Waivers and Phase-In Time Extensions for the Implementation of the New ESRD Conditions for Coverage

The new ESRD Conditions for Coverage provide clearer and better provisions for patient safety and improved quality of care. While the overall effective date was October 14, 2008, the rule recognized that not all facilities may be in a position to fully meet all new or revised requirements of the Conditions for Coverage on that date. Therefore, the rule specifies separate effective dates for certain Conditions and provides that some facilities may request a waiver for certain other requirements. In this memorandum we describe the procedures we are implementing for requesting a waiver or time-limited extension of the time needed to phase-in the program improvements needed to achieve full compliance.