January 2021
Announcements & Updates
“Stay Strong”: A message FROM kidney patients TO kidney patients
The Forum's Kidney Patient Advisory Council (KPAC) has developed a poster to encourage their fellow patients to stay strong and continue to be diligent about using COVID-19 safety precautions. They understand the challenges patients have faced in 2020 and they want to send an encouraging message to stay safe and healthy. Please consider printing this poster and sharing it with your kidney patients.  

The poster is free to download from the Forum website, at:
COVID?...FLU?...Cold?....Allergy?... How Can I tell The Difference?
The ESRD Network program has created this resource for you screening teams and patients to use during the upcoming months to identify symptoms for winter screening. Please provide to patients and post prominently so patients can utilize this tool to promote a culture a "Call Ahead" culture to notify the facility prior to arriving.
Attention all providers participating in the ETC model
The Centers for Medicare and Medicaid Services CMS has developed the End Stage Renal Disease (ESRD) Treatment Choices (ETC) payment model to encourage greater use of home dialysis and kidney transplant. CMS has randomly selected ESRD facilities to participate in this payment model by Hospital Referral Region (HRR).

REMINDER: The initiative began January 1, 2021. All ETC participating facilities are required to prominently display information about the model in a common area of the facility where Medicare ESRD Beneficiaries receive dialysis care. Please download and print the Medicare ETC Model Instructions and Beneficiary Notification to meet this requirement.

For questions related to the ETC Model, please contact the ETC Model team at ETC-CMMI@cms.hhs.gov.
Quality Improvement Initiatives
NCC Home and Transplant Change Packages: A Best Practice Menu for Dialysis Facilities
Through interviews with high performing dialysis organizations across the country, the ESRD National Coordinating Center (NCC) has put together a collection of best practices in improving the rate of patients initiating home therapies or being placed on the waitlist. These best practices and interventions compose the Home Dialysis Change Package, and Transplant Change Packet respectively. These guides have been provided to the ESRD Networks to use to support dialysis providers in improving their referrals to these preferred modalities focusing on the unique challenges and barriers inherent in those processes. The packet organizes the interventions as actionable change ideas through primary and secondary drivers which focus on changing culture or practices.

We are sharing this information with all the Network providers to utilize in your work to improve home initiation rates and transplant wait listing. We strongly suggest that those providers who are in the mandatory ESRD Treatment Choices (ETC) payment model review the materials to determine if they will assist you in reaching the goals of the ETC.

The supporting materials that have been developed by the NCC for each area are provided here:

Home Therapies:

Home Dialysis Heroes - This is a peer program guide that the ESRD Network will support in collaboration with the dialysis facility to connect patient leaders receiving home dialysis modality and that can share their experience with an in-center patient interested in home dialysis. This program considers virtual ways for patients to connect. 

Universal Staff Education - This is a 3-module educational resource for in-center dialysis staff to increase their knowledge and confidence in educating patients for home dialysis. Each module takes about 30 minutes to complete, and it offers 1.5 CEU for CCHT, RN, RD and SW. Facility staff must log-in by submitting their name, job title, facility name and email address to gain access to the modules. At the end of module 3, a link to a quiz will be available in order to gain access to the CEU certificate. 

Nephrology Round Tables - These are virtual meetings, where HD expert nephrologists can share best practices and knowledge to their colleagues who have less experience in this area. This is a good opportunity to share best practices about telehealth and transitional care units. Your facility could help identify nephrologists that would benefit from these meetings. 

