CMS has provided a one-page summary on “5 Ways for Healthcare Providers to Get Ready for New Medicare Cards.” Find a copy at https://www.cms.gov/Medicare/SSNRI/5-Things-What-to-do-Now-Drop-In-English.pdf?linkId=38944698 . Find background information at https://www.cms.gov/Medicare/SSNRI/Index.html .
CMS has proposed a new rule that modifies the QIP for PY2019-21. Comments on the rule will be accepted until August 28, 2017. The proposed rule includes updates to reimbursement rates, the ESRD QIP Extraordinary Circumstances Exception Policy (ECE), PSC, NHSN dialysis event data validation sampling methodology, and quality measures. The rule also requests comments on how to include individuals with AKI in the ESRD QIP, and on the feasibility and appropriateness of accounting for social risk factors in the program. Find an advance copy of the proposed rule at https://s3.amazonaws.com/public-inspection.federalregister.gov/2017-13908.pdf . The proposed rule is scheduled for the July 5, 2017 Federal Register. A copy of the CMS press release on the proposed rule can be found at https://www.cms.gov/Newsroom/MediaReleaseDatabase/Press-releases/2017-Press-releases-items/2017-06-29.html .
A CMS Fact Sheet summarizes the various changes and proposals in the rule, and also introduces a planned CMS RFI that will welcome continued feedback on the Medicare program with the aim of increasing efficiency, transparency, flexibility, program simplicity, and innovation. Find the Fact Sheet at https://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2017-Fact-Sheet-items/2017-06-29.html .
NKF and HealthUnlocked have created four new online communities to provide help, support, and information for:
- Kidney Disease Community for anyone affected by or at risk of kidney disease – https://healthunlocked.com/nkf-ckd
- Kidney Dialysis Community for support of people on dialysis – https://healthunlocked.com/nkf-dialysis
- Living Donor Community for people who have donated a kidney – https://healthunlocked.com/nkf-donors
Transplant Community for people who have had a transplant, are waiting for a transplant, or are a family member/friend/caregiver – https://healthunlocked.com/nkf-kidneytransplant
HealthUnlocked is the third largest health website in the UK and in the top 20 globally. With over 40 million users per year in over 500 unique communities, the HealthUnlocked website increases patient engagement and contributes to improved health outcomes through its online health and well-being forums. https://healthunlocked.com/ is a social platform and mobile application with moderated online health communities in which visitors can access useful information and services; seek advice, support and mentoring from peers; be empowered to make better healthcare decisions; and help advance medical research and understanding. The HealthUnlocked platform is used as a clinical care planning tool in 75 hospitals in the UK.
Find the NKF announcement at https://www.kidney.org/news/new-collaboration-between-nkf-and-healthunlocked-to-provide-free-online-support-community .
We’ve inquired, and CDC informs us that the new deadline for entering and correcting Q1 NHSN data to have it count toward the ESRD QIP is indeed July 31, 2017. They have assured us that the “Clarification” announcement dated June 26, 2017 supersedes the June NHSN Newsletter.
The most important news on NHSN is that according to an email “Clarification” sent June 26, 2017, the deadline for entering and correcting data for Q1 2017 has been extended until July 31, 2017, for reasons explained and documented below. The June NHSN Newsletter documents the deadline as June 30, 2017; however, CDC says to trust the “Clarification” date rather than the Newsletter date.
CDC has released the June NHSN Newsletter, at https://www.cdc.gov/nhsn/newsletters/index.html . News on the Dialysis Component is on pages 16-17, and includes articles on:
- How to handle AKI patients in NHSN:
- The Newsletter advises that AKI Dialysis Events “should” be entered, but if it’s done properly they won’t be counted against a facility’s QIP scores.
- However, in a separate email announcement on “Clarification on Patients with AKI and [NHSN] Reporting…” they say that reporting PBCs in AKI patients is optional, and extend the Q1 2017 QIP deadline to July 31. CDC has advised us that this announcement supersedes the Newsletter. Find a copy of this email at https://s3-us-west-2.amazonaws.com/nwrn.org/files/NHSN/0617/nhsn0626.pdf . The email included two attachments:
- “Adding and Editing Dialysis PBC Events to Indicate an AKI Patient … 2017” gives instructions for entering AKI PBCs properly so they won’t count on your PSR, should you decide to enter them. Find it at https://s3-us-west-2.amazonaws.com/nwrn.org/files/NHSN/0617/AKI.Instr.PBC.2017.pdf .
- “Editing Denominators [in NHSN] to Remove AKI Patient Counts … 2017” describes how to make sure your AKI patients are not counted for QIP purposes. Find this document at https://s3-us-west-2.amazonaws.com/nwrn.org/files/NHSN/0617/AKI.Inst.Denoms.2017.pdf .
