2/21 CMS Proposed Rule on OPO Measures Comment Period

In December CMS proposed revisions to Organ Procurement Organization Performance Measures for Kidney Donation Rate and Transplant Rate, and to OPO monitoring and benchmarking.  The revised measures aim to increase the number of Kidney Transplants by about 5,000 per year.  The revisions are described in the Fact Sheet at https://www.cms.gov/newsroom/fact-sheets/organ-procurement-organization-opo-conditions-coverage-proposed-rule-revisions-outcome-measures-opos.  Public Comment is due by February 21, 2020.  The Proposed Rule is published in the Federal Register at https://www.federalregister.gov/documents/2019/12/23/2019-27418/medicare-and-medicaid-programs-organ-procurement-organizations-conditions-for-coverage-revisions-to.

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:

RSN re Preventing Transplant Rejection

The Renal Support Network has added a new podcast on Understanding and Preventing Transplant Rejection, featuring an immunologist talking about antibodies and their impact on transplant decisions and graft rejection.  Find the audio at https://www.rsnhope.org/kidneytalk/understanding-and-preventing-transplant-rejection/.

Transitional Care for Urgent Starts in Dialysis

Home Dialysis Central has published a blog post on Traditional Dialysis vs. Transitional Care for Urgent Starts.  Transitional Care for Urgent Starts (TCU) provides a gentler and more supportive introduction to dialysis for people whose kidneys fail with little warning, helping them get past the shock of a “sudden” change of just about everything in their life, and helping them make informed decisions about treatment modality.  Of course kidneys don’t fail suddenly, but sometimes it seems that way to the person whose kidneys have failed.  Find the post at https://homedialysis.org/news-and-research/blog/330-traditional-dialysis-vs-transitional-care-for-urgent-starts.

Transplant CoP Changes

Modifications to the Conditions of Participation for kidney transplant programs (formerly transplant centers) have been published in the Federal Register for September 30, 2019.  They will take effect on November 29, 2019.  The primary change is that an approved transplant program will no longer be required to submit outcome data for periodic re-approval.  The modifications are summarized by the American Society of Transplant Surgeons at https://asts.org/news-and-publications/asts-news/article/2019/09/27/cms-removes-outcomes-requirement-for-transplant-center-re-approval, and detailed in the Federal Register at https://www.govinfo.gov/content/pkg/FR-2019-09-30/pdf/2019-20736.pdf, pp.51748-50.

RSN Podcast on Pets and Transplant Safety

The Renal Support Network has added to their website a KidneyTalk audio presentation on Pets and Kidney Transplant Safety.  Find it, along with their long list of prior podcasts, at https://www.rsnhope.org/kidneytalk/pets-kidney-transplant-safety/.  Recent prior audios include Active Living/Travel, Are You at Risk – Just Diagnosed, and Emotion and Communication.

Scarcity of Deceased Donor Kidneys by Area

Kidney International Reports has estimated that between 2015 and 2018, there were 12 to 17 patients added to the kidney transplant waitlist for every ten deceased donor kidneys that became available in Network 16, and in Network 18 between 17 and 48 newly waitlisted patients for every ten newly available kidneys.  The greatest scarcity of kidneys (26-48 candidates per ten available kidneys) occurred in San Luis Obispo, King, Tulare, and Inyo Counties of California.  Areas with more newly available deceased donor kidneys than waitlist additions (10-18 new kidneys per ten new candidates) included Nevada, northwestern Arizona, Oklahoma, northwestern Ohio, eastern upstate New York, western Vermont, and east-central Florida.  For details see https://www.kireports.org/article/S2468-0249(19)31474-3/fulltext.