ESRD Conditions for Coverage

§ 494.150 Responsibilities of the Medical Director

The dialysis facility must have a medical director who meets the qualifications of § 494.140(a) to be responsible for the delivery of patient care and outcomes in the facility. The medical director is accountable to the governing body for the quality of medical care provided to patients. Medical director responsibilities include, but are not limited to, the following:

(a) Quality assessment and performance improvement program.
(See 494.110 Condition: Quality Assessment and Performance Improvement)

(b) Staff education, training, and performance.
Keeping Kidney Patients Safe – Patient Safety Improvement Plan Basics
Staff Activity Planning Guide

AAMI RD52: Dialysate for hemodialysis

(c) Policies and procedures. The medical director must—

  1. Participate in the development, periodic review and approval of a ‘‘patient care policies and procedures manual” for the facility; and
  2. Ensure that—

(i) All policies and procedures relative to patient admissions, patient care, infection control, and safety are adhered to by all individuals who treat patients in the facility, including attending physicians and non-physician providers; and

Resource: RPA – The Role of Medical Directors in Dialysis Facilities Series

  • Medical Director Contracting
    by Pristave, Robert J.; Velez, Ruben L.
    Semin Dial. 2008 Jul-Aug;21(4):338-40. Epub 2008 Jul 9.
  • The Role of the Medical Director: Changing with the Times
    by Lowthian, Judy; Walker, Rowan G.
    Semin Dial. 2008 Jan-Feb;21(1):54-7.
  • How Dialysis Is Paid For: What the Dialysis Medical Director Should Know, and Why
    by DeOreo, Peter
    Semin Dial. 2008 Jan-Feb;21(1):58-62. Epub 2007 Dec 11.
  • The Dialysis Medical Director’s Role in Quality and Safety
    by Kliger, Alan S
    Semin Dial. 2007 May-Jun;20(3):261-4.
  • Medical Direction of Dialysis—A Critical Leadership Role by Gutman, Robert A
    Semin Dial. 2007 May-Jun;20(3):257-60.

(ii) The interdisciplinary team adheres to the discharge and transfer policies and procedures specified in § 494.180(f). (See executive summary of RPA Clinical Practice Guideline #2: Shared Decision-Making in the Appropriate Initiation of and Withdrawal from Dialysis or order online)




The Renal Network, Inc.
911 E. 86th Street, Suite 202
Indianapolis, IN 46240
Phone: (317) 257-8265
Fax: (317) 257-8291
Patient Line:
1 (800) 456-6919
Email: [email protected]

Last updated on: April 24, 2009