- The June 17, 2017 release of NHSN v.8.7 was announced on June 20, with a note that any analysis or reporting must be preceded by generation of new datasets:
- This announcement included Release Notes, which can be found at https://s3-us-west-2.amazonaws.com/nwrn.org/files/NHSN/0617/NHSN8.7.pdf . However, for the Dialysis Component they said only “Analysis and Reporting: An update for 2015 aggregate data has been completed so that users can have access to the most recent data available when comparing a facility or group’s rate to the national pooled mean rate. This update includes new aggregate rates, p-values, and percentiles for 6 rate tables and 6 run charts (all of those in Analysis Reports > Dialysis Events > Rates > CDC-Defined Output).”
- On the other hand, the June Newsletter included a long article on “Release 8.7 Updates.” Find this article on page 16 at https://www.cdc.gov/nhsn/newsletters/index.html .
- “Prevention Process Measures Analysis” describes how to differently ask for Injection Safety reports on older and later data (page 17).
- The June 30, 2017 QIP deadline, which has been extended to July 31, 2017 (see lead paragraph above). This article includes instructions for reviewing your data for accuracy and completeness (p.17).
Networks are required by CMS to track the status of facility operations and patient access to treatment during emergency events, and we are entering wildfire season. If the operations of your facility, or ability for patients to have access to dialysis are impacted by emergency events, please let your Network know right away.
- In Washington, Oregon, Idaho, Montana, and Alaska (Network 16), contact Lisa Hall at LHall@nw16.esrd.net or 206-923-0714. We also ask that you fill out and submit our Disaster Reporting Form, which you can find at https://nwrn.org/files/E/Interruptions.pdf .
- In Southern and South-Central California (Network 18), contact Eileen Rhodes or Julie Aguilar at 888-268-1539 or by email at ERhodes@nw18.esrd.net or JAguilar@nw18.esrd.net , and fill out the form at http://www.esrdnetwork18.org/machform/embed.php?id=16298 . Instructions for the form are at http://www.esrdnetwork18.org/emergency/ .
CMS will host a July 10, 2017 webinar on ESRD QIP: Previewing Your Facility’s PY2018 Performance Data. The Preview Period will begin July 17, when CMS will make Preview PSRs available to facilities. These reports show the performance results that CMS will use to determine if a facility will incur a payment reduction for PY2018. The PY2018 QIP process is described at https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/ESRDQIP/Downloads/PY-2018-Program-Details.pdf . During the month-long Preview Period, facilities can review their measure scores and ask CMS questions about how their scores were calculated. Facilities will also be able to submit one formal inquiry if they find or suspect an error in how their scores were calculated. The webinar will describe the steps that dialysis facilities need to take to participate in the Preview. Register for the webinar at https://register.gotowebinar.com/register/3216642538964021761 .
On June 28, 2017, a webinar will provide an update to CMS dialysis quality measures and Star Ratings, and discuss recommendations and next steps from the recent Star Ratings Technical Expert Panel and Patient Summit. Register at https://register.gotowebinar.com/register/4557956566332806147 . Direct questions to CMSESRD@ketchum.com .
NKF and the Portland Kidney Group will present their Annual Community Picnic & Kidney Wellness Fair in Portland on August 20, 2017. Bring your family, friends, and appetite, and don’t forget to RSVP. Volunteers will be appreciated. Find full details at https://s3-us-west-2.amazonaws.com/nwrn.org/files/N/PKG.Picnic.0817.pdf .
JCAHO and CMS have issued a new ruling that texting of medical orders from a personal mobile device (such as a smartphone) is no longer permitted, whether or not the texting service claims to be secure. The preferred method is to enter orders directly into the Electronic Health Record. Written order are still permitted, as are verbal orders when neither EHR nor written orders are feasible.
This is the headline article in the June 2017 issue of Network 16 News. This issue also contains:
- An article on “Are you State Survey Ready?” that provides advice on avoiding Condition Level citations.
- A note about possible confusion between HBsAg and HBeAg that can cause a facility to miss a Hepatitis B infection.
- Flags in the “Hot Dates” section on:
- The August 20, 2017 NKF Annual Community Picnic & Wellness Fair in Portland; see https://s3-us-west-2.amazonaws.com/nwrn.org/files/N/PKG.Picnic.0817.pdf
- The September 23-25, 2017 ANNA Nephrology Nursing Leadership Conference in Miami FL; see https://www.annanurse.org/events/nephrology-nursing-practice-management-leadership-conference
- The October 22, 2017 Network 16 Annual Quality Conference in Tukwila WA; see
Find all Network 16 News issues at https://nwrn.org/providers-and-professional-staff/nw16n.html .