Header:
WISCONSIN ADMINISTRATIVE CODE
DEPARTMENT OF HEALTH SERVICES
CHAPTER DHS 152. REIMBURSEMENT FOR TREATMENT OF CHRONIC RENAL DISEASE
Date:
08/31/2009
Document:
DHS 152.07 Standards for renal transplantation centers.
(1) GENERAL. To be reimbursed by the CRD program, renal transplantation centers shall comply with the standards in this section.
(2) STAFFING. A renal transplantation center shall have the following staff:
(a) A transplant surgeon;
(b) A nephrologist;
(c) Other physicians licensed in Wisconsin or, if employed by an ESRD unit approved under this chapter in a border state, in that state, with experience in the following specialties: cardiology, endocrinology, hematology, neurology, infectious disease, orthopedics, pathology, psychiatry, nuclear medicine, radiology, urology, immunology, anesthesiology, gastroenterology, vascular surgery, pediatrics if pediatric patients are under care, neurosurgery and cardiovascular surgery;
(d) A nurse;
(e) A dietitian; and
(f) A social worker.
(3) SERVICES. The hospital housing the renal transplantation center shall:
(a) Be approved under ss. 50.32 to 50.39, Stats., and ch. DHS 124, meet all the requirements of 42 USC 1395x (e) and be a certified medicare provider;
(b) Be approved under 42 USC 1395rr (b);
(c) Have laboratory services approved for participation in medicare and under 42 CFR 493 (CLIA) available for cross--matching of recipient serum and donor lymphocytes for preformed antibodies by an acceptable technique on a 24--hour emergency basis. Other available laboratory services shall include:
1. Suitable maintenance of recipient sera and typing reagents;
2. Phenotyping for donors and recipients;
3. Updating and retyping for human lymphocyte antigens (HLA);
4. Screening of recipient sera for preformed antibodies with a suitable lymphocyte panel;
5. Testing the mixed lymphocyte cultures to determine cellularly defined antigens;
6. ABO blood grouping and typing;
7. Unusual pathogen culturing, fungal cultures, tissue cultures and tuberculosis cultures;
8. Immunofluorescence and electron microscopy;
9. Urine glucose, protein, and microscopy;
10. Complete blood count (CBC) and platelet count;
11. Blood gases and blood pH;
12. Serum calcium, potassium, phosphorous, and glucose:
13. Blood urea nitrogen (BUN), creatinine, serum glutamic-oxaloacetic transaminase (SGOT), serum glutamic-pyruvic transaminase (SGPT), lactic dehydrogenase (LDH) and prothrombin time; and
14. Spinal fluid and bone marrow exams;
(d) Have available other support services, including physical therapy, pharmacy, inhalation therapy, blood banking, dialysis, nerve conduction, cardiac catheterization, electroencephalography, diagnostic ultrasound, angiography and diagnostic radioisotopic scanning;
(e) Participate in a patient registry program; and
(f) Provide outpatient services for the evaluation, care and follow--up of renal transplantation patients.
(4) PHYSICAL DESIGN. In regard to physical design, the renal transplantation center shall:
(a) Provide a minimum of 10 beds to accommodate patients before and after transplantation; and
(b) Have rooms on the unit designed to provide isolation or segregation from patients with an infection or a communicable disease.
(5) EQUIPMENT AND SUPPLIES. In regard to equipment and supplies, the renal transplantation center shall have:
(a) Donor kidney preservation equipment on the premises or available under arrangement or agreement, with donor kidneys preserved by currently acceptable medical methods; and
(b) Emergency resuscitation equipment available on the premises.
(6) POLICIES AND PROCEDURES. In regard to policies and procedures, the renal transplantation center shall have:
(a) Unit policies and procedures which shall be in writing and updated at least annually. These policies and procedures shall relate to the operation of the unit and shall include infection control and emergency evacuation policies and procedures; and
(b) Patient care policies and procedures which shall be in writing and updated at least annually. These policies and procedures shall include the development of an individualized care plan for every patient, a list of patient rights and responsibilities and a grievance mechanism which is made available to all patients.
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