • Submitting jointly with the dialysis facility, and obtaining approval for a Special Project for home hemodialysis in the nursing home using the request form developed by the Department; and,
  • Entering into a written agreement with the dialysis facility for home hemodialysis in the nursing home.

The Dialysis Facility is responsible for:

  • Meeting licensure requirements and, prior to providing service as a certified provider, obtaining certification approval to provide home dialysis;
  • Submitting jointly with the nursing home, and obtaining approval for a Special Project for home hemodialysis in the nursing home using the request form developed by the Department; and,
  • Entering into a written agreement with the nursing home for home hemodialysis in the nursing home.

Requests for approval of a Special Project for home dialysis should be submitted by email to: HFLLicenseAction@Mass.Gov with a copy to Walter.Mackie@Mass.Gov.

The special project approval process should not be used to request a waiver of a nursing home or dialysis facility licensure requirement. Waiver requests should be made using a Waiver Request Form, and submitted to either the Plan Review unit or Licensure Unit depending on the nature of the waiver request.

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