Volume 29, Fall 2008
Table of Contents
Psychosocial Aspects of the 2008 End-Stage Renal Disease Conditions for Coverage
Teri Browne, MSW, LSW, University of South Carolina College of Social Work, Columbia, SC; Chairperson, Council of Nephrology Social Workers
On October 14, 2008, practices and policies in every dialysis unit in the United States and its territories will be significantly changed with the implementation of the 2008 Conditions for Coverage (CfCs) for End-Stage Renal Disease Facilities (Office of the Federal Register, 2008). These CfCs mark the first wholesale change in the regulations for dialysis units in more than 30 years, and the Council of Nephrology Social Workers (CNSW) is making every effort to provide its members with the tools and resources they need to adapt to and adopt these new CfCs. This special issue of The Journal of Nephrology Social Work is intended to provide members with an introduction to the sections of the CfCs that are relevant to social workers and an overview of the CfCs and relevant resources created by the CNSW.
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Psychosocial Aspects of the 2008 Dialysis Conditions for Coverage
Council of Nephrology Social Workers
This table was created by the Council of Nephrology Social Workers (CNSW) to help inform and educate the kidney community about the psychosocial aspects of the new Conditions for Coverage (CfCs) for End-Stage Renal Disease Facilities. The implementation and interpretation of the new CfCs is anticipated to be a dynamic process. This document reflects the information available to the kidney community as of its version date. Please confirm with CNSW whether further information, resources or guidance has been provided on this subject. Information provided by CNSW is not intended to establish or replace policies and procedures provided by dialysis providers to their facilities. Please check with your dialysis facility management before implementing any of the information provided herein. The CfCs were published April 15, 2008, by the Department of Health and Human Services, Centers for Medicare and Medicaid Services, to be in effect October 14, 2008, in every U.S. dialysis unit. You can find the entire CfCs at http://edocket.access.gpo.gov/2008/pdf/08-1102.pdf
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Comprehensive Multidisciplinary Patient Assessment (CMPA) Example Questions
Social Work-Focused Criteria
Council of Nephrology Social Workers
The Department of Health and Human Services, Centers for Medicare and Medicaid Services (CMS), published the Final Conditions for Coverage (CfCs) for End-Stage Renal Disease (ESRD) Facilities on April 15, 2008. In anticipation of the final publishing of the CfCs for ESRD facilities, CMS encouraged the National Kidney Foundation (NKF) and American Nephrology Nurses Association (ANNA) to establish a task force to develop resources and guidelines to assist facilities in complying with the requirement for a comprehensive, multidisciplinary patient assessment (CMPA). The CMPA replaces the requirement for individual assessments by each discipline (ref: § 494.80). The CMPA needs to be completed on the following schedule:
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Quality-of-Life Assessment Tools
Council of Nephrology Social Workers
Conditions for Coverage (CfCs): Subpart C Patient Care/Patient Plan of Care 494.90(a)(6)
Psychosocial status. The interdisciplinary team must provide the necessary monitoring and social work interventions. These include counseling services and referrals for other social services, to assist the patient in achieving and sustaining an appropriate psychosocial status as measured by a standardized mental and physical assessment tool chosen by the social worker, at regular intervals, or more frequently on an as-needed basis.
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Ethics and the New Conditions for Coverage for End-Stage Renal Disease Facilities
Wendy Funk Schrag, LMSW, ACSW, Fresenius Medical Care North America, Newton, KS
Social workers bring a unique perspective of values and ethical decision-making skills to their work environments. Trained in the basic values of service, social justice, dignity and worth of individuals, importance of human relationships, integrity and competence, social workers are equipped to help the health care team face ethical dilemmas and use these values to promote ethical decision making. The new Conditions for Coverage for End-Stage Renal Disease Facilities include some new guidance on current ethical dilemmas. These include the patient care environment, patient rights, advance care planning and involuntary discharge. At this critical juncture, social workers can assist their health care team in creating new processes and policies for ethically-sound practice with people on dialysis.
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Resources and CNSW Research Grants Program
In keeping with the overall goals of the National Kidney Foundation (NKF) and its Council of Nephrology Social Workers (CNSW), the purpose of the CNSW Research Grant Program is to further knowledge of psychosocial factors in kidney failure and to enhance clinical social work intervention with dialysis and transplant patients/ families.
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