A Periodic Newsletter from The Mid-Atlantic Renal Coalition | www.esrdnet5.org
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February 18, 2016 
MARC e-lerts 
The Mid-Atlantic Renal Coalition (MARC) distributes MARC e-lerts to share important information affecting the Network 5 renal community.  We hope you find this edition's reminders, educational opportunities, tools, and resources helpful.  
 
NOTE: To ensure delivery to your inbox, please add marc@nw5.esrd.net to your address book. 

Message from the Director
In this jam-packed issue of e-lerts, we have several pieces of important information from CMS regarding the ESRD QIP. Please read this information carefully as it pertains to facility compliance. We also highlight a couple of opportunities to provide public comment on SMR and SHR measures and OPTN/UNOS policies and bylaws. And, we have information about the ICH CAHPS survey manual as well as guidelines for opting out of administering the survey.

All of this plus the 2016 Virtual Council Meeting (register now--it's happening next week), lots of patient resources, and a variety of continuing education opportunities. We hope you enjoy this issue!



Nancy Armistead
Executive Director, MARC

VirtualCouncilMeeting24Join Us for the 2016 Virtual Council Meeting
The Network will host its annual Virtual Council Meeting webinar on February 25.  Please join us for this FREE continuing education (CE) credit opportunity.  It is strongly recommended that each facility have at least one representative on this call, as MARC staff will describe Network 5's 2016 focus, which emphasizes patient- and family-centered care and provider collaboration with the Network, and also provide an opportunity for open Q & A.   Register your facility.

QIPQuality Incentive Program 
MeasuresCMS Seeks Public Comments on Hospitalization, Mortality Measures
The Centers for Medicare & Medicaid Services (CMS) has contracted with the University of Michigan Kidney Epidemiology and Cost Center (UM-KECC) to evaluate the potential of including prevalent comorbidities in the SMR and SHR risk adjustment models. Measure specifications for two measures have been posted on the CMS site for public comment. The public comment period begins February 8 and closes on February 22.

The following documents are posted on the CMS public comment page for comment:
  • Standardized Mortality Ratio Measure Information Form
  • Standardized Mortality Ratio Measure Justification Form
  • Standardized Hospitalization Ratio Measure Information Form
  • Standardized Hospitalization Ratio Measure Justification Form
Project-Specific Instructions:
  • Do not include personal health information in your comments.
  • If you are providing comments on behalf of an organization, include the organization's name and your contact information.
  • If you are commenting as an individual, submit identifying or contact information.
  • Please indicate which measure (s) you are providing comments on.
  • Please send all comments to dialysisdata@umich.edu no later than February 22.
Implementing the Extraordinary Circumstances Exception in the ESRD QIP
In 2014, CMS finalized (79 FR 66189) that, for PY 2017 and beyond, it would exempt a facility from all ESRD QIP requirements during the time that the facility was forced to close temporarily due to a natural disaster or other extraordinary circumstances beyond the facility's control. In order to receive consideration for such an exception, the facility would need to submit a CMS Disaster Extension/Exception Request Form through www.qualitynet.org within 90 calendar days of the date of the disaster or extraordinary circumstance.

As of January 2016, the ECE request form is still under review for compliance with the Paperwork Reduction Act and until further notice it is not available for use by ESRD facilities. CMS has implemented a process for use by facilities requesting an exemption until the form is available on www.qualitynet.org. Read the CROWN memo.

CMS Extends Compliance Date for Posting PY 2016 PSCs
CMS has updated the date by which facilities must post their ESRD Quality Incentive Program (QIP) Performance Score Certificates (PSC) in both English and Spanish for Payment Year (PY) 2016. During the PY 2019 Final Rule National Provider Call on January 19, 2016, CMS set the deadline at February 1, 2016, for facilities to post their PSCs in a prominent patient area. Subsequently, CMS has learned that facilities may have experienced obstacles in accessing their accounts on www.qualitynet.org and retrieving their reporting documents. In light of those developments, CMS has updated the deadline for facilities to post their PSCs to  February 22 . Facilities should retain an electronic copy of their reporting documents for reference throughout the year in the event that the posted hard copies need to be replaced due to damage or other unforeseen events.