Transplant Wait Listing:

Kidney Transplant Hub: This website is a collection of transplant related resources grouped by the topic below for easy navigation. The resources are targeted for patients, but they can also be used by dialysis providers.
  • Choose Transplant
  • Get on a waitlist
  • Stay healthy on the waitlist
  • Receive a kidney sooner
  • Connect with the community
  • Enjoy life after transplant

Understanding High-KDPI and Increased Risk Kidneys Patient Video: This is a 2-minute video that provides education for dialysis staff and patients on the alternative of using high Kidney Donor Profile Index (KDPI) and high risk kidneys to increase the opportunities of receiving a kidney transplant.
Transplant Trailblazer Program: This is a peer program guide that the ESRD Network will support in collaboration with the dialysis facility and transplant centers to connect patient leaders who are waitlisted and that can share their experience with a dialysis patient interested in pursuing a kidney transplant. This program considers virtual ways for patients to connect. 
COVID-19 Best Practices for Transporting Dialysis Patients Who Reside in a Nursing Home/Home or Skilled Nursing Facility
The IPRO ESRD Network of the South Atlantic recognizes the challenges that the COVID-19 pandemic has inflicted in patient coordination and care. Especially of those dialysis patients residing in a Nursing Home or Long Term Care facility. All parties involved in the coordination of these patients play a key role in their health, including transportation providers who are the linking organization among these providers. 

Please watch this 13 minute video to learn about key information and best practices from Logisticare, a transportation provider who serve the dialysis community, including those residing in nursing homes:

  • Special services to respond to COVID-19 
  • Precautions drivers are taking
  • Communication practices with dialysis providers and nursing home facilities
  • Key points for dialysis providers to know 
  • New CMS protocol for Nursing Home Patient transportation 

For dialysis providers in Georgia, you might be interested in also reviewing best practices from SoutheasTrans during this 7 minute video
Patient Services
What Dialysis Facilities Need to Know about the Grievance Process
In efforts to meet the Network Statement of Work goals and assist facilities with education to improve their internal grievance process, provide patients with the tools to file a grievance, and how the Network’s role is incorporated into the process. The Network has developed several resources and tools which can be distributed to the dialysis staff and patients. Attached to this memorandum are the several resources. You can also access these materials by visiting our website https://esrd.ipro.org/. According to CMS a grievance is defined as:

"a written or oral communication from an ESRD patient, and/or an individual representing an ESRD patient, and/or another party, alleging that an ESRD service received from a Medicare-certified provider did not meet the grievant’s expectations with respect to safety, civility, patient rights, and/or clinical standards of care." 

Your facility is required to ensure a process has been implemented for patients to express concerns about their care without reprisal or denial of services. Below are some actions your facility can take as well as resources to reference:

Patients being educated on the grievance policy and procedure included timeframes for reviewing grievances (Annual) Display of the Network grievance poster with contact information. Provide contact information for the State Surveyor Agency Education to patients about their rights and responsibilities. Refer to the IPRO ESRD Network Program Patient Rights and Responsibilities guidance. Provide patients with the Grievance Process Guide: A Guide for Patients and Families brochure.

Watch A Crash Course in Assessing Patient Grievances is part one of the Network’s webinar series, this presentation for providers outlining the definition of a grievance, the three grievance types, the grievance process and much more. The webinar can be watched here. 

Visit the blog Home Dialysis Central for the article Patient Grievances and How to Avoid Them.
Access to Care
The Network is actively seeking ways to reduce patients being involuntarily discharged (IVD). Without preventative interventions performed at the facility level patients are at risk for being discharged without placement, which increases their risk of morbidity and mortality. Network Patient Services Directors continue to discuss appropriate access to care approaches with facility leadership, as per the CMS Conditions for Coverage.

All members of the interdisciplinary team should follow the regulations regarding patient discharge as set forth in the CMS Conditions for Coverage to address the problems in a mutually beneficial way for the patient. Reassessment should focus on identifying the potential root causes of the behavior (disruptive, abusive, non-adherence), create a plan of care aimed at addressing those causes and resolve unacceptable behavior to prevent an involuntary discharge. When the Network is contacted during the early stages of an issue, we can offer guidance and recommendations to assist with conflict resolution and to prevent any escalation that could lead to a patient discharge. The Network will provide assistance to both the facility and the patient. Please visit The Network website to learn more about access to care and IVD's.
Upcoming Vocational Rehabilitation Education Opportunities
Each month the Ticket to Work program hosts the Work Incentives Seminar Event (WISE) which are free webinars on vocational rehabilitation services for eligible populations. They are held on the fourth Wednesday of each month. You can register here at https://choosework.ssa.gov/wise.  
Below is a past webinar Ticket to Work and Mental Health which was originally presented in June of 2020. The presentation, transcript and video can be viewed here.

