Dialysis Patient Care Techs: Get certified--or lose your job

2/23/2010
Dialysis Patient Care Techs: Get certified--or lose your job

By Mark E. Neumann

If you are a patient care technician working at a dialysis clinic and are not certified, you have less than seven weeks left before you may lose your job in patient care. That is, unless you have taken and passed a national certification exam or a state standardized test.

The revised Conditions for Coverage for Dialysis Facilities, which sets the rules for clinics to become eligible for Medicare and Medicaid funding, took effect Oct. 14, 2008. Included in the updated language is a requirement that by April 15, 2010, all PCTs working at a dialysis clinic and providing direct patient care at that time must pass a national certification exam or a state-approved standardized test that meets Conditions for Coverage regulations. That deadline gave technicians--and their employers--more than 18 months to prepare for one of the exams, set a test date, and get a passing grade. Technicians newly hired after April 15 can perform patient care duties if they have successfully completed a training program that meets the minimum CMS requirements, and achieve certification within 18 months from their hire date. In some states, however, PCTs can only work as a trainees until they become state certified.

According to the Conditions for Coverage, PCTs must possess a minimum of a high school diploma or its equivalent (GED), in addition to passing a national certification exam or state standardized test. PCTs with greater than four years of work experience as of Oct. 14, 2008, may use experience in lieu of the high school diploma.

In California and New Mexico, PCTs can take a standardized test approved by the state's certification and competency program. Tests in those states have been reviewed and approved by CMS as meeting federal requirements. The standardized tests available in those states must be administered in a proctored environment by an independent examiner, and be specific to patient care dialysis technicians. Taking a state-approved standardized test, however may limit a PCT's practice to that state alone.

Be prepared to pay
Becoming a certified PCT is not cheap. Test fees range from $175 to $245. Fees for retaking the test can vary, but can be as high as $185. Once you pass the test, certification is good for three to four years. Recertification fees range from $55 up to $100, and require evidence of continuing education.

Some PCTs are ahead of the game; prior to CMS making certification mandatory, a number of states passed laws requiring that PCTs be nationally certified to work in those states. They include California, Colorado, Connecticut, Ohio, Oregon, Mississippi, Montana, Virginia, West Virginia, and Arizona.

Results are in ...
And many technicians who are still uncertified may be running out of time. It's not just taking the exam that becomes time-sensitive; the testing organizations have to grade the results and let the taker know if they passed or failed. Most of the certification organizations require a 70% to 75% minimum grade for passing.

PCTs taking the computer-based tests (CBTs) have the best chance of getting results back sooner, but those tests are not available in all areas. The Nephrology Nursing Certification Commission told NN&I it can turn around test grades on the CBTs before the test-taker leaves the testing site; test takers using the traditional "pencil-and-paper" testing format might have to wait up until two weeks to get their results back.

The rush by PCTs to sit for the exams to meet the April 15 deadline has been overwhelming for some of the testing organizations. The home page of the Board of Nephrology Examiners Nursing and Technology has a message for visitors that reads: "Due to the April 15 federal deadline, we have received an overwhelming number of applications. The (BONENT) staff is extremely busy processing to meet all deadlines. Do NOT call and leave several messages with one or several staff, as the call volume is enormous." BONENT, along with the other testing organizations, do offer computer-based testing to help speed up test results.

The California Dialysis Council's certification exam, which is accepted by that state and CMS in lieu of national certification for PCTs working in California, has remaining test dates open and has indicated that test takers sitting for their April 6 exam will get their results before the April 15 deadline. The National Nephrology Certification Organization requires a minimum one-month application time.

Get it done
Patients deserve some kind of nationally accepted measure that says the PCTs who care for them have basic knowledge of how dialysis works. Other subspecialties that care for dialysis patients, nurses, social workers, dietitians, and physicians, must be credentialed; PCTs who also provide direct patient care should not be exempt. Dialysis providers need to help PCTs who are good caregivers to pass these exams to avoid major changes in the workforce. If that occurs, it will clearly impact patient care when experienced PCTs are sent packing on April 15.

Mr. Neumann has been editor of Nephrology News & Issues since 1989.

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