Developed by the American Nephrology Nurses’ Association
and the National Kidney Foundation
Download the Patient Assessment Tool
Introduction to the Patient Assessment Tool
The new Conditions for Coverage (CfCs) for End-Stage Renal Disease Facilities were published in the Federal Register on April 15, 2008. Dialysis facilities now have 180 days from the date posted (October 14, 2008) to ensure that they are compliant with all the changes this ruling has established. One major change in the ruling is a new condition requiring that a comprehensive interdisciplinary patient assessment be completed on all patients new to their facility.
ESRD facilities have within the latter of 30 days or 13 hemodialysis treatments to complete this assessment, which is to be followed up by a comprehensive reassessment within 3 months of completion of the initial assessment. The comprehensive patient assessment is intended to be used to develop the patient plan of care and will need to be updated annually on all stable patients and monthly for unstable patients (see guidelines for criteria for an unstable patient). Components of the comprehensive patient assessment include anemia, adequacy, access, bone disease, nutrition, psychosocial status, home dialysis, transplant status, functional status and rehabilitation.
To help ESRD facilities implement this new condition into their practice, ANNA and the National Kidney Foundation (NKF) joined forces and assembled an interdisciplinary team to create a patient assessment tool. This project has taken over 1 year to complete with numerous conference calls and lots of discussion. It is our intent for the ESRD facility either to use this tool in its entirety, or to use the tool as a guide to implement the required components into their practice. The Centers for Medicare & Medicaid Services (CMS) supports the use of integrated tools, and surveyors who have reviewed this tool have stated that appropriate use of this tool to document patient comprehensive assessments would be one way of meeting the new federal regulations in this area.
The first thing you will notice when you see the tool is that it is detailed and long! The tool is full of examples of what dialysis facilities may want to include in their own tools. The second thing you will notice is that we designed the tool to be user-friendly. Many sections of the assessment tool are laid out so that the user only has to check a box next to any item that may apply.
The patient assessment tool is available for you to download (above). Please feel free to use the tool and incorporate into your practice. Thanks to ANNA and NKF for having the foresight and willingness to undertake this difficult task and create this tool to aid dialysis facilities meet the new regulations.
Members of the joint task force that worked on this project include:
Sheila Deziel, BSN, RN, CNN, Task Force Chair
Debbie Benner, MA, RD, CSR
Sandy Bodin, MA, RN, CNN
Teri Browne, MSW, LSW
Danilo Concepcion, BS, CHT
Duane Dunn, MSW
Sandie Dean, MSW, LICSW
Kay Hall, BSN, RN, CNN
Jeff Harder, MSW, LICSW
Aaron Herold, MSW
Maria Karalis, MBA, RD, LDN
Carol Kinzner, MSN, APRN-BC, CNN, NP
Maria Luongo, MSN, BA, RN
Melinda Martin-Lester, BA, RN, CNN
Nancy Pelfrey, RN, CNN, NP
Mark Short, BSN, RN, CNN
Karen Vinson, MSN, MHA, RN, CNN
Barbara Zebrowski, MS, RD, CSR, LDN
Mark Short, BSN, RN, CNN
Task Force Member
Dunelands Chapter #338