Should you have questions, you may reach out to:

Jordan Fowler
Program Outreach Specialist
Ticket Program Manager | Social Security Administration’s Ticket to Work Program
Office: 703.336.8147

Additionally, the nonprofit Medical Education Institute (MEI) has officially launched TWO NEW modules from the award-winning program Kidney School. These are free to the ESRD patients.
Kidney Failure and Your Work Life goes into great detail on the importance of employment, work-friendly treatment options, how to keep your job, how to deal with symptoms, asking for accommodations, getting back to work, discrimination, and much more. Paying for Dialysis or Transplant covers Medicare application and coverage, Medigap plans, and other ways of paying for treatment.
Data Systems and Reporting
2746 Forms – Resume Submitting
We advised to stop submitting 2746 forms due to known issues associated with EQRS migration. Please resume submitting 2746 forms. The developer has indicated the issues have been resolved.

2746s in SAVED status: Any 2746s that were left in saved status prior to the email asking that you stop 2746 submissions should be deleted and redone.

2746s submitted after EQRS went live (11/9/20): Review any 2746s that you may have submitted after EQRS went live. If the forms are incorrect, contact the QualityNet Help Desk and ask that these submitted forms be deleted. If you find the submitted form is accurate you do not need to do anything.

Going forward: Review the 2746 form carefully to ensure everything is correct before submitting it. Pay close attention that the correct facility is listed as the provider with CCN and address. Also look to make sure that the list of physicians in the drop down actually belong to your facility. When printing make sure that the modality at time of death is listed (#8) and that the physician name is correct at the bottom of the form. If you are still encountering issues, report to the QualityNet Help Desk.

EQRS Clinical Deadline Extended

The Centers for Medicare & Medicaid Services (CMS) is extending the January 4, 2021 deadline for the following data submission to the End-Stage Renal Disease (ESRD) Quality Reporting System (EQRS): September 2020 and October 2020 Clinical Data Submissions.

The January 4, 2021 submission deadline for data supporting the September 2020 and October 2020 Clinical Months has been extended to February 1, 2021 at 11:59 PM Pacific Time. Please note that this date adjustment is for the January 4, 2021 data submission deadline only and will have no effect on previous or future due dates.

Should you have any questions, contact the QualityNet Service Desk via email at qnetsupport-esrd@hcqis.org or telephone at 1-866-288-8912.

Clinical closure dates apply to all Collection Types (Hemodialysis; Peritoneal Dialysis). Additionally, clinical data submissions apply to all submission methods.

ESRD QIP Final PSRs and PSCs for PY 2021 Now Available Online

CMS has released the Payment Year (PY) 2021 End-Stage Renal Disease Quality Incentive Program (ESRD QIP) Final Performance Score Reports (PSR) and Performance Score Certificates (PSC). Authorized facility staff may log onto the ESRD Quality Reporting System (EQRS) to download and save these documents as soon as possible. For more information, Please see https://qualitynet.cms.gov/esrd/esrdqip/resources#tab2
Network Staff Directory
Shannon Wright, BSW, PMP, ITIL v3
Executive Director
(919) 463-4512

Loretta Ezell, MSN, RN, CNN
Quality Improvement Director
(919) 463-4507

Chanell McCain, MSW
Patient Services Director
(919) 463-4523

Jaya Bhargava, PhD, CPHQ
Regional Operations Director
(203) 285-1215

Shasha Aylor, MBA
Data Analyst
(919) 463-4520

Alexandra Cruz, MHA, RD, LDN
Network Assistant Director
(919) 463-4506

Michelle Lewis
Quality Improvement Coordinator
(919) 463-4510

Kathryn Betts, MSW
Patient Services Coordinator
(919) 463-4529

Danielle Andrews, MPH, GCPH
Community Outreach Coordinator
(516) 209-5549

Jasmine Taborn
Data Coordinator
(919) 463-4522