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Welcome to the November 16 issue of the Quality Insights Renal Network 4 e-newsletter. In this issue, we bring you information about patient education features, the upcoming CMS Quality Conference, our quality improvement activities, other upcoming events, CROWNWeb updates, continuing education opportunities,  resources and much more. We encourage you to  contact us with any questions, concerns or suggestions.  
FeedbackPlease provide us with your feedback on last month's Facility-LED PATIENT EDUCATION
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Disease Management
We provide a Network 4 Patient Education Sheet each month in 2018. These documents are also located on our website. Please provide all of your patients with this education sheet this month.   Also, we ask that you please encourage your facility's Patient  Representatives to pass out this educational information as well. 
MeaslesPA Department of Health Alert: Suspect Case of Measles in Central PA
On October 24, 2018, Pennsylvania Department of Health was notified of a suspect measles case in a patient who was a resident of New York State and had traveled to Juniata County, Pennsylvania during the week of October 14-19, 2018.

Please note that there have been a number of reported cases of measles from New York State who have recently returned from Israel.  In light of this possibility, the Pennsylvania Department of Health request that all health care providers maintain a high index of suspicion for measles in persons with a febrile rash illness, especially in those with no history of measles vaccination. Consider measles as a diagnosis in anyone with a febrile rash illness lasting three days or more, a temperature of 101ºF (38.3ºC) or higher, and clinically compatible symptoms (cough, coryza and/or conjunctivitis). 

Immunocompromised patients may not exhibit rash or may exhibit an atypical rash. The incubation period for measles from exposure to rash onset is usually 14 days (range, seven to 21 days). While most people are not at risk because they have been immunized or have had measles, the following groups of individuals are susceptible to becoming infected with measles:

Anyone born since 1957 who has not received two doses of effective measles vaccine known as MMR, which would include infants too young to have been immunized; persons who were vaccinated with an inactivated vaccine, which was used from 1963 through 1967, and have not been re-vaccinated; and those who refused vaccination.

Persons whose immune systems are compromised due to disease or medication. If measles is suspected, the illness should be immediately reported to the Pennsylvania Department of Health at 1-877-PA-HEALTH or 1-877-724-3258 to facilitate consultation and to assist with diagnosis, tracking of contacts and initiation of control measures. 

Providers suspecting measles should do the following:
  • Advise patients who call not to expose others. Arrange for exam in isolated area if indicated.
  • Should a suspected case present for care, place a mask on patient and isolate immediately. 
  • Obtain specimens for testing, including serum for measles IgM and IgG and throat swab in viral transport media and urine for confirmation and genotyping. 
  • Contact the PA Department of Health at the numbers above. 
The Pennsylvania Department of Health urges all health care providers to assure their patients are vaccinated against measles and other vaccine-preventable diseases.
UpcomingEventsUpcoming Events

save the date: 2019 cms quality conference 
The 2019 Centers for Medicare & Medicaid Services (CMS) Quality Conference will take place January 29 - 31, 2019 at the Hilton Hotel in Baltimore, MD. Registration is now open. If you have question or concerns regarding CMS Quality Conference registration and housing, please don't hesitate to contact the CMS Logistics Team directly at

QIAsQuality Improvement Activities (QIAs)

national coordinating center introduces lan-specific webpage 
The End Stage Renal Disease National Coordinating Center (ESRD NCC) has announced the availability of a newly-developed webpage that provides a simplified method for members of the ESRD community to access Quality Improvement Activity (QIA) Learning and Action Network (LAN) materials.

This webpage provides visitors with a description of the CMS national goal for each QIA and gives a brief overview of how LAN meetings are utilized to help support the ESRD Networks' efforts to better the quality of care administered to ESRD patients.

Items available via this webpage include:
  • National QIA LAN materials (BSI, Home Modality, and Transplant)
  • Population Health Focused Pilot QIA (PHFPQ) LAN materials
  • Patient Experience of Care (PECO) LAN materials
  • Medication Management and Opioid (MMO) LAN materials
  • Registration opportunity for upcoming events
  • Access to past events
  • Access to intervention steps and documents used to support QIA efforts

Please note that this webpage will continue to be maintained to include new materials that could be used to support the ESRD community's needs. Access the webpage.  

