A Periodic Newsletter from The Mid-Atlantic Renal Coalition | www.esrdnet5.org
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June 1, 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 issue, we have lots of important information to share from CMS and CROWNWeb, as well as updates on our quality improvement activities

CMS has released its ESRD Measures Manual, which provides details on how CMS ESRD measures are calculated. CMS is seeking public input; please read the article and register to submit your comments.

Big changes are coming to the ESRD Quality Reporting Systems! Make sure you register for the upcoming CROWNWeb Town Hall event. We're also excited to share the progress we are making on our CROWNWeb data clean-up project.

June 1 marks the start of Atlantic hurricane season, and we have information on the  #HurricaneStrong initiative to increase preparedness. It's also a great time to register for the 5-Diamond Patient Safety Program where you and your facility can complete the emergency preparedness module and earn a Diamond.

Lastly, don't miss the many great patient resources and opportunities for patient and provider education we have in this issue, including how to apply for the Jenny Kitsen Patient Safety Award and an opportunity for your patients to enter RSN's annual essay contest.
We hope you enjoy this issue.

Nancy Armistead 
Executive Director, MARC 

ESRDMeasuresManualCMS Releases Its ESRD Measures Manual
The Centers for Medicare & Medicaid Services' (CMS) ESRD Measures Manual contains the detailed specifications that underwrite clinical performance measures in the ESRD Quality Incentive Program (QIP) and Dialysis Facility Compare (DFC). In this way, CMS provides a transparent and detailed description of how CMS ESRD measures are calculated, offering the public a comprehensive understanding of how CMS evaluates the quality of care provided by dialysis facilities.
In order to provide a forum for the public to pose questions and provide feedback about these measure specifications, CMS designated a section on the Office of the National Coordinator (ONC) Issue Tracking System's JIRA platform for this purpose. CMS also developed a User Guide for the JIRA feedback system.
The Manual and the JIRA User Guide are available on the ESRD QIP section of CMS.gov. CMS plans to provide training in the coming weeks that will explore the Manual and the methods for the public to comment on its contents. That training will be the subject of a future CROWN Memo, which also will specify the date and method of registration for attendees.
The Network encourages facilities to explore the Manual and submit comments on the detailed measure specifications by registering for a user account on the JIRA platform and creating issues in the Manual section.

Emergency Preparedness
HurricaneStrongBe #HurricaneStrong
The Atlantic hurricane season starts on June 1, and lasts until November 30; the greatest potential for storm activity is the months of August and September. It only takes one storm to change your life and community. If you live in an area prone to hurricanes and tropical storms, you need to be prepared. Even areas well away from the coastline can be threatened by dangerous flooding, destructive winds, and tornadoes from these storms. Now is the time to prepare for a potential land-falling tropical storm or hurricane. Be #hurricanestrong; click here for preparedness tips and share them with your patients, coworkers, and families. It's also a great time to register for the 5-Diamond Patient Safety Program where you and your facility can complete the emergency preparedness module and earn a Diamond. 


TownHallDon't Miss the CROWNWeb Town Hall
QualityNet Authorization Role Management (QARM) is a central repository for user roles and privileges across ESRD Quality Reporting Systems (CROWNWeb, REMIS, QIP). Enterprise Identity Management (EIDM) will enable future retirement of the existing QIMS identity management system used by ESRD Quality Reporting Systems. 

What does this mean? QIP, CROWNWeb, and REMIS applications will be merged together and will no longer use separate sites. The user registration process for quality reporting accounts will become paperless. Integration into QARM will be done in phases, starting when QARM is deployed, currently planned for later this year. QIMS will be retired after this integration is complete. 

How will this impact ESRD quality reporting? Users will authenticate through one identity management system and have the ability to select their organization and role to access each of the quality reporting system applications (CROWNWeb, REMIS, QIP). Users can switch between reporting applications without logging out.

Register for the upcoming CROWNWeb Town Hall event, "Connecting the Pieces: Introducing EIDM and QARM." 

CWDataCleanupCROWNWeb Clean-Up Project Making Great Progress
Network 5 launched the CROWNWeb Clean-Up Project on May 11. If you missed the kickoff webinar, view the recorded webinar and slide presentation on our website. Since project notifications were distributed on April 29, over 200 CMS-2728s have been submitted. Additionally, Network 5 was recognized by CMS on the May 26 CRAFT call for having the most improvement in saved 2728s. In one month we submitted over 350 forms-thank you for your commitment to this project!

Let's keep up the great work. Submission of CMS-2728s and CMS-2746s back dated to 1/1/2012 are due by Friday, June 3. Facilities are also required to work their outstanding notifications and accretions (action list) and update their facility personnel in CROWNWeb by the June 3 deadline.

