CMS has published a comprehensive update of chapter 2 (ESRD) of the State Operations Manual (SOM), which describes the oversight activities of State Survey Agencies for certified Medicare providers and suppliers. Chapter 2 of the SOM includes guidance and instructions on procedures for ESRD facilities, including nursing homes. The update incorporates current Conditions for Coverage, and CMS policies for ESRD issued previously through memoranda. Find the document at https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Downloads/QSO18-22-ESRD.pdf.
Kidney Care Partners (https://www.pr.com/press-release/744275) has summarized the ESRD-related provisions of the new budget law, H.R.1892 – Bipartisan Budget Act of 2018; the Act “will expand the use of home dialysis therapy through use of telehealth services; expedite patient access to quality dialysis care at newly certified facilities; and extend authority for Special Needs Plans (C-SNPs) without interruption in care.” In addition, payments for non-emergency ambulance use are reduced.
While the legislation as passed and signed may not be effective until HHS converts it to administrative law, the original lawyerese can be found at:
- For home health telehealth, https://www.congress.gov/bill/115th-congress/house-bill/1892/text#toc-HD17800AE048F430AB1B9EEFBB03FDD55.
- For newly certified units: “an initial survey of a … renal dialysis facility … shall be initiated not later than 90 days after such date on which both the provider enrollment form … [is] complete and the provider’s enrollment status indicates approval is pending the results of such survey,” https://www.congress.gov/bill/115th-congress/house-bill/1892/text#toc-H63740900ED184AAFA50F73B6BE696312.
- For continued access to Medicare Advantage special needs plans for vulnerable populations, https://www.congress.gov/bill/115th-congress/house-bill/1892/text#toc-H89926B550ADD45858E6C1A410176952E.
- For reduction of non-emergency ESRD ambulance transport payments, https://www.congress.gov/bill/115th-congress/house-bill/1892/text#toc-HC2CE8E0B05404D7CAB3E35F887FDC255.
The Greater Puget Sound Chapter #503 of ANNA will present their 2018 Renal Update February 1-2, 2018 in Lynnwood WA. Topics include incivility, surveys, iatrogenic death, teach-back, calciphylaxis, difficult conversations, passion and compassion, AKI, organ donation, ultrafiltration, lupus, hyponatremia, hyperoxaluria, and the future of dialysis. Registration is online only, and closes on January 29, 2018. Discounts are available until 11:30 pm PST January 10, 2018. For more information see https://s3-us-west-2.amazonaws.com/nwrn.org/files/N/ANNA/RenalUpdate2018.pdf.
The November 2017 issue of Network 16 News focuses on the new CMS Emergency Preparedness Rule for dialysis facilities. The Rule requires two exercises per year, one of which must be full-scale. The other can be what they’re calling a “table-top” exercise, or a disaster-response simulation. The bulk of the News issue describes a sample table-top exercise. The Question Corner deals with what State Surveyors will look for when assessing facility compliance with the Rule.
Another article advises that you need to know your facility’s “CCN” or CMS Certification Number. This 6-digit number uniquely identifies your facility, and avoids the confusion of multiple or ambiguous facility names. For instance, in CROWNWeb there are facilities that have entered their facility name as “Fresenius Medical Care” and “Pacific Northwest Renal.” If a facility reported a name like this during a disaster, rather than their CCN, the Network would have to call fifty facilities to find the one with the emergency.
November’s News also flags the March 8-9, 2018 NWRD Annual Conference in Spokane and the April 11-14, 2018 NKF Spring Clinical Meetings in Texas in the “Hot Dates” section. See our Facility Calendar at https://nwrnbulletins.wordpress.com/staff-education-calendar/ for more information on these and other dates.
Current and historical Network 16 News issues are online at https://nwrn.org/providers-and-professional-staff/nw16n.html .
The new CMS Emergency Preparedness Rule for dialysis facilities will be enforced starting November 15, 2017. The Kidney Community Emergency Response Coalition (KCER) has prepared resources for facilities, including Interpretive Guidelines and Survey Procedures, a Survey Tool, and a Knowledge Center. Find them at http://www.kcercoalition.com/en/resources/professional-resources/ .
The Rule requires dialysis facilities to conduct two emergency preparedness exercises per year. One must be full-scale, but the other may be a “table-top exercise,” a group discussion led by a facilitator using a narrated, clinically-relevant emergency scenario that challenges an emergency plan. KCER is also preparing a variety of table-top exercise templates that facilities may copy; see http://www.kcercoalition.com/en/resources/professional-resources/table-top-exercises/ .
We’ve added the July issue of Network 16 News to our website. This edition summarizes the recent Network 18 Quality Conference that featured sessions on palliative care and violence prevention, and announces that registration is open for the October 22, 2017 Network 16 Quality Conference in Tukwila WA (Southcenter), at http://events.r20.constantcontact.com/register/event?oeidk=a07ee1vuqhebf5c5af8&llr=hakkwkrab . The Network 16 Conference will feature sessions on mental health, fluid control, survey readiness, AKI, residual function, and palliative care.
The Network 16 News issue also links to the August 20, 2017 NKF Annual Community Picnic & Wellness Fair in Portland, the September 24, 2017 Strut Your Kidney run/walk in Portland, and the September 23-25, 2017 ANNA Nephrology Nursing Practices, Management & Leadership Conference in Miami FL. Find more information about these events by clicking on “Facility Calendar” at the top of this page.
You can find current and past Network 16 News issues at https://www.nwrn.org/providers-and-professional-staff/nw16n.html .
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 .