9/21+ ANNA 503 Fall Workshop

The ANNA Chapter 503 Fall Workshop will be held in Seattle on September 29, 2018, but online pre-registration is required by September 21, 2019.  There will be no on-site or by-mail registration.  Topics include Learning Cultures, HD Case Studies, Marijuana, AKI, PD Catheter Placement, Gn, and Ethics.  7.2 CE are available.  For more information see https://s3-us-west-2.amazonaws.com/nwrn.org/files/N/ANNA/ANNA503Fall.pdf.  Register at https://www.eventbrite.com/e/anna-503-fall-renal-workshop-2018-tickets-47333611105, and find directions to the Workshop venue at http://www.seattlechildrens.org/contact/main-hospital/map/.  Parking is free in Lot 1; follow walkway to “River” Entrance.

9/25+ CCCC News

News about Coalition for Compassionate Care of California events:

  • April 8-9, 2019: CCCC Annual Summit, San Francisco, for everyone who wants to learn more about palliative care, share innovative practices and be part of a growing movement to improve the care of seriously ill people of all ages.  For details see http://ccccsummit.org/?mc_cid=9688cbc52e&mc_eid=67e1ad4c31.

* Check with CCCC about times for these webinars; their bulletin says PST, but the rest of California is on PDT, so it’s hard to say which they intend.

8/15 CMS Opioid Forum Call

CMS will present an August 15, 2018 Open Door Forum (national conference call) on Sharing Federal Strategies to Address the Opioid Epidemic.  For details see https://www.cms.gov/Outreach-and-Education/Outreach/OpenDoorForums/ODFSpecialODF.html (August 1, 2018 entry) and https://www.cms.gov/Outreach-and-Education/Outreach/OpenDoorForums/Downloads/08152018SODFAgenda.pdf.

9/10 QIP PY2021-24

CMS has released the proposed ESRD QIP Technical Specifications for PY2021, 2022, and 2024.  Proposed changes include:

  • Elimination of Pain Assessment (NOT Depression Screening as indicated earlier), NHSN Healthcare Personnel Vaccination, Anemia Management, and Serum Phosphorous in PY2021.
  • New measures for Medication Reconciliation Reporting and Existing-Patient Transplant Waitlist for PY2022.
  • A new measure for Incident-Patient Transplant Waitlist in PY2024.
The proposed Technical Specifications can be found at https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/ESRDQIP/061_TechnicalSpecifications.html.  Comments on the proposals are due by September 10, 2018.  For more information see https://nwrnbulletins.wordpress.com/2018/07/11/cy2019-esrd-pps-proposed-rule/.

9/10 CY2019 ESRD PPS Proposed Rule

CMS has released a proposed rule for the CY2019 ESRD PPS, titled Proposed Updates to Policies and Payment Rates for the ESRD PPS, … QIP; and Payment for Renal Dialysis Services Furnished to Individuals with AKI and a fact sheet summarizing it.  The ellipsis in the title refers to durable medical equipment changes included in the same proposed rule.  Find the fact sheet at https://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2018-Fact-sheets-items/2018-07-11.html.

The fact sheet includes summaries of:

  • Removing the Healthcare Personnel Vaccination, Pain Assessment, Anemia Management, and Serum Phosphorus reporting measures from the PY2021 QIP.
  • Restructuring domains and weights in the PY2021 QIP.
  • Expanding NHSN validation in both PY2021 and PY2022.
  • Adding measures for Percentage of Patients Waitlisted and Medication Reconciliation to the PY2022 QIP.
  • Adding a measure on Standardized First Transplant Waitlist Ratio for Incident Patients to the PY2024 QIP.

The proposed rule can be found on the Federal Register at https://s3.amazonaws.com/public-inspection.federalregister.gov/2018-14986.pdf.  Comments must be received by September 10, 2018.

CDC HAN on Coagulopathy

CDC has published a Health Alert Network advisory on vitamin K-dependent antagonist coagulopathy caused by synthetic cannabinoids apparently contaminated with the rodenticide brodifacoum.  While CDC does not report any cases from the West Coast, they advise proceduralists who deal with blood, and others, to be aware of the possibility.  The HAN includes:

  • Recommendations for clinicians, including notifying health authorities, especially in cases where a synthetic cannabinoid user has recently donated blood
  • Recommendations for public health officials, including notifying CDC
  • Recommendations for the general public, including avoiding synthetic cannabinoids

For details see https://emergency.cdc.gov/han/han00410.asp.

There is no suggestion that natural, non-synthetic cannabinoids are similarly contaminated; these are regulated and legal by state law in all of Networks 16 and 18 except Idaho, and increasingly used for medical purposes.  There is also no suggestion that natural, non-synthetic, non-psychoactive CBD oil made from industrial hemp, which is available throughout the US, is similarly contaminated; however, outside of the regulated marketplace, industrial-hemp CBD oil is unregulated, so the potential for contamination of some kind is always present.