QIA2Infection Prevention
NHSN Release 8.5.4 Set for June 18
Great updates are coming for National Healthcare Safety Network (NHSN) users. NHSN Dialysis Event rate tables and run charts will be updated to reflect 2014 national aggregate data for benchmarking (includes: IV antimicrobial starts, local access site infections, bloodstream infections (BSIs), access-related BSIs, and vascular access infections). This information can be utilized by providers to compare their facility's performance to the rest of NHSN. There will also be a new facility-level standardized infection ratio (SIR) report available. Facilities can use this report to track their performance for the QIP Infection Monitoring: NHSN Bloodstream Infection measure. The SIR compares the number of BSIs that a facility reported to the number of infections predicted for that facility based on the national aggregate data across several vascular access types.   

Save the Date: HAI LAN on June 28
The next Healthcare-Associated Infections Learning and Action Network (HAI LAN) will be held June 28 at 2:00 p.m. All Network providers are invited to attend. The presentation will focus on care transitions and how improving care transitions can impact infection prevention efforts.  

Project WipeOut Focuses on Sustainability
Facilities enrolled in the Network's 2016 HAI Project received a data feedback report on project performance on May 17. Audit reporting has improved significantly. Cycle 4 wrapped up on Tuesday, May 31; at this point, facilities should have all eight CDC Core Interventions up and running in the clinic. Facilities should focus on sustainability of these interventions through the end of June. Contact Amber at apaulus@nw5.esrd.net if you have any questions.    
Vascular Access
QIAProjectsLong-Term Catheter QIA Project Webinar Available, Reporting Tool Due
On May 17, the Network hosted a project webinar focused on patient and family engagement in vascular access. If you missed the event, the recorded webinar is available on our website. Project webinars for the long-term catheter project occur the third Tuesday of every month. The next webinar for enrolled facilities will be June 21.

Enrolled facilities' "On-Goal Report Catheter Reduction Tool" is due Friday, June 3.

ICH CAHPS QIA Seeks to Increase Patient Knowledge
The ICH CAHPS QIA aims to increase the number of positive responses to question 39 of the ICH CAHPS survey for enrolled facilities by a relative 5 percent.

Question 39: "Peritoneal dialysis is dialysis given through the belly and is usually done at home. In the last 12 months, did either your kidney doctors or dialysis center staff talk to you about peritoneal dialysis?"

The baseline rate has been established at 44.3 percent of patients responding "yes" to the question. The goal is to exceed 47.1 percent.

Clinics are distributing postcards for selected patients to indicate their answer to this question. Postcards were due by May 30 for this first round of surveying. A new set of patients will be asked to answer the question each month until the end of the project. No patients will be asked to do this more than one time.

For more information about the project, resources, and progress visit the ICH CAHPS project page.

Spanish ICH CAHPS Frequently Asked Questions Available
The ICH CAHPS frequently asked questions (FAQs) have been translated into Spanish. The Spanish FAQs can be found here. These Spanish FAQs can be provided to your bilingual customer service toll-free number staff and bilingual interviewers. Please contact the ICH CAHPS coordination team via email at ichcahps@rti.org or call (866) 245-8083 if you have any questions.

Patient Services
The first Patient Engagement Learning and Action Network (PELAN) Session was held May 5. The topic was how to modify everyday clinic activities in a way that truly engages patients. Three clinics and two patient subject matter experts presented examples of their patient engagement activities. A recording of the session is available. ENGAGE members who were not present for this live session should review the video links and webinar recording and submit the attestation form.

Monthly PELAN sessions are held on the 1st Thursday of each month at 1:00 p.m.

June 2 Patient Engagement: Involving Patients in Meaningful Use of Data
July 7 Patient Engagement: Patients as Committee & Governing Body Members
August 4 Patient Engagement: Creating & Sustaining the Culture

ENGAGE members and SMEs will receive reminders with login information each month. A recording of the session is available. ENGAGE members who were not present for this live session should review the video links, webinar recording, and submit the attestation form

Grievance QIA Aims to Decrease Grievance Scores
The Grievance QIA aims to decrease overall grievance scores by a relative 20 percent. This project requires enrolled facilities to record patient concerns and submit them to the Network where each grievance receives a score (1-5) based on the type of concern. The baseline rate has been established at 4.0. The goal is 3.4. Most patient concerns are related to interpersonal issues/conflict between patients and staff as well as environmental issues, such as the temperature of the facility. For more information about the project, resources, and progress, visit the grievance project page.

