Conditions for coverage released: implications for nephrology dietitians.
THE CENTERS FOR MEDICARE and Medicaid Services (CMS) released the final rule of the Conditions for Coverage on April 4, 2008. These are ‘‘rules’’ that dialysis facilities must follow to be Medicare-certified in the United States. This is the first update to these rules since 1976. The end-stage renal disease final rule (116-page document) can be found at http:// www.cms.hhs.gov/center/esrd.asp. This final rule focuses on ‘‘the patient and the results of care provided to the patient, establishes performance expectations for facilities, encourages patients to participate in their plan of care and treatment, eliminates many procedural requirements from the previous conditions for coverage, preserves strong process measures when necessary to promote meaningful patient safety, well-being, and continuous quality improvement.’’ In the previous ruling, a ‘‘qualified dietitian’’ was a registered dietitian with the Commission of Dietetic Registration, and the registered dietitian (RD) had to meet the practice requirements of the state in which he or she was employed. The only change here is that the dietitian must have a ‘‘minimum of one year of professional work experience in clinical nutrition as a RD in order to qualify to perform the special responsibilities of renal dietitians.’’ The National Kidney Foundation/Council on Renal Nutrition (NKF/ CRN) and the American Dietetic Association Renal Practice Group supported this definition.