California Code of Regulations
Title 22 - Social Security
Division 5 - Licensing and Certification of Health Facilities, Home Health Agencies, Clinics, and Referral Agencies
Chapter 1 - General Acute Care Hospitals
Article 6 - Supplemental Services
Section 70443 - Chronic Dialysis Service General Requirements

Universal Citation: 22 CA Code of Regs 70443

Current through Register 2024 Notice Reg. No. 38, September 20, 2024

(a) Written policies and procedures shall be developed and maintained by the person responsible for the service in consultation with other appropriate health professionals and the administration. Policies shall be approved by the governing body. Procedures shall be approved by the administration and medical staff where such is appropriate.

(b) The responsibility and the accountability of the chronic dialysis service to the medical staff and administration shall be defined.

(1) Have two or more dialysis stations. A minimum of five dialysis sessions per week should be performed at each station.

(2) Work in cooperation with other facilities providing care for patients with end-stage renal disease.

(3) Make chronic dialysis services available to patients with end-stage renal disease referred from other facilities which do not provide chronic dialysis serviced.

(4) Participate in the development and use of a registry of prospective recipient patients.

(5) Participate in kidney procurement, preservation and transport program.

(6) Review all patients with end-state renal disease to determine the appropriateness of their treatment modality, including self-dialysis, home dialysis and renal transplantation and cooperate with other facilities for the timely transfer of medical data.

(d) The hospital shall provide directly:

(1) Respiratory therapy.

(2) Twenty-four hour laboratory capability of performing, as a minimum, the following determinations: C.B.C., B.U.N., creatinine, platelet count, blood typing and cross matching, blood gas analysis, blood pH, serum glucose, electrolytes, coagulation tests, spinal fluid examination and urinalysis.

(3) Chronic dialysis on an outpatient basis.

(4) Angiography.

(e) The hospital shall provide directly or by arrangement:

(1) Immunofluorescence studies.

(2) Electron microscopy

(3) Microbiological studies for rickettsiae, fungi, bacteria and viruses.

(4) Tissue culture.

(5) Outpatient services.

(6) Self-dialysis training program.

(7) Home-dialysis training program.

(8) Transplantation evaluation of patients with end-stage renal disease.

(9) Renal transplantation.

(10) Nuclear medicine service.

(f) There shall be a separate designated area as needed for patients undergoing chronic dialysis who are known to be hepatitis B surface antigen positive.

(g) The particular requirements for patients on chronic dialysis shall be accommodated in the disaster and fire plans of the hospital,

(h) There shall be inservice training and continuing education for all medi-cal, nursing and other personnel.

(i) There shall be a written hepatitis control program.

(j) Periodically, a committee of the medical staff shall evaluate the services provided and make appropriate recommendations to the executive committee of the medical staff and administration.

1. Amendment of subsections (f) and (i) filed 6-15-89 as an emergency; operative 6-15-89 (Register 89, No. 25). A Certificate of Compliance must be transmitted to OAL within 120 days or emergency language will be repealed on 10-13-89.
2. Certificate of Compliance as to 6-15-89 order transmitted to OAL on 10-13-89 and disapproved by OAL on 11-13-89 (Register 89, No. 46).
3. Amendment of subsections (f) and (i) refiled 11-16-89 as an emergency; operative 11-16-89 (Register 89, No. 46). A Certificate of Compliance must be transmitted to OAL within 120 days or the section will be reinstated as it existed prior to the emergency on 3-16-90.
4. Certificate of Compliance as to 11-16-89 order including nonsubstantive change of subsections (f) and (i) transmitted to OAL 3-15-90 and filed 4-16-90 (Register 90, No. 17).

Note: Authority cited: Sections 208(a) and 1275, Health and Safety Code. Reference: Section 1276, Health and Safety Code.

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