7/26 Survey re COVID Expansion

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Washington State Governor’s Proclamation 20-36 waived portions of the CoN statutes and rules to allow providers to expand and/or establish new services to meet COVID-19 treatment and quarantine needs. Washington State DOH has now requested that Washington providers respond to a Survey if they changed their services as a result of this Proclamation. No date has been set for rescinding the Proclamation, but DOH is currently planning how and when to return to CoN-approved services, and needs to know how many facilities were involved, and the nature of their involvement, so they can coordinate their rescission plan. Find the Survey at https://fortress.wa.gov/doh/opinio/s?s=CoNPandemicTransitionPlan. The Survey must be completed by July 26, 2021.

EQRS Data Entry FAQs

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EQRS has published a list of Frequently Asked Questions about the resumed entry into EQRS of the September-December 2020 Clinical Data, ICH CAHPS Attestations, and Clinical Depression Screening and Follow-Up Plan data (see previous post). This data entry must be completed by September 1, 2021. The FAQs also point out how important it is to comment on the CY2022 PPS Proposed Rule (see previous post); comments are due by August 31, 2021. Find the FAQs at https://mycrownweb.org/wp-content/uploads/2021/07/FAQ_Resuming-2020_2021Clinical-Data-Submission_Final_508.pdf.

7/12+ QIP Updates; Resume EQRS Clinical Data Entry

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We haven’t found notice on their website yet, but in an email after COB on July 2, 2021, CMS/EQRS announced that facilities and providers can begin on July 12, 2021 entering into EQRS Clinical Data, ICH CAHPS Attestation, and Clinical Depression Screening and Follow-Up Plan data, for September through December 2020 only. This data must be entered by September 1, 2021 at 11:59 pm PT. This applies to both HD and PD, and all submission methods. Providers and facilities are urged to avoid bunching this data entry in late August, because corrections cannot be made after September 1, and the data will be used for their PY2022 QIP. That gives providers about four weeks to enter four months worth of Clinical and other QIP data. Entry of this data was suspended at the end of January 2021. We expect to find this information published soon at https://mycrownweb.org/#cmstag. See also the next post.

CMS/EQRS will announce separately when 2021 data can be entered into EQRS for the PY2023 QIP.

Separately, CMS has announced in a Fact Sheet at https://www.cms.gov/newsroom/fact-sheets/end-stage-renal-disease-esrd-prospective-payment-system-pps-calendar-year-cy-2022-proposed-rule-cms that a Proposed Rule for the CY2022 QIP has been posted to the Federal Register. This Fact Sheet and the Proposed Rule include:

  • Payment rate updates, including for AKI;
  • Changes to, and requests for comments on, the ETC Model;
  • Formalization of the delays detailed above;
  • Advice that no facility would receive a payment reduction for PY2022;
  • COVID- and EQRS-related adjustments to some PY2022 QIP measures;
  • Proposal to base PY2024 performance standards on CY2019;
  • Request for information on COVID-19 vaccinations;
  • Request for information on health disparities;
  • Request for comments on certain demographic and electronic data plans;
  • Request for comments on future QIP measurement and data collection plans.

Find the Federal Register notice itself at https://www.federalregister.gov/public-inspection/2021-14250/medicare-program-end-stage-renal-disease-prospective-payment-system-payment-for-renal-dialysis.

EQRS has also announced:

More Hot Weather Tips

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Here are some additional resources in advance of this week’s extreme heat in our region:

Cool Tips for Hot Weather, a patient resource developed by Northwest Kidney Centers: https://www.nwkidney.org/wp-content/uploads/2014/07/Nutrition-Tips-Cool-Tips-for-Hot-Weather.pdf or see below.

Preventing Heat-related Illnesses (OHA): https://www.oregon.gov/oha/ph/Preparedness/Prepare/Pages/PrepareForExtremeHeat.aspx.

Extreme Heat (CDC): https://www.cdc.gov/disasters/extremeheat/index.html.

Warning Signs and Symptoms of Heat-related Illness (CDC): https://www.cdc.gov/disasters/extremeheat/warning.html.

