May 2021
Announcements & Updates
COVID-19 Trend Maps Available
The End Stage Renal Disease National Coordinating Center (ESRD NCC), in collaboration with Kidney Community Emergency Response, presents COVID-19 positive case rates among the general population and the ESRD population in maps. Maps are organized by ESRD Network service area and presented in PDF format, both in color and black and white, optimized for printing in grayscale. The ESRD NCC encourages sharing these maps with facilities, transplant centers, and all ESRD patients.

This overview data is meant for general illustrative purposes and should not be construed as the final and most up-to-date detailed analysis, as this includes self-reported data. For the most accurate data related to COVID-19 cases, please go to the Centers for Disease Control and Prevention COVID Data Tracker webpage at
May is Mental Health Month
May has been designated Mental Health Month since 1949. The impact of COVID-19 has been felt by both patients and staff. This May, both the National Alliance on Mental Illness (NAMI) and Mental Health America (MHA) have shared tools and resources to help promote treatment, self care with a goal to reduce the stigma that surrounds mental health diagnosis. The IPRO ESRD Network Program encourages dialysis providers to review the following resources and incorporate in your work with your patients and staff.

Be Ready, Be Prepared!
Hurricane Preparedness Week is May 9-15, 2021
With the onset of the 2021 hurricane season closely upon us, now is the time to start preparing! The Atlantic hurricane season runs from June 1st to November 30th. Forecasters are predicting that oceanic and atmospheric conditions in the Atlantic will be favorable for a more active than usual hurricane season in the months ahead. Planning and preparing now can make a big difference in safety and resiliency in the wake of a hurricane. The ability to quickly recover following a hurricane requires a focus on preparedness, advance planning, and knowing what to do in the event of a hurricane.

Prepare Your Staff and Patients: Get the Conversation Started!
One of the most effective ways to share information and motivate people to take steps for personal preparedness is to talk to staff members and patients. Add a preparedness discussion to the weekly huddle, your next staff organizational QAPI meeting, or arrange a lunch and learn session. You can cover the basics in about 15 minutes; but 30 minutes will provide more time for open discussion and/or questions. 

Be Prepared! Plan Ahead.
Begin preparing now and know what you’re going to do in the event of a hurricane. Planning ahead gives you more options and better control over situations that could become chaotic at the last moment if you’re not ready. To learn more about how to prepare for a hurricane visit Find out about preparedness drills or exercises in your area at

Tips for Planning Ahead
Data Systems and Reporting
Connecting You to the ESRD Network Data Support Team is Just a Click Away!
The IPRO ESRD Network Customer Support Portal provides centralized technical assistance to support all of your data submission requirements. By registering for the IPRO ESRD Network Support Portal, you will be able to quickly and easily open a support ticket with the Network staff from your computer without making a phone call. The support request will go to the Network data team queue for investigation and response.  You can also track the status of the request or search our Frequently Asked questions in the knowledgebase.

You can register for the portal by going to Please print and share the IPRO ESRD Network Program Customer Support Portal resource with your staff. Encourage staff to try this method as the quickest and easiest way to get their data issues and questions answered.

NOTE: When submitting a request to the Network, you should NEVER include any patient-specific information such as Name, Date of Birth, Social Security Number, Medicare Claim Number, etc. The only patient identifier that can safely be communicated is the Unique Patient Identifier (UPI) from CROWNWeb.

If you have any questions or require assistance, please open a customer support ticket at
Quality Improvement Initiatives
World Hand Hygiene Day is May 5, 2021
As described by the World Health Organization (WHO), the SAVE LIVES: Clean Your Hands global campaign, launched in 2009 and celebrated annually on 5 May aims to maintain global promotion, visibility and sustainability of hand hygiene in health care and to ‘bring people together’ in support of hand hygiene improvement around the world.