New resource addresses challenges associated with kidney transplant 
Quality Insights Renal Network 4 recently completed a brochure titled "Understanding Challenges: A Guide to Understanding the Challenges of a Kidney Transplant Evaluation and Workup." Download the brochure  
CMSUpdatesCMS Updates
CY2019 QIP Final Rule
The Centers for Medicare & Medicaid Services (CMS) has filed the CY2019 Final Rule for Medicare Program; End-Stage Renal Disease (ESRD) PPS, Payment for Renal Dialysis Services Furnished to Individuals with AKI, ESRD QIP, Durable Medical Equipment Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Process (CBP) and fee schedule amounts, and technical amendments to correct existing regulations related to the CBP for certain DMEPOS
Read the CMS press release.

View the Final Rule

View the fact sheet
new hipaa fact sheet now available
The Centers for Medicare & Medicaid Services (CMS) has published a new fact sheet on Medical Privacy of Protected Health Information, a six-page summary of the major provisions of HIPAA, with extensive links to additional resources.  Download the fact sheet.  
update to the cms esrd state operations manual for esrd facilities and nursing homes
CMS has published a comprehensive update for Chapter 2 End-Stage Renal Disease (ESRD) of the State Operations Manual (SOM), which describes the oversight activities of State Survey Agencies for certified Medicare providers and suppliers. Chapter 2 of the SOM includes guidance and instructions on procedures for ESRD facilities, including nursing homes. The update incorporates current Conditions for Coverage, and CMS policies for ESRD issued previously through memoranda.  View the document.

There was also a new memo released in August 2018 that discusses the Survey Process for Reviewing Home Dialysis Services in a Long Term Care (LTC) Facility. View the memo
CY2019 esrd pps proposed rule webinar slides and recording now available
In case you missed the August 14 CMS conference call on the CY2019 ESRD PPS Proposed Rule, impacting PY2021-24 you can still review the presentation slides and listen to the speakers. The audio is available on the CMS website. The slides from the call are available now.

The Proposed Rule includes language for new facilities to begin QIP reporting in their fourth month of operation rather than their first month (slide 31). The slides also include timelines and resources. The call did not include questions, as listeners were directed to use the Federal Register comment process, which is detailed on the slides.  Learn more
november 2018 crownweb newsletter now available
The November 2018 edition of the CROWNWeb Newsletter is now available online. The CROWNWeb Newsletter focuses on user-specific topics, such as training, account management, use of the CROWNWeb system, and tips and tricks, as well as key technical aspects of CROWNWeb.

This month's featured stories include:
  • The Journey to EQRS with Release 2.0
  • Foreign Nationals
  • November New User Training
  • Clinical Closures
CEUOppsEducation and CEU Opportunities
Advanced Renal Education
This educational site provides CEU credits for anyone who completes a course. Register to gain access and complete a course.
American Kidney Fund
The American Kidney Fund offers several online courses that provide free CEs for health care professionals. Learn more
American society of nephrology 
The American Society of Nephrology announces the next Targeting Zero Infections Webinar - Hepatitis C Detection, Prevention and Treatment on Thursday, December 6 from noon until 1:00 p.m. EST 

Hepatitis C is associated with increased mortality among patients in the US on hemodialysis. Hepatitis C has a 10-fold higher prevalence in hemodialysis patients than in the general population with an overall prevalence of 14%.

This complimentary program will review the critical role that nephrologists and dialysis professionals have in preventing infections and diagnosing infections when they occur. Discover the new CDC/ASN recommended algorithm for hepatitis C surveillance and referral.

Learning Objectives: Upon completion of this session, the participant will be able to:
  1. Demonstrate understanding of the need for timely monitoring and surveillance of individuals on dialysis for the presence of hepatitis C.
  2. Discuss the process for hepatitis C detection, as well as what to do if a positive seroconversion is detected.
  3. Discuss the procedures necessary to prevent the spread of hepatitis C within the dialysis facility.
  4. Summarize the 2018 KDIGO guidance for the detection and treatment of hepatitis C for individuals undergoing dialysis treatment.
  5. Apply any modifications needed in either the detection, prevention, referral, and treatment for hepatitis C within your dialysis facility.

