In response to the novel coronavirus, CMS is providing its advice on patient contact with dialysis facilities. The memoranda was built from commonly asked questions about engaging with patients in the midst of COVID-19, said the agency in a statement. The guidance provides health care staff with straightforward, actionable guidelines on the screening, diagnosis, and discharge protocols to be followed while communicating with patients said the CMS press release.

The advice is intended to help monitor and prevent infection from spreading. In particular, the new guidance urges all Medicare-enrolled dialysis centers to recognise high-risk individuals before appointments or upon entry, and to start screening immediately for fever or signs of respiratory infection such as cough and sore throat.   Patients with respiratory infection problems should put on a facemask before check-in and keep it until they leave the facility.

CMS said dialysis workers who have signs and symptoms of a respiratory infection should not show up at work. Facilities should enact policies on sick leave that are non-punitive, versatile and compatible with public health policies that encourage ill workers to stay at home, said the agency. Facilities will also provide space in waiting rooms for ill patients to sit at least 6 feet away from other patients, the guideline said.

Ideally it will provide dialysis facilities to symptomatic patients in a separate room (if available) with the door closed. Insulation rooms for hepatitis B will be used to dialyze patients if the patient with suspected or confirmed COVID-19 is positive hepatitis B surface antigen or the facility does not have positive hepatitis B surface antigen patients that would need treatment in the isolation space.