For World Hand Hygiene Day 2021, WHO calls on health care workers and facilities to achieve effective hand hygiene action at the point of care. The point of care refers to the place where three elements come together: the patient, the health care worker, and care or treatment involving contact with the patient or their surroundings. To be effective and prevent transmission of infectious microorganisms during health care delivery, hand hygiene should be performed when it is needed (at 5 specific moments) and in the most effective way (by using the right technique with readily available products) at the point of care. This can be achieved by:
Patient Services
Access to Care
The Centers for Medicare & Medicaid Services (CMS) strives to assure appropriate access to dialysis care for ESRD patients who require life-sustaining dialysis treatment, regardless of modality. Failure to Place (F2P) incidences occur when there are no outpatient dialysis facilities that will accept an ESRD patient for routine outpatient dialysis treatment. Therefore, an Involuntary Discharge (IVD) or Involuntary Transfer (IVT) should be rare and preceded by demonstrated effort on the part of the interdisciplinary team to address the problem in a mutually beneficial way. The facility must have written policies and procedures that support the Conditions for Coverage (CfC), and ensures that physician management encourages patients being maintained in consistent dialysis care regardless of patient’s adherence.

The following attached resource is to be utilized to help dialysis patients with access to care barriers.

Dialysis facility leadership are encouraged to discuss access to care barriers and the Network's role in preventing and reducing IVDs with facility staff. Please visit
QAPI Meetings Should Address All Systems of Patient Care and Prioritize Patient Involvement
Your facility's Quality Assessment and Process Improvement (QAPI) program should be comprehensive and cover all aspects of a patient's care in the facility. When fully implemented, a QAPI program should cover all systems of patient care, quality of life, and patient choice. QAPI meetings should patient representation both because it is what a facility should be doing, and because it will set up your facility for success.

There was been debate as to the ways patients can be included in the QAPI process while respecting patient confidentiality and Health Insurance Portability and Accountability Act of 1996 (HIPAA). Here are a few options that have worked well for facilities across our service area:

  • Consider Conference Calls: Patients can call in to your QAPI meetings for a portion of the call and then drop off when sensitive information might be shared.
  • Patient Reports: Ask your Patient Facility Representative to write out or submit a voice recording of their concerns to be shared at your QAPI meeting.
  • Go Virtual: Meet patients where they are in their treatment schedule by utilizing Zoom, Google Meets, FaceTime, or other virtual platforms so patients can participate in QAPI meetings without having to come into the clinic.

Please review the QAPI section (pages 30-33) of the Dialysis Patient Grievance Toolkit developed by the Forum of ESRD Networks Kidney Patient Advisory Council (KPAC) to help identify ways to include patients in QAPI meetings at your facility.
Depression and Peer Mentoring
The 2007 Kimmel, P. L., Cukor, D., Cohen, S. D., and Peterson, R. A. study, Depression in End-Stage Renal Disease Patients: A Critical Review, acknowledged depression as the most common psychological disorder among end-stage renal disease (ESRD) patients. "Depression among ESRD patients is believed to have a prevalence rate between 20-25%." There are several studies linking depression with mortality in ESRD, therefore early diagnosis, effective treatment and peer mentoring are essential to boost ESRD patients’ overall quality of life. The mechanisms linking depression with survival in ESRD patients have been correlated to treatment compliance, improvement in nutritional parameters, increased perception of social support, and modulation of the immune system. Peer mentoring presents a unique experience to facilitate relationship building, patient goal setting, and treatment adherence. Effective peer mentoring may allow patients to reshape their perspectives on dialysis and ESRD that are more reflective of a higher quality of life. Essentially, this can be accomplished through a continuous supportive relationship between two patients who share common experiences, characteristics, and beliefs.

Action Items
To learn more about the Network's Peer Mentoring Program, go to

Review the Network's Mental Health Resources for ideas on how to help dialysis patients through mental health difficulties:
Network Staff Directory
Susan Caponi, RN, BSN, MBA, CPHQ
(516) 209-5619

Jeanine Pilgrim, MPH, PMP, CPHQ, CHES,CPXP
Network Program Director
(516) 209-5365

Anna Bennett
Emergency Manager/QI Coordinator
(516) 209-5474

Erin Baumann, LMSW, MSL
Patient Services Director
(516) 209-5348

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

Shasha Aylor, MBA
Data Analyst
(919) 463-4520
Laura Edwards
Administrative Coordinator
(516) 209-5672

Elena Balovlenkov, RN, BSN, MS
Quality Improvement Director
(516) 209-5416

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

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

Sharon Lamb
Data Coordinator
(516) 209-5459