CMS published a final rule April 15 updating conditions for coverage for ESRD facilities. The rule seeks to: (1) focus on the quality of care provided to the patient, (2) establish a performance monitoring program for facilities, (3) encourage patients to participate in their plan of care and treatment, and (4) eliminate certain outdated procedural requirements for coverage. The rule generally is effective October 14, 2008, although certain provisions related to data reporting, infection control, and fire safety do not go into effect until February 2009.