Category Archives: Hospitalization

More January+ News and Events

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New CMS Rule for CY2022

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CMS has published an update for CY2022 to the QIP, ETC Model, and PPS AKI payments. Among other issues, the update emphasizes Healthcare Equity and the lingering impact of COVID-19. Find a summary Fact Sheet at https://www.cms.gov/newsroom/fact-sheets/cy-2022-end-stage-renal-disease-prospective-payment-system-final-rule-cms-1749-f, and the Final Rule at https://public-inspection.federalregister.gov/2021-23907.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:

Possible New QIP Measures

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CMS is in the process of deciding which new measures to add to its Quality programs. For the ESRD QIP, measures under consideration include in-center patient Coronavirus vaccination coverage, health care personnel Coronavirus vaccination coverage, and Standardized Hospitalization Ratio. For details see https://www.cms.gov/files/document/measures-under-consideration-list-2020-report.pdf – suggested new ESRD measures are summarized on p.82. Measures under consideration are being sent to the National Quality Forum’s Measure Applications Partnership (https://www.qualityforum.org/map/). After the “MAP” has evaluated them, measures still under consideration will be published in the Federal Register for public comment sometime after February 1, 2021.

AAKP Seeks CCPD Patient/Caregiver Input

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AAKP is supporting a research initiative with Relavo, a medical device company aiming to make peritoneal dialysis safer and more accessible by reducing the risk of peritonitis, which hospitalizes 15% of PD patients annually.  Relavo is a recent winner of the KidneyX Innovation Accelerator Phase 2: Redesign Dialysis Competition, and of the KidneyX Patient Innovator Challenge.  AAKP and Relavo are seeking patients and caregivers with CCPD experience that are over 18, currently live in the US, and read/understand English, to participate in an online survey.  The results will be used to ensure that a Relavo device, the PeritoneX, addresses what matters most to patients and caregivers.  Learn more about PeritoneX, which disinfects CCPD tubing during treatment set-up, at https://relavomedical.com/.  Find the survey at https://www.surveygizmo.com/s3/5787206/Relavo-Device-Survey.

RSN Podcasts on Hospitalization, Emotional Balance

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RSN KidneyTalk has published two new podcasts on:

4/2+ ASN COVID-19 Webinars on Hospitalization and Home

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ASN will present an April 2, 2020 webinar on Hospital Care and Treatment Options for COVID-19 Positive Patients with ESKD and AKI that will address key areas of concern in the management of COVID-19 positive patients receiving RRT in the hospital setting, including treatment options, staffing, and safety.  Register at https://register.gotowebinar.com/register/4478274981960155148.

There’s no link yet, but ASN has also promised an April 9 webinar on Considerations in the Home Dialysis Setting. 

Recordings of the two previous ASN COVID-19 webinars are available at:

September Is Sepsis Awareness Month

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In a new Safe Healthcare blog post at https://blogs.cdc.gov/safehealthcare/sepsis-awareness-month-why-each-person-matters/, CDC’s Dr. Denise Cardo highlights efforts to protect patients from #SEPSIS and how CDC’s partners in healthcare have impacted this work.  Dr. Cardo also includes many links to useful resources for combatting sepsis.  Join the conversation on Twitter or on the Safe Healthcare blog itself, and spread the word.  It could save a life.  #SAM2019

Diabetic Foot Care

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A recent study published in the American Diabetes Association’s (ADA) journal Diabetes Care (http://care.diabetesjournals.org/content/early/2019/05/28/dc19-0296) using 2000-2015 USRDS data has shown that the rates of nontraumatic lower-extremity amputation (NLEA) among adults with ESRD and diabetes fell 44% between 2000 and 2013 from 7.5 to 4.2 NLEA per 100 person-years, while NLEA among ESRD patients without diabetes declined 31% over the same period, from 1.6 to 1.1 per 100 person-years.  Both reductions were highly statistically significant.  However, both rates flat-lined after 2013.

We want to stress the importance of improving patient and staff education on diabetes self-management and preventive foot care, in order to resume the reductions in these rates.  CDC’s recommendations on diabetic foot care can be found at https://www.cdc.gov/features/diabetesfoothealth/index.html.  The ADA’s input is at http://www.diabetes.org/living-with-diabetes/complications/foot-complications/foot-care.html in English and http://www.diabetes.org/es/vivir-con-diabetes/complicaciones/el-cuidado-de-los-pies.html in Spanish.

6/25 CMS Seeks Comment on Rural Hospital Payment Changes

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CMS has proposed that they improve their payments to rural hospitals, in an effort to improve rural health in the US.  While this isn’t directly relevant to ESRD, it will certainly be relevant whenever a kidney patient needs services at a hospital in a rural area.  Find the Proposed Rule and Request for Comment at https://www.govinfo.gov/content/pkg/FR-2018-05-07/pdf/2018-08705.pdf, and a Notice of Corrections at https://www.govinfo.gov/content/pkg/FR-2018-06-20/pdf/2018-13152.pdf.  Comments are due by June 25, 2019.  For background information see https://www.cms.gov/blog/putting-our-rethinking-rural-health-strategy-action and https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/FY2019-IPPS-Proposed-Rule-Home-Page-Items/FY2019-IPPS-Proposed-Rule-Regulations.html?DLPage=1&DLEntries=10&DLSort=0&DLSortDir=ascending.