Dialysis follows a prescribed schedule, and skipped sessions can be dangerous. Complications tied to missed or shortened treatments include dangerously high potassium, fluid overload, and pulmonary edema. When a nursing home fails to arrange a ride or confirm an appointment, that coordination gap can become a legal issue.

Who Must Get the Resident to Treatment

A federal nursing home rule, 42 CFR § 483.25(l), requires facilities to give residents who need dialysis care that matches professional standards, their care plans, and their preferences. According to CMS’s inspector guidance on dialysis care, the nursing home remains responsible for the resident’s overall care, must help arrange safe transportation to off-site treatment, and must keep open communication with the dialysis provider.

Responsibility can be shared. The dialysis provider generally manages the kidney treatment itself, and a transportation company may also play a role. A contract between those parties does not automatically settle who answers for a missed session.

Proving a Missed Session Caused Harm

A skipped treatment is not always negligence. A medical reason, emergency, or the resident’s informed refusal may explain it. Claims get stronger when records show repeated lapses and tie the gap in care to a complication, such as a hospital stay for fluid overload.

According to O.C.G.A. § 31-8-126, residents may bring civil actions over violations of their rights, but O.C.G.A. § 9-11-9.1 requires an expert affidavit in professional malpractice cases. In Williams v. Alvista Healthcare Center, Inc., the court drew a line between claims attacking professional nursing judgment and claims built on statutory residents’ rights, which can decide whether an affidavit is needed.

Helpful evidence includes:

  • Transportation bookings and cancellation records
  • Dialysis center records of missed or rescheduled treatments
  • Nursing notes and dialysis center communications
  • Hospital records and lab results

Ask Questions and Keep Dated Records

Families can ask who confirms appointments, what happens when a driver cancels, and whether the dialysis center and physician heard about a missed session. When problems continue, put complaints in writing and note the dates. The Georgia Long-Term Care Ombudsman Program also helps with facility concerns.

The Williams Litigation Group can review dialysis schedules, transportation records, and care plans to help work out who may be responsible and whether missed treatment caused harm. If someone you love was affected, reach out to us or call 866-214-7036.