This letter from CMS outlines the requirements for nursing homes and other healthcare facilities to provide parenteral fluids (fluids or medications administered through an intravenous, subcutaneous, intramuscular, or mucosal route) to maintain adequate hydration, restore and/or maintain fluid volume, reestablish lost electrolytes, or provide nutrition. The letter provides guidance on professional standards of practice, care and use of equipment, and prevention of infection. It also outlines the risks associated with intravenous fluid administration, such as infiltration, bruising, embolism, phlebitis, fluid overload, electrolyte imbalance, and infections. Facilities are responsible to administer IV therapy according to the resident-centered care plan, physician orders, and the resident's goals, preferences, and advance directives, as applicable and according to State law. Nursing homes and healthcare facilities must develop and implement policies and procedures based on current professional standards of practice to ensure safe and appropriate administration of parenteral fluids and to minimize risks to the resident. Additionally, they must monitor for complications related to IV therapy and ensure that the resident is receiving the correct type and amount of fluid according to the physician's orders.

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