CROWNWeb 
CMS2744OCT Offers Training on CMS-2744
The Outreach, Communications, and Training Team (OCT) for CROWNWeb will provide CMS-2744 training on Wednesday, March 2, 2016 at 2:00 PM. During this webinar session, attendees will gain an understanding of the purpose of the CMS-2744 form and how it impacts facilities, how to complete the CMS-2744, and how to utilize CMS-2744 reports to resolve errors. Attendees can register here. Timeline for the CMS-2744 Annual Facility Survey:

Task
Deadline
Generating the 2744
February 15
Submitting the balanced 2744 with any comments to the Network
April 1

Network Resources

Infection Prevention
Decrease in BSI/ARBSI is Achievable and Sustainable 
A new  Centers for Disease Control and Prevention (CDC) study shows that decreases to certain bloodstream infection (BSI) rates can be maintained through the use and implementation of CDC dialysis BSI prevention tools. The new study reported a 44 percent drop in access-related bloodstream infections (ARBSIs) and estimated more than 60 percent of expected ARBSIs may have been prevented over the 4-year period among dialysis patients treated at facilities using the CDC's Core Interventions for Dialysis BSI Prevention as part of a collaborative project. This study followed up with 17 outpatient dialysis facilities that implemented CDC BSI prevention tools as part of a CDC-initiated infection prevention collaborative.

CDC's 2013 study of the collaborative reported drops in overall BSI and ARBSI during the first 15 months of the intervention period. The present study tracked the progress of these clinics for an additional 33 months into the intervention, referenced as the later intervention period. Reductions in ARBSI rates continued at dialysis facilities during the later intervention period even after formal collaborative efforts and intensive technical assistance from CDC ended. These findings show that reduction in infection rates is both achievable and sustainable up to four years following adoption of the CDC Core Interventions. No changes in BSI rates were detected in this study.

Attention Project WipeOut Participants
Intervention resources can now be downloaded from our website.

NHSN Outpatient Dialysis Center Practices Survey is Released
The 2016 Outpatient Dialysis Center Practices Survey (required for Dialysis Event reporting) became available in NHSN on February 1. Many questions in the 2016 survey pertain to the first week of February; therefore, NHSN users are encouraged to begin the survey on or after February 1. The survey cannot be submitted to NHSN (i.e., "saved as complete") until after the first week of February. Please contact the NHSN helpdesk ( nhsn@cdc.gov) for questions, and enter "Dialysis" in the subject line.

CDC Releases Recommendations for Reducing Hepatitis C Transmission during Hemodialysis Treatments
The CDC released recommendations for reducing transmission of the Hepatitis C virus (HCV) during in-center hemodialysis treatment. According to CDC, HCV starts as an acute infection, and approximately 75-85 percent of people who become infected develop a lifelong, chronic infection which can lead to severe liver disease and liver cancer. Curative therapy is now available, even for some patients with end-stage renal disease. Because HCV is transmitted through percutaneous blood exposure and can survive in the environment for extended periods of time, lapses in infection control practices at dialysis facilities could expose patients to HCV. You can review the fact sheet about the release of the CDC recommendations here, as well as the CDC Health Advisory that was released on January 27. 

Transplant
PoliciesBylawsOPTN/UNOS Requests Public Comment on Policy and Bylaw Proposals
The Organ Procurement and Transplantation Network (OPTN)/ United Network for Organ Sharing (UNOS) has offered nine proposals, developed by its committees, for public comment. When the public comment period ends on March 25, each sponsoring committee will review the feedback it received and consider modifications to the original proposals. The OPTN/UNOS Board of Directors may then review and vote on these proposals at its meeting on June 6 and 7. Please provide your comments on these proposals. You may also continue to send general feedback to publiccomment@unos.org. Please submit all comments no later than March 25. For general questions about the proposals, please contact your Regional Administrator at (804) 782-4800.

OPTN/UNOS welcome your feedback on these proposals and other aspects of the public comment process as it continues to improve the way that it communicates with the community.
Thank you in advance for your careful review and feedback on these proposals.