JennyKitsenApply for the AAKP's Jenny Kitsen Patient Safety Award
Applications for the Jenny Kitsen Patient Safety Award are now available from the American Association of Kidney Patients. Applications are due July 31, 2016 . The Jenny Kitsen Patient Safety Award funds an annual lecture or presentation that will advance patient safety by exploring innovation in health systems management.  The award was created in 2014 by the former Network of New England; its Board of Directors established an endowment to continue the patient safety work of the non-profit organization led by Jenny Kitsen. Applications can be completed online, or for more information contact Diana Clynes, Director of Programs and Services, at dclynes@aakp.org .

RSNEssayContestEnter RSN's 14th Annual Essay Contest
The Renal Support Network (RSN) invites people with kidney disease to enter its Annual Essay Contest. This year's theme is "What Do You Know Now about Chronic Kidney Disease That You Wish You'd Known When You Were Diagnosed?" View official rules and enter the contest before August 1.

PatientResourcesPatient Resources
Eating on the Machine
Attitudes are shifting regarding eating during in-center hemodialysis and are expressed in the following articles from the Clinical Journal of the American Society of Nephrology (CJASN). ASN membership is required to access these. Ask your nephrologist to share them with your team.
Information on Medigap Plans Available
This blog post from Home Dialysis Central provides information about the availability of assistance with Medicare Part A and Part B deductibles, hospital copays, and Part B coinsurance.

CMS Revises Resources for Medicare Beneficiaries Booklet A revised Resources for Medicare Beneficiaries Booklet is available. Learn about resources providers can use to answer beneficiaries' questions on
  • Medicare, Medicare supplements, and other insurance
  • Medical expenses and basic needs
  • Long-term care
  • Informed decisions, rights and protections, notices, and forms
  • Fraud, waste, and abuse
  • Caregiving
Use Multilingual Resources to Help Newly Insured Make the Most of Their Insurance
CMS' Coverage2Care initiative has made resources available to help people understand their health coverage and connect to primary care and preventive services. The following resources are available in Arabic, Chinese, English, Haitian Creole, Korean, Russian, Spanish, and Vietnamese:
  • "A Roadmap to Better Care and a Healthier You"
  • Sample insurance card
  • Sample explanation of benefits
  • "Know Where to Go"
  • "5 Ways to Make the Most of Your Health Coverage" (available in English and Spanish)
Monitor Your Patients' Mental Health
Medicare covers several preventive services to help monitor your patients' mental health, including the Initial Preventive Physical Examination, Annual Wellness Visit, and depression screening. For more information, see these resources:
Visit the Preventive Services website to learn more about Medicare-covered services.

Senior Care
The following are informative articles from CaregiverStress.com about working with older people:
AKFPatientEdAKF Hosts Monthly Webinars for Patients/Caregivers
The American Kidney Fund has launched a monthly series of free, live, 1-hour webinars for kidney patients and caregivers. Each month, experts share practical knowledge and advice on a range of topics. Advance registration is required to participate. Register and watch previous webinars at www.KidneyFund.org/training/webinars.
  • Tuesday, June 14 at 1:00 p.m. ET: "What CAN I Eat? Nutrition for Dialysis Patients." Led by Janeen Leon, MS, RDN, LD, of Case Western Reserve University, this webinar will help patients and loved ones find foods that will work with their strict diet.
PKD National Convention 2016
The Polycystic Kidney Disease (PKD) National Convention will occur at the Walt Disney World Resort in Orlando, Florida, June 24-26. Learn more about registration and special financial aid opportunities.

AAKP Hosts National Patient Meeting
AAKP will hold its 2016 National Patient Meeting 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 opens in early spring.

ASA Offers Online Courses
As society and the dialysis population are aging, you might consider becoming more informed on the issue to better serve your patients. The American Society on Aging is offering an online certificate program in gerontology. For more information about this and other ongoing learning opportunities, visit their website.

NRAA Presents Pediatric Dialysis Education Series
The National Renal Administrators Association's (NRAA) Pediatric Dialysis Education Series is geared toward pediatric dialysis providers and features a 4-part webinar series. Additional educational opportunities will be offered at the 2016 NRAA Annual Fall Conference. Learn more about the Pediatric Dialysis Education Series.

NHPCO Offers Intensives Conference
The National Hospice and Palliative Care Organization (NHPCO) is offering one to two days of in-depth learning on topics of your choosing at the Diplomat Resort and Spa in Hollywood, FL. Each day offers four different advanced-level sessions from which to choose. Watch the video to learn more about The Intensives: Mastering What's Next in Patient and Family Care and register.

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Patient Toll-Free: 866.651.6272