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Dialysis Technician Training in North Carolina

There are no state regulations affecting dialysis technician training and certification requirements in North Carolina state. The Department of Justice in North Carolina has determined that the tasks performed by dialysis technicians does not require the specialized skills of a registered nurse and that technicians are not subject to the requirements of the Nurse Practice Act. The North Carolina Division of Health Service Regulation defers judgement to federal technician regulations.

Dialysis technician regulations are unique from other healthcare specialties because the federal government has taken over responsibility for covering most of the costs associated with treatment. In the past, end stage renal failure patients were responsible for coming up with the required funds to pay for their own treatment. Most insurance companies were unwilling to issue policies covering dialysis treatment because of the enormous costs. In response, hospitals formed dialysis boards that were tasked with the difficult job of determining which patients would receive treatment and which ones would be allowed to die. Needless to say, this unethical approach to patient care got the attention of the public and led to the government takeover of dialysis reimbursement.

Today, the Centers for Medicare and Medicaid Services (CMS) reimburse dialysis facilities for approximately 80% of the costs associated with treatment. Since the federal government has established its own dialysis technician requirements, many states do not feel the need to use their own limited resources to further impose regulations on technicians. While some states do adopt their own requirements, they are usually very similar to those of the CMS. North Carolina has not established its own dialysis technician regulations.

CMS regulations 494.140 (e)(1-4) require that patient care technician training and certification requirements adhere to the following standards:

1. Meet all state requirements for:
   • Education
   • Training
   • Credentialing
   • Competency
   • Standards of practice
   • Certification
   • Licensure
2. Have a High School Diploma or GED
3. Complete an approved program that includes the following:
   • Principles of dialysis
   • Care of patients with kidney failure
   • Possible complications of dialysis
   • Water treatment and dialysate preparation
   • Infection control
   • Safety
   • Dialyzer reprocessing
4. Certification by a State or National Program within 18 months of employment

In order to comply with federal dialysis technician regulations, individuals should learn about the many certification options that are available. Currently, there are three nationally recognized organizations that offer dialysis technician certifying exams. Some states and dialysis employers require technicians to complete a specific exam while others allow their new technicians to choose which exam they wish to take.

In most cases, a technician is allowed to work for 6 to 18 months prior to completing a certification exam. This gives individuals the time they need to successfully complete a training program and acquire the knowledge they need to pass the exam.

Nationally recognized certification options include:

1. The Nephrology Nursing Certification Commission (NNCC)
   • Certified Clinical Hemodialysis Technician (CCHT) Exam
2. The Board of Nephrology Examiners Nursing and Technology (BONENT)
   • Certified Hemodialysis Technician (CHT) Exam
3. The National Nephrology Certification Organization, Inc. (NNCO)
   • Certified in Clinical Nephrology Technology (CCNT) Exam
   • Certified in Biomedical Nephrology Technology (CBNT) Exam

Each state is a member of one of 18 non-profit networks established by Congress in 1978 to monitor the quality of care being delivered by dialysis facilities across the country. These networks have jurisdiction over one to six states where they gather statistical data, encourage rehabilitation, and serve as an informational resource for both dialysis patients and clinic personnel. North Carolina belongs to Network 6 along with South Carolina and Georgia.

North Carolina Dialysis Technician Training and Career Links

1. Carolinas Medical Center
2. Davita
3. Dialysis Center, Inc.
4. DSI Dialysis
5. Duke University Medical Center
6. Fresenius Medical Care
7. Gambro Healthcare
8. Wake Forest Baptist Health
9. Wilkes Regional Medical Center

State Contact Information

Phone:          (919) 855-3750
Fax:               (919) 733-2757

2701 Mail Service Center     Raleigh, NC 27699-2701

Web Site:     Department of Health and Human Services

National Network:   Network 6