End Stage Renal Disease Facility Requirements in Response to COVID-19 Emergency Rule Expired August 3, 2022

Emergency rule §500.21, ESRD Facility Requirements During the COVID-19 Pandemic, adopted under Texas Administrative Code Title 26 (26 TAC), Part 1, Chapter 500, Subchapter B expired on August 3, 2022. This emergency rule permitted end stage renal disease facilities (ESRDs) to comply with alternative operational requirements related to staffing ratios, in-home visits, telemedicine, incident reporting, and education and training requirements for staff to safely and effectively treat patients and utilize staff during the COVID-19 pandemic.

Effective August 4, 2022, all ESRDs must resume complying with all the following operational requirements under 25 TAC Chapter 117:

• Timeframe for quality assessment and performance improvement meetings required by 25 TAC §448.117.43(e)
• Timeframe for documentation of physician orders required by 25 TAC §117.45(c)(3)
• Home dialysis appointment requirements under 25 TAC §117.45(i)(2)(C)
• Home dialysis staffing levels required by 25 TAC §117.45(j)(4)
• Home dialysis curriculum training requirements under 25 TAC §117.45(j)(5)(A)
• Initial monitoring visit for home training requirements under 25 TAC §117.45(j)(9)(A)
• In-person visit requirement for home patients under 25 TAC §117.45(j)(9)(B)
• Charge nurse training and experience requirements under 25 TAC §117.46(c)(2)
• Self-care training experience for nurses required by 25 TAC §117.46(c)(4)
• Timeframe for incident reporting required by 25 TAC §117.48(a)
• Dialysis technician training requirements under 25 TAC §117.62(i)

For questions or more information, please contact us by emailing HCR_PRU@hhs.texas.gov.