Many California Dialysis Technicians Fail Federally Mandated Competency Test

Many California Dialysis Technicians Fail Federally Mandated Competency Test

by Marian Wang
ProPublica, Jan. 26, 2011, 2:05 p.m.

A large percentage of dialysis technicians in California have been unable to pass the state’s certification exam after testing was revamped as part of a new federal mandate, according to a story by California Watch.

Within the state, the new rules have cut down the number of technicians working in an industry that is already stretched in terms of staffing. Here’s our former colleague, Christina Jewett:

The California Dialysis Council, which has administered its test to about 1,200 people so far, is seeing a pass rate of about 56 percent, according to the group’s executive director.

Statewide, the workforce of dialysis technicians has fallen from a steady 5,200 to about 3,800, according to a Department of Public Health spokesman. That’s a 27 percent drop in the number of certified technicians.

As we’ve reported, dialysis clinics rely heavily on unlicensed technicians, who can start work with a high-school diploma and in-house training. In 2008, Medicare rules changed to require technicians then at work in clinics to pass national or state certification tests within 18 months. Last April, the deadline passed to comply with those requirements.

California was one of the few states that had a state certification test before Medicare began requiring it—that’s why the state actually has statistics on the drop in certified technicians.

Workers who fail the test can retake it as many times as they want, according to California Watch, but in the meantime they cannot work with patients directly unless supervised.

As we’ve reported, Medicare does not set staffing ratios for dialysis centers, and neither do most states.

To check the quality of the dialysis clinics in your state, check our Dialysis Facility Tracker.


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I saw this story, Plugger, and what occurred to me was folks telling us that it was very hard to get home dialysis programs started in California, because it could take the state YEARS to get around to doing the inspection that would let them open.. One key factor in the quality of care is inspections. Another–in-center–is staff training. I doubt that California is actually unusual, though. As this article pointed out, they were unusual in that they actually HAD stats about what % of techs passed the exam. The other states just don’t have the data…

I remember back in 2007 when we started our bill here in Colorado, the state was ranked 41st in the country for inspections. Looks like that is changing:

“Colorado passed legislation requiring dialysis clinics to report incidents resulting in patient deaths and injuries and recently increased licensing fees to pay for additional inspections. Regulators expect to check one-third of the clinics statewide by July 1, 2011.”

Looking to me like something the Feds ought to consider.

Dori, if I recall, the providers pushed to have their new facilities timely inspected so that they could open these units up to serve patients. There have been many new units inspected more timely, as well as, to recall surveyors hired. Hence, I would bet that providers, as powerful as they are with things as this, that they could get their home dialysis units inspected timely.
Roberta Mikles

BTW, the article may have overstated one thing. It said that a PCT could continue to work with supervision without passing the certification exam. This may not be true. If a PCT has worked in a dialysis clinic for 18 months after 10/14/2008, he/she cannot do any direct patient care until certified…not even with supervision. The goal of certification is to assure as much as possible that patients have qualified personnel taking care of them.

If nearly half the PCTs are failing the exam, one has to wonder about the quality of their training, both written content and practical experience. One also has to wonder whether RN or PCT preceptors were able to show them the right way to do all the aspects of care PCTs are tested on when training the PCTs needing certification.

Last I heard, the pass rate for the national PCT certification exams was higher than reported here.