7/26 Survey re COVID Expansion

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

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

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:

• An EQRS Town Hall on July 8, 2021; see https://mycrownweb.org/pcw_community_events/july-2021-town-hall/.
• EQRS New User Training on July 20, 2021; see https://mycrownweb.org/2021/06/nut-july-2021-announce/.

Extreme Heat Expected

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:

• Extreme Heat, https://www.ready.gov/heat.
• Heat Stress Related Illness (how to identify signs of heat exhaustion or heat stroke, and what to do about it), http://www.cdc.gov/niosh/topics/heatstress/heatrelillness.html.
• KCER Extreme Summer Heat, https://www.kcercoalition.com/en/resources/hazards-resources/ (scroll down to “Extreme Heat” section).
• Fluid Management Tips in English, https://s3-us-west-2.amazonaws.com/nwrn.org/files/NW18/Fluids.Eng.pdf.
• Same in Spanish, https://s3-us-west-2.amazonaws.com/nwrn.org/files/NW18/Liquidos.esp.pdf.

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.

6/15 EQRS New User Training

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/.

NW16 New IVD Guidelines

Find our new Involuntary Discharge Guidelines, with clarification of facility staff and Medical Director responsibilities, at https://www.nwrn.org/providers-and-professional-staff/patient-services/ivd.html.

5/18 EQRS New User Training

The EQRS staff will present an online May 18, 2021 EQRS New User Training. For more information and to register see https://mycrownweb.org/pcw_lems/may-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/.

4/22+ Staff Education

Recently announced staff education opportunities:

• April 22, 2021: NIDDK will host a live Facebook event on CKD: Hope through Research, featuring Directors of NIDDK discussing advances in artificial kidneys, and research on genetic causes of CKD. Find details and sign up at https://www.facebook.com/events/727026381297271.

• Weekdays in April and May: The Fresenius Global Medical Information & Education Office frequently repeats their extensive suite of CKD staff education webinars and product training presentations. The sessions are open to all, and CEUs are available. Recent additions include a webinar on Non-Infectious Complications of PD, and a Review of the Liberty Select Cycler. Find the course list, May Calendar, a link to more information, and registration instructions at https://custom.cvent.com/0C5715850B334257947E1386198E9836/files/cc507ac1225e456ba9d837d4a6bfa85d.pdf.

• April 29, 2021: EQRS Town Hall on how to admit, discharge, view, and edit patients, and submit initial 2728 Forms. These are data reporting requirements that have NOT been suspended until further notice (see https://nwrnbulletins.wordpress.com/2021/02/01/eqrs-clinical-data-deadline-suspensions/ for details). Find more information on the Town Hall and register at https://mycrownweb.org/2021/04/april-2021-town-hall-registration-open/.

• May 4, 2021: The Coalition for Compassionate Care of California will present a webinar on Caring & Commemoration: Creative Models for the Dying in the Face of COVID. The webinar is free to members, and one CEU is available for nurses and social workers. Find more information and tickets at https://www.eventbrite.com/e/caring-commemoration-creative-models-for-the-dying-in-the-face-of-covid-tickets-149609767843, and in the first picture below.

• July 14, 2021: NIDDK will present a six-hour workshop on Technologies to Optimize Kidneys for Transplant, in an effort to increase the supply of kidneys for transplantation. Find more information and register at https://www.niddk.nih.gov/news/meetings-workshops/2021/technologies-optimize-kidneys-transplant, and in the second picture below.

4/15+ April Staff Education

A partial list of April 2021 CEU and other staff education opportunities follows:

• April 2021 weekdays: FMC Global Medical Office Medical Education Online Webinar Series and Product Training Presentations. Multiple topics, many repeated monthly, CEUs available. New for April: Clinical & Surgical Management of Non-Infectious Complications of PD, Virtual PD Product Demonstrations, ESRD Care: New CMS Payment Models and Resources. Find details and register at https://custom.cvent.com/0C5715850B334257947E1386198E9836/files/33a31c5178af411a82d4608ad5d39703.pdf.

• April 15, 2021: CMS National Training Program Medicare Update & Education Webinar. Find details and register at https://cmsnationaltrainingprogram.cms.gov/moodle/login/index.php.

• April 15, 2021: Advanced Renal Education Home Dialysis Webinar on A Patient’s Journey Through Transitional Care. CEUs available. Find details and register at https://web.cvent.com/event/5431acd7-886f-4c2a-85ca-2a1d1889b772/summary.

• April 20, 2021: EQRS New User Training. Find details and register at https://mycrownweb.org/pcw_lems/april-2021-new-user-training/.

• April 22, 2021: Advanced Renal Education Home Dialysis Webinar on Vascular Access in HHD & Hands-on Self-Cannulation Training. CEUs available. Find Details and register at https://web.cvent.com/event/c9dd79e6-b4ae-4adc-b336-edb43ccfc042/summary.

• April 23, 2021: PFCC webinar on Reigniting Partnerships with Patients and Families. Find details and register at https://us02web.zoom.us/meeting/register/tZIpcO2urj0rHt32Rc8UPd8iLWbDoFOMtkTB.

• April 29, 2021: KDIGO webinar on CKD-MBD Guideline: 4 Years On and Time for Change? Find details and register at https://register.gotowebinar.com/register/330719217881283595.

Note that Continuing Education Credit may be available even where not indicated above.

4/20 EQRS April News

EQRS has published their April News letter, featuring articles on

• Continuing the January 29, 2021 advice to suspend entry of Clinical Data, ICH CAHPS Attestation, and Depression Screening/Follow-Up into EQRS until further notice. Find details at https://mycrownweb.org/2021/01/eqrs-system-announcement-jan-2021/.
• Overview of KCER’s participation in the March 2021 EQRS Town Hall.
• Emergency Preparedness Checklist.
• A note on how EQRS data supports CMS and the ESRD NCC.
• A reminder that Clinical Data submissions have been suspended.
• Notice of New User Training on April 20, 2021.

And the usual comprehensive list of relevant resources. Find the News at https://mycrownweb.org/2021/03/april-2021-newsletter/.