Patient Services
ICHCAHPSSurveyICH CAHPS Survey Administration and Specifications Manual, Version 4.0 is Now Available
The In-center Hemodialysis CAHPS (ICH CAHPS) Survey Administration and Specifications Manual, Version 4.0 is now available. The protocols and guidelines described in Version 4.0 of this manual are effective immediately and supersede those described in previous versions of the manual. An electronic version of the manual in both MS Word and PDF is now available on the ICH CAHPS Survey website

OptOutOptions for Facilities Declaring Non-Participation: Deadline is February 28
In-center hemodialysis (ICH) facilities that do not plan to administer the ICH CAHPS Survey must complete and submit via the ICH CAHPS website a Facility Non-Participation Form to indicate that they will not be administering the ICH CAHPS Survey in calendar year (CY) 2016. The Facility Non-Participation Form is valid for one year only; facilities that submitted the form in CY2015 must submit the form for CY2016 and each year thereafter if they do not plan to administer the survey for a specific year. Any dialysis facility (CCN) that qualifies as a non-participant and decides not to administer the ICH CAHPS Survey during a specific calendar year now can choose one of two options.

March 10 is World Kidney Day
Contact your local National Kidney Foundation (NKF) office for events related to World Kidney Day. Check out the official World Kidney Day website for additional ideas and information.

PatientResourcesPatient Resources
AAKP Offers FREE HealthLine Conference Calls
The American Association of Kidney Patients (AAKP) presents monthly FREE HealthLine conference calls for patients. Encourage your patients to join the upcoming call:

February 24: "The Importance of Exercise for All Stages of Kidney Disease"
March 10: "Mastering Social Media as a Patient Advocate"

Find more information about these calls, and how to register. For recordings of previous HealthLine calls, visit the AAKP website

AAKP Hosts National Patient Meeting
AAKP is pleased to announce its 2016 National Patient Meeting will be held in Nashville, TN, September 23-25. AAKP is looking forward to returning to Tennessee to build on the excitement, success, and education of last year's meeting. Registration will open soon.

PKD Foundation Resources for Patients and Professionals
The Polycystic Kidney Disease (PKD) Foundation is a go-to source for health professionals and patients.
  • Ready, Set, Resources - an array of tools and resources for patients looking for education, support, and community
  • UpToDate - an evidence-based, peer-reviewed information resource, available via the Web, desktop computer, and PDA
Support Resources
NKF Peers - Patients can connect to someone who has been there with NKF's national support program.  They now have a new peer group for people considering living donation.  Call (855) 653 - 7337 for more information. 
 
NKF Cares - Patient Information Help Line, NKF Cares, offers support for people affected by kidney disease, organ donation, or transplantation. Offers support for patients, family members, and caregivers. Available in Spanish. Call (855) 653-2273 for more information.
 
Does your clinic offer a support group? Will you welcome patients from outside your clinic? If so, please share your information with Renée Bova-Collis through email or call (804) 320-0004, ext. 2705. We'd like to help spread the word.


EducationEducation
NKF Adds New Topics to PERC
The NKF has added new topics to its Professional Education Resource Center (PERC). This resource center is designed for professionals committed to continuing their education and improving patient outcomes by offering online CME/CE courses. There are a variety of activities on carefully selected topics given by renowned faculty. New courses will continue to roll out. Courses are free to NKF members and non-members pay a per-course fee. Find additional information.

NANT Annual Symposium is Scheduled for March 21-24
The National Association of Nephrology Technicians (NANT) Annual Symposium provides up to four days of dialysis technician-focused education. Technicians who participate in all four days can earn 25 contact hours. View complete information  

NKF's 2016 Spring Clinical Meetings
Registration is now open. The NKF's SCM16 presents a unique opportunity for busy renal health care providers to learn new developments related to all aspects of nephrology. Early bird deadline is February 19. 

47th ANNA National Symposium Will Be Held in May
ANNA will be hosting its 47th National Symposium May 1 - 4 at the Marriott Louisville and Kentucky International Convention Center in Louisville, KY. The symposium provides opportunities for nephrology nurses to expand their knowledge, enhance clinical skills, and widen professional networks. For more information, visit www.annasymposium.org

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