The NHSN June Newsletter can be found at http://www.cdc.gov/nhsn/newsletters/index.html . The Newsletter includes articles on AKI, Release 8.7 updates, Prevention Process Measures analysis, Release 8.8 beta testing volunteer opportunities, and training updates. Find material specific to dialysis on pages 16-17, and information relevant to all NHSN users on pages 2 and 18ff.
NHSN will twice present a webinar on Introduction to the NHSN Dialysis Event Surveillance Protocol, once on August 3, 2017 and again on August 4, 2017. NHSN Dialysis Event Surveillance reporting is required for the CMS ESRD QIP. This webinar will provide a complete introduction to the NHSN Dialysis Event reporting requirements and the surveillance definitions necessary to complete accurate monthly reporting. CDC subject matter experts will be available to answer questions, and continuing education credits will be provided. Pre-registration is required, at:
- August 3, 2017: https://cc.readytalk.com/registration/#/?meeting=9mk8wwdsoete&campaign=75teltj89f5v .
- August 4, 2017: https://cc.readytalk.com/registration/#/?meeting=69hc839cwgvq&campaign=tti2zfpgfm4y .
Continuing education credits are also available for NHSN’s recorded presentations. Find these, with instructions for obtaining CE credits, at https://www.cdc.gov/nhsn/Training/continuing-edu.html .
CDC is soliciting volunteer clinics to beta test version 8.8 of NHSN, currently scheduled for full release on December 9, 2017. The beta testing period will be open from October 23, 2017 to November 3, 2017. During this time, dummy data will be populated into the beta website for testers to manipulate within NHSN 8.8. New data will be available each morning after a purge of all data submitted the previous day. Beta testing will provide an opportunity for NHSN users to explore new NHSN features and potentially identify issues that can be resolved prior to the full release. If you have any questions or want to volunteer for beta testing, contact NHSNBeta@cdc.gov with “Dialysis Component” in the subject line.
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 .
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).
CMS has published the 2o17 edition of the CMS ESRD Measures Manual, which details how the PY2017 (CY2017) QIP and October 2017 DFC Star Ratings are calculated. The Manual includes information on the new Kt/V and NHSN QIP measures, TPS calculation, PY2020, and changes to DFC and Star Rating calculations. Find a copy of the CMS press release, which includes links to the Manual and supporting material, at https://s3-us-west-2.amazonaws.com/nwrn.org/files/QIP/CMS%2CQIP.061617.pdf .