Extreme Heat Expected

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The National Weather Service anticipates this weekend to bring record breaking heat to our region with temperatures expected above 100 degrees in multiple locations. The following resources offer tips for patients and providers to use to stay cool during this extreme heat and how to properly manage fluids for those on dialysis. Ways to stay cool:

Networks are required by CMS to track the status of facility operations and patient access to treatment during emergency events. If the operations of your facility, or ability for patients to have access to dialysis are impacted by emergency events, please inform the Network right away. Contact Lisa Hall at LHall@comagine.org or 206-923-0714, and submit our Facility Interruption in Service Form located at https://esrdforms.comagine.org/machform/view.php?id=12270.

CDC Train Continuing Education

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CDC has created and assembled a catalog of on-demand healthcare CME, CNE, and CPE Continuing Education coursework called CDC Train. It offers more than a thousand courses developed by CDC and others, many translated into 109 different worldwide languages. Train is introduced at https://www.train.org/cdctrain/welcome. Project Firstline is their general Infection Control coursework featuring single-question segments that earn as little as 1/20th of a contact hour each and can be done in a few minutes; see https://www.train.org/cdctrain/training_plan/5045. Train’s COVID-19 courses, in English, French, and Spanish, can be found at https://www.phf.org/resourcestools/Pages/Coronavirus_Disease_2019_COVID_19_Training.aspx. That page includes a link to their customizable COVID-19 Contact Tracing training program, in which a facility can assemble segments to design their own online Contact Tracing coursework, in order to standardize training for all facility staff.

CMS Vaccination Campaign

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HHS and CMS are sponsoring a vaccination campaign oriented toward various vaccine-hesitant groups, called We Can Do This. They’ve developed a bewildering array of toolkits and resources, in English, Spanish, and several Asian languages, for general audiences, parents and teens, adolescents, skeptics, the curious, faith-based leaders, family and friends, essential agriculture workers, community health workers, Puerto Ricans, community-based organizations, black colleges, black civic organizations, shared housing, masks, clinics, older adults, nurses, pharmacists, rural communities, caregivers, healthcare navigators, mayors, older Hispanics, social media, Medicare beneficiaries, communities of color, side effects, safety, confidence and trust, US regions, socializing, traveling, risks, stress, self-care, pediatricians, Native Americans and Alaskans, immigrants, and many others! Find these toolkits, posters, podcasts, videos, etc., including a selective retrieval tool, at https://wecandothis.hhs.gov/.

The campaign also includes half-hour webinars introducing specific categories of resources, all at 10 am PDT:

Recall: 2 Lots Metformin XR 750mg

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The FDA has announced the recall of two lots of Viona Pharmaceuticals Metformin HCl Extended Release 750mg tablets because of impurities. Lot or “Batch” numbers are M915601 and M915602, NDC 72578-036-01, expiring October 2021. For details see https://www.fda.gov/safety/recalls-market-withdrawals-safety-alerts/viona-pharmaceuticals-inc-issues-voluntary-nationwide-recall-metformin-hcl-extended-release-tablets.

6/15 EQRS New User Training

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The EQRS staff will present an online June 15, 2021 EQRS New User Training. For more information and to register see https://mycrownweb.org/pcw_lems/june-2021-new-user-training/.

Remember that Clinical Data entry is still paused. From our February 1, 2021 EQRS Clinical Data Deadline Suspensions post (https://nwrnbulletins.wordpress.com/2021/02/01/eqrs-clinical-data-deadline-suspensions/):

“At this time, we are suspending EQRS Clinical Data, ICH CAHPS Attestation, and Clinical Depression Screening and Follow-Up Plan submission, effective immediately. Users should not send any additional clinical data to CMS… Users must continue to use EQRS to complete tasks such as admit and discharge patients, complete CMS forms (such as the 2728, 2744, and 2746), add or update treatment summaries, and resolve notifications within a timely manner. Users should also continue to keep facilities’ information up-to-date.“

The suspension is reiterated and detailed in the May EQRS Monthly Newsletter, at https://mycrownweb.org/2021/04/may-2021-newsletter/.