Revised Appendix B, Interpretive Guidelines for Home Health Agencies: New Acceptance-to-Service requirements for home health agencies at 42 CFR 484.105(i).
This transmittal includes revisions based on an amendment to the Social Security Act that expands telehealth access to home dialysis patients (Bipartisan Budget Act of 2018) and Federal regulation changes that adopt the 2012 editions of the Life Safety Code and the Health Care Facilities Code (84 FR 51732). It also incorporates guidance from QSO-24-16-ESRD, which clarified medical director board certification qualifications, and QSO-18-24-ESRD, which introduced supplemental survey procedures for evaluating home dialysis in a long-term care setting. Lastly, technical revisions are being made to the interpretive guidance in Appendix H, the survey protocol, and the surveyor worksheets (new to Appendix H) to assist state survey agencies, accrediting organizations, and the public in understanding the requirements and expectations for ESRD facilities.
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: August 17, 2026
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