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WAC 388-97-1900

Dialysis services.

(1) The nursing home must ensure that appropriate care, treatment, and services are provided to each nursing home resident who receives dialysis in the nursing home.
(2) For the purposes of this section the following definitions apply:
(a) "Dialysis" means the process of separating crystalloids and colloids in solution by means of the crystalloids and colloids unequal diffusion through a natural or artificial semipermeable membrane. This includes both peritoneal and hemodialysis.
(b) A "kidney center" means a facility as defined and certified by the federal government to provide end stage renal (ESRD) services.
(3) The nursing home must not administer dialysis for a resident with acute renal failure in the nursing home.
(4) A nursing home may only administer maintenance dialysis in the nursing home after:
(a) Other options have been analyzed and rejected, based on the resident's best interest; and
(b) A decision is made jointly by a team of individuals representing the kidney center and the nursing home, the resident, and the resident's nephrologist.
(5) The nursing home must ensure that a current written agreement is in effect with each kidney center responsible for the management and care of each nursing home resident undergoing dialysis. The agreement must include all aspects of how the resident's care is to be managed including:
(a) Medical and nonmedical emergencies;
(b) Development and implementation of the resident's care plan related to dialysis issues;
(c) Interchange of information useful/necessary for the care of the resident; and
(d) The responsibility for waste handling, sterilization, and disinfection of equipment for dialysis done in the nursing home.
(6) The nursing home must ensure implementation of policies and procedures developed with the kidney center that:
(a) Meet current standards of practice;
(b) Addresses both dialysis provided by or in the nursing home as well as dialysis provided by the kidney center; and
(c) Addresses all of the nursing home responsibilities related to a resident on dialysis.
[Statutory Authority: Chapters 18.51 and 74.42 RCW. WSR 10-02-021, § 388-97-1900, filed 12/29/09, effective 1/29/10. Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-1900, filed 9/24/08, effective 11/1/08.]
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