ABMS/ACGME Core Competencies(s): Systems-based Practice, Practice-based Learning and Improvement, Medical Knowledge, Patient Care and Procedural Skills


Register today

Armstrong Institute for Patient Safety and Quality
The Armstrong Institute for Patient Safety and Quality is now offering short, interactive samples of courses to get a feel for how it creates engaging learning experiences that are relevant and applicable to your work improving patient safety. Samples are now available for the following cours es:
  • Patient Safety Certificate Program
  • Human Factors for Patient Safety
  • Becoming a Patient Safety Hero
  • Foundations of CUSP
These samples will work on mobile devices; however, for the best experience use on a laptop or desktop computer. Browse the course catalog for details on all courses, including continuing education credits, learning objectives and costs.
Centers for Disease Control and Prevention (CDC)

Tune In for Safe Healthcare Webinar Series
The CDC has new free continuing education opportunities available through its Tune In for Safe Healthcare webinar series. Webinars include: 
  • Empowering Nurses to Protect Themselves and Their Patients: The Importance of Collaboration between Nurses and Environmental Services
  • Infections in Dialysis Centers: Understanding what Matters to Patients
  • Empowering Nurses for Early Sepsis Recognition
Medscape Education opportunity
Medscape recently released the following new Continuing Education (CE) course.  This activity is intended for internists, allergists and clinical immunologists, cardiologists, family medicine/primary care practitioners, nurses, obstetricians/gynecologists/women's health clinicians, pediatricians, pharmacists, pulmonologists, public health and prevention officials, and other members of the healthcare team involved in influenza vaccination.

The goal of this activity is to provide medical news to primary care clinicians and other healthcare professionals in order to enhance patient care.

Upon completion of this activity, participants will be able to:
  • Assess updated Advisory Committee on Immunization Practices recommendations regarding vaccine virus composition for 2018 to 2019 US seasonal influenza vaccines and use of quadrivalent live attenuated influenza vaccine
  • Evaluate updated Advisory Committee on Immunization Practices recommendations regarding influenza vaccination of persons with a history of egg allergy and recent regulatory actions, including new vaccine licensures and labeling changes
  • Outline Implications for the healthcare team
Access other free MMWR/Medscape CE activities. If you are not a registered user on Medscape, please  register for free or login without a password and get unlimited access to all continuing education activities and other Medscape features.
renal physicians association e-Learning portal offers new course
The Renal Physicians Association (RPA) has an eLearning portal that offers a wide variety of courses. The newest course, 2018 Fundamentals of Nephrology Coding and Billing, is now available online. This course will provide a better understanding of the federal and regulatory requirements for proper nephrology coding, billing and documentation. 
ESRDResourcesESRD Resources
Latest edition of KCER Watch is Now Available  
The  October 2018 issue of KCER Watch , the monthly environmental scan that provides timely and pertinent information related to emergency preparedness, is now available. Kidney Community Emergency Response (KCER) reviews available literature from peer-reviewed journals and emergency and disaster related trade publications; social media postings; and stakeholder websites to identify news and events in the emergency management field that are beneficial to the ESRD community.  The goal of KCER Watch is to facilitate the exchange of information, sharing of resources, and advancement of knowledge and expertise among ESRD and emergency management stakeholders. The Network encourage you to share KCER Watch with your colleagues and patients. 
new network resource now available: Staying Healthy Through Work  
The Network recently completed the Staying Healthy through Work trifold brochure. This brochure highlights the benefits of staying active through work for patients with kidney disease. Download the brochure
Check out the ESRD NCC Information Exchange
The ESRD Network Coordinating Center (NCC) provides centralized coordination and support for the Medicare ESRD Network program. Each month, the ESRD NCC distributes an e-newsletter, known as the Information Exchange, that compiles the most important information from numerous ListServs and publications related to renal health. To sign up to receive this informative newsletter, please contact the ESRD NCC at or visit the ESRD NCC website

Executive Director
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610 Freedom Business Center,  
Suite 102 
King of Prussia, PA 19406 
(610) 265-2418 
(800) 548-9205 (patients only) 
(610) 783-0374 (fax) 
This bi-weekly e-newsletter will serve as our primary method of communicating important news and updates. We encourage you to visit our Web site for the most up-to-date information or to contact us with questions, comments or suggestions.
This material was prepared by Quality Insights Renal Network 4 under contract with the Centers for Medicare & Medicaid Services (CMS). The contents do not necessarily reflect CMS policy.

Publication No. ESRD4-111518