Are you all aware that the 'new' proposed language for ESRD regulations has been published to the Federal Register (2/4/05)).. This means that these proposed regs are open for public comment for ninety days, at which time, public comments are reviewed by those developing new regulations. I would suggest that anyone who is involved with dialysis/ESRD takes time to read these as they will affect staff and patients. The new regulations are not prescriptive as the existing ones are and are more outcome oriented. Additionally, many existing regs are being deleted. Now is the time to be heard if you have concerns about delivery of care. Please take time to read.
put in your search engine 'federal register february 4, 2005',, (without quotes) then click onto CMS - ESRD and you can pull up.. 50 pages of good worthwhile reading..........
Jnette: Please explain what you mean that I have much to learn. From speaking with many Surveyors if they find a negative outcome that is related to insufficient staffing, then the facility is cited for a deficient practice (non compliance with regulations). However, please explain as I am trying to understand this dialysis environment and am here to learn as well as share my thoughts, opinions and desires for a better healthcare setting (for patients and staff). Thanks.
Can anyone tell me about the 'sanctions' or 'consequences' for facilities that do not adhere to regulations. In my review of the new proposed language for ESRD regulations (Federal Register) I note that there is no mention of what happens when facilities are continually out of compliance. When I was reviewing the survey inspection results at http://www.dialysisethics.org I noted that some facilities had revisits and continued to be out of compliance, over and over with the same regulation. Also, noted that the only requirement for a facility being out of compliance is a required plan of correction. Any light shed on this would be greatly appreciated. Thanks.
Can anyone tell me about the 'sanctions' or 'consequences' for facilities that do not adhere to regulations. In my review of the new proposed language for ESRD regulations (Federal Register) I note that there is no mention of what happens when facilities are continually out of compliance. When I was reviewing the survey inspection results at http://www.dialysisethics.org I noted that some facilities had revisits and continued to be out of compliance, over and over with the same regulation. Also, noted that the only requirement for a facility being out of compliance is a required plan of correction. Any light shed on this would be greatly appreciated. Thanks.
I don't know all too much about that end of things, imperial.. just know that our Clinincal Mgr. has said that a facility can be shut down IMMEDIATELY if the noncompliance issue is a major one.. and it could be just ONE issue.. not a string of them. They can and DO shut you down, and transfer your patients out.. and this can be overnight.
Needless to say, we do stay on top of things.. and so it should be.
If they are considered "minor" infractions, you can buy some time and show a "plan of action" as you said.. but they WILL and DO return to see that you have implemented them in a given time.. THEIR time.
Yes, I agree. Everyone involved should read and make public comment. These regulations have not been revised in over 30 years, now what does that tell you?
We've had too many Republicans in the White House????
Can anyone tell me about the 'sanctions' or 'consequences' for facilities that do not adhere to regulations. In my review of the new proposed language for ESRD regulations (Federal Register) I note that there is no mention of what happens when facilities are continually out of compliance. When I was reviewing the survey inspection results at http://www.dialysisethics.org I noted that some facilities had revisits and continued to be out of compliance, over and over with the same regulation. Also, noted that the only requirement for a facility being out of compliance is a required plan of correction. Any light shed on this would be greatly appreciated. Thanks.
I know you have told us you have an "official" reason for your accusations and questions. Have you had a family member die in a dialysis unit?
Jnette: Please explain what you mean that I have much to learn. From speaking with many Surveyors if they find a negative outcome that is related to insufficient staffing, then the facility is cited for a deficient practice (non compliance with regulations). However, please explain as I am trying to understand this dialysis environment and am here to learn as well as share my thoughts, opinions and desires for a better healthcare setting (for patients and staff). Thanks.
Have you heard of the nursing shortage. And do you think dialysis machines are at the local 7-11.. Where do you suppose 80-90 patients are gonna be dialyized TOMORROW...
Many units are good some are bad. The government doesn't even have enough surveyors to keep up with the units let alone give us enough money to run them adequately.
I'm a Traveling Hemodialysis RN. I've worked from Maine to Cali and back . I've worked in 7 states in 3 years. Chronic outpatient Hemodialysis patients are some of the best taken care of patients in this country.. They see an RN 3 times a week and a Medical Practitioner 4 times a month. They have their Blood Pressure taken 24-26 times a week. They have access to a Social Worker , a dietician sees them at least once a month. They have blood work done at least twice a month. Their medication list is up dated monthly if they bring in their meds for us to check or they know what meds they are taking.
Now you tell me what patient population get better care than that?
As to why they don't follow their diet. I'd ask you about the people in the US who are obese. Are you saying they don't know the consequences. And I'd ask you to never eat oranges again, soak your potatos over night, not eat a banana. And drink only 2 quarts of water or less a day. Don't forget no chocolate either..And give up your life to come to dialysis for the rest of your life 3 times a week. I won't even mention the 15 guage needles we use.
And as to the other poster who say nurses like control I guess you'd know about control since you brought up the issue.
How I get to the proposed language is put in the search engine 'federal register 2/4/05 and it comes up..
As far as adequate staffing. A facility, to my knowledge, would be cited for this requirement if a patient experienced a negative outcome related to not having enough staffing. Of course, acuity would be looked at, etc.
Are you aware there are NO nurses who can walk into a dialysis unit and perform adequately. An ICU nurse could work on a M/S unit. An ER nurse could work on other units,. Neither of those nurses could ever perform up to the standards of care in a dialysis unit.
I'd suggest you get your head out of your books, publications, and research. Use some common sense and get on with reality.
Are you a nurse. If so take a position in a dialysis unit. Work there for a year and then you'll know first hand what happens there..YOu won't have to wonder if we are telling you every thing. If you truly wanna know about something ..DO IT that would be the best way to learn.
BTW a surveyor in NC wanted to cite the unit I was working in last year because I didn't have an NC RN license. I didn't need an NC license. NC is in the compact. Maine is in the compact Maine is my original state of licensure. I claim residence there . I have my car resigetered there, I vote there. The surveyor didn't know what she was talking about. People who live in glass houses shouldn't s**t on the floor.
J'nette: What is ultra care? What does it encompass in training? What is the goal? In other words, what IS ultracare? Can you give a few examples of ultracare?
Each state has their own staffing ratios. To be honest, these are in hospitals and nursing homes and I really don't know how they apply to renal outpt units. I do know, according to the regulations, that some states do have ratios for renal units. The states are specifically mentioned in the proposed language, although I do not remember. I do know, from my reading, that in California recently, the Governor vetoed the bill that would have mandated staffing ratios in hospitals.
Do other companies have the same as FMC i.e. ultracare?
That Republican didn't veto California's staffing ratios. He vetoed the next step in staffing ratios. I think you need to be sure of what you already know before you strike out on something new.
imperial
108 Posts
Jnette: Please explain what you mean that I have much to learn. From speaking with many Surveyors if they find a negative outcome that is related to insufficient staffing, then the facility is cited for a deficient practice (non compliance with regulations). However, please explain as I am trying to understand this dialysis environment and am here to learn as well as share my thoughts, opinions and desires for a better healthcare setting (for patients and staff). Thanks.