12/12+ Fall 2019 Provider Newsletter and Archive

We’ve published the Fall 2019 ESRD Network 16/18 Provider Newsletters.  Find them at:

We include links to earlier issues at the end of this post.  Most content is the same for both Networks, but not all.  We’ve marked where they differ, and we’ve used blue type where information in one version also applies to the other Network.  The Fall 2019 issue feature articles on:

  • Quality Improvement:
    • 2020 Quality Improvement Activities, which we expect to begin before Christmas.
    • Changes to the ESRD QIP, which include changes to measures for the Transplant Waitlist, Medication Reconciliation, Transfusions, and BSIs.  We’ve scheduled a December 12, 2019 webinar to summarize these QIP changes (and the many other measures that aren’t changing).
    • Opioid Awareness and Pain Management.
    • Diabetes Self-Management.
  • Patient Services:
    • Managing Patient Expectations to help create a calm and conflict-free environment.
    • The Dialysis Patient Depression Toolkit.
    • Patient Newsletters in English and Spanish for each Network.
  • Data:
    • The importance of Keeping Patient Information Up to Date, especially patient addresses, which are critical for tracking everyone in emergencies and disasters, for identifying home facilities and transplant centers near the patient, for receiving notices like the New ESRD Patient Orientation Packet, and for monitoring patient clusters so your organization can effectively plan where to locate new facilities.
    • A mini-lesson on how to admit a new patient into CROWNWeb if they do not have an SSN or MBI.
  • Emergency Preparedness:
    • Fire Danger Power Shutoffs and Fire Resources in California (NW18 version).
    • The new ESRD Facility Emergency Preparedness Final Rule that went into effect on November 29, 2019 (NW18 version but also relevant to NW16).
    • New KCER document on Emergency Disconnect Procedure for In-Center Hemodialysis Patients (NW16 version but also relevant to NW18).
    • Notify the Network of any Interruptions in Service.
    • KCER Newsletter.
  • Notify the Network of any Personnel Changes.
  • Upcoming Events!

We also list events of interest to Dialysis Facilities, Transplant Centers, and staff, on our Facility Calendar, via the link at the top of this page.

Find previous issues at:

9/27 CMS Proposed Changes to Dialysis Reimbursements

CMS will publish in the Federal Register on August 6, 2019 a Proposed Rule that includes changes to the CY2020 ESRD PPS, ESRD QIP, AKI payments, and many other details, including adjustments to the PY2022 NHSN and STrR measures, and provisions for new and innovative treatments.  The Proposed Rule also includes requests for public comment on the case-mix adjustment model and wage indices.  Comments will be due by September 27, 2019.  Find:

DFC January Update

CMS has announced that new data on the care quality of dialysis facilities is now available on Dialysis Facility Compare (DFC), the website that allows patients and health centers to view and compare quality data about dialysis facilities.  CMS uses this data, organized into a series of measures, to create a 5-Star Rating system that can help patients make educated decisions about where to get their dialysis treatments, as well as to assist them in speaking with their healthcare team regarding their care.

The January revision has updated information for Standardized Transfusion Ratios, Standardized Mortality Ratios, Standardized Hospitalization Ratios, Standardized Readmission Ratios, vascular access types (fistula and catheter), bloodstream infections, hemoglobin management, and the CAHPS survey on in-center hemodialysis patient experience.  The July 2017 DFC data for dialysis adequacy, hypercalcemia, serum phosphorus, and the facility Star Ratings will remain until the next update.

Find DFC at https://www.medicare.gov/dialysisfacilitycompare/#.

If you’re computer-savvy, you can download supplementary DFC data from https://data.medicare.gov/data/dialysis-facility-compare.

UNOS, CDC on Zika

UNOS/OPTN has issued a bulletin covering Guidance for Organ Donation and Transplantation Professionals Regarding the Zika Virus. The bulletin includes notes about transfusion.  Much information remains unknown, and the Guidance revolves around recent donor travel history and risk considerations, with the warning that vulnerability to Zika may also mean vulnerability to Dengue and Chikungunya.  For details see https://optn.transplant.hrsa.gov/news/guidance-for-organ-donation-and-transplantation-professionals-regarding-the-zika-virus/ .

CDC has also issued a HAN Health Alert on Zika, HAN #392, CDC Recommendations for Subsequent Zika IgM Antibody Testing.  It warns healthcare facilities that they may need to collect a second blood sample if they don’t hold back and refrigerate a portion of the original sample for additional testing.  Find the HAN at  http://emergency.cdc.gov/han/han00392.asp .

Zika is a nationally notifiable condition.  As of mid-June, 48 cases of the Zika virus had been lab-confirmed in (all of) California, and 13 cases in Oregon (7), Washington State (5) and Montana (1), all travel-related.  The spread of Zika in the US is tallied at http://www.cdc.gov/zika/geo/united-states.html .  Travel locations vulnerable to acquiring Zika via mosquitoes are listed at http://wwwnc.cdc.gov/travel/page/zika-travel-information .