December 2017

Quick Links
Click here to learn more about the IPRO ESRD Networks (1, 2, 6 & 9).
What You Need to Know about CMS' 2018 Priorities, Goals, and Quality Improvement Activities

Join us for an informative webinar, hosted by the Network, to understand CMS' expectations for dialysis facilities in 2018.
Wednesday, January 17, 2018
Noon - 1:00 PM EST

Registration: Click here to register online
Meeting Flyer (please share with colleagues)
Dialysis professionals are invited to attend a webinar about the role of the ESRD Network, and how the National Quality Strategy (NQS) principles, Department of Health and Human Services (HHS) priorities, and CMS goals will affect ESRD patient care in 2018.  The medical directors, facility administrators, nurse managers, social workers, and dietitians from each dialysis facility are strongly encouraged to attend to better understand facility-level expectations for 2018 initiatives.
Topics include:
  • Patient and Family Engagement
  • Emergency Preparedness
  • Data Management
  • Healthcare Associated Infections (HAIs)
  • Long-Term Catheter (LTC) Reduction
  • Transplant Referral Coordination
  • Home Therapies
  • Vocational Rehabilitation
  • Learning and Action Networks (LANs) 

For more information, please contact the Network at 203-387-9332.

Quality Improvement
Best Practices in Infection Prevention
REGISTER NOW for this in person training conducted by the Massachusetts Department of Public Health.
The Massachusetts Department of Public Health, in partnership with the Centers for Disease Control and Prevention (CDC), is offering an interactive training session to prepare and align dialysis nursing and technician staff in using infection prevention best practices.
The training will be offered at three locations over the next few months. Select the location and date that is most convenient for you and register using one of the links below:
Contact Eileen McHale at  or Barbara Bolstorff at
Strategies for Preventing Catheter-Related Bloodstream Infections in Hemodialysis Patients
A 2016 article in the International Journal of Nephrology and Renovascular Disease evaluates management strategies for preventing catheter-related bloodstream infections, with recognition that many patients begin hemodialysis (HD) with a catheter. The authors conclude that "Early efforts must be directed toward preventative care emphasizing placement of other vascular accesses or initiating an alternative dialysis modality, such as timely peritoneal dialysis (PD) to avert HD catheter placement before it becomes necessary ."
Findings include:
  • "Urgent start PD" programs are a safe alternative to HD in patients without an established AV fistula or graft.
  • Should no options exist outside of catheter placement, proper catheter care and infection control procedures implemented through educating and auditing dialysis unit staff as well as patients, are the first step in preventing infections.
  • In high-risk groups for whom all other conservative measures to prevent infection have failed, the authors recommend consideration of antimicrobial lock (AML) therapy.
" Prevention of catheter-related bloodstream infections in patients on hemodialysis: challenges and management strategies,"Int J Nephrol Renovasc Dis. 2016; 9: 95-103. Published online 2016 Apr 18. doi:  10.2147/IJNRD.S76826
Patient Services
How Does the ESRD Network Partner with Facilities to Improve Patient Care?

Under contract with CMS, ESRD Networks are charged with achieving healthcare transformation, promoting the  National Quality Strategy , and supporting the Health and Human Services Secretary's  priorities , by working with dialysis providers, government agencies, ESRD stakeholders, patients, family members and care partners to reach CMS set goals. The Network strives to achieve these goals through activities that include:
  • conducting directed quality improvement activities focused on patient care,
  • maintaining a patient registry,
  • assisting with emergencies,
  • providing educational materials, and
  • investigating patient grievances. 
On December 1, 2017, all 18 ESRD Networks across the country began a new contract year.

Do you want to learn more about the work of the Network?
Empower Your Patients
With your help, we can make a difference!

Have any of your patients or their caregivers/family members shared with you their feelings about not being heard?

Has a patient ever shared an idea they felt would be useful for others with ESRD?

If so, we know you'll understand the value of engaging such individuals in efforts to improve patient care. We need your help!
The Network has convened a group of Patient Subject Matter Experts (SMEs) to provide patient perspective and feedback to the Network on educational materials, quality improvement projects and other issues that relate to our work in improving care to ESRD patients.  Please consider nominating patients, transplant recipients, and family members/care partners who are interested in sharing their talents and ideas with other SMEs in the Network.
What do SMEs do? Ultimately, they help Network staff understand what is important to patients, share useful ideas and experiences, and foster Network initiatives at their own dialysis facility and transplant center.  Their efforts focus on providing feedback on Network quality improvement activities related to infection prevention, transplant referrals, home dialysis training, vocational rehabilitation, and patient engagement.
For more information, please contact Merari Rosario , Community Outreach Coordinator, at 203-285-1223.

Please print and complete the Patient SME Nomination Form and return it to the Network by December 31, 2017.
The Grievance Process: Do You Know Your Facility's Responsibilities?

Dialysis facilities are required to ensure a process has been implemented for patients to express concerns about their care without reprisal or denial of services. 
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." The grievant is not required to explicitly state that the care did not meet professionally recognized standards.
Federal regulations at 42 CFR §405.2112(g) specify "evaluating and resolving patient grievances" as one of the Network's functions.  The Network's case review responsibilities include investigating grievances filed with the Network and addressing non-grievance access to care cases.  However, some concerns do not fall under the jurisdiction of the Network; in these cases patients would be referred to a more appropriate agency, such as the state health department.
The following resources provided by the Network can help educate staff and patients about grievances:
An updated Grievance Poster will be sent to facilities by the end of December.  Please post it in a prominent area in the facility by the first of the year.
For more information, or assistance with patient grievances, please contact the Patient Services Director in your Network.
News for Your Patients: CMS Announces Improved Access to High-Quality Health Coverage Choices; Decreased Premiums for 2018

The Centers for Medicare & Medicaid Services (CMS) recently released 2018 benefit and premium information as well as Star Ratings for Medicare health and drug plans. Changes announced represent more health coverage choices, improved access to high-quality health choices, and decreased premiums in 2018. "Medicare's top priority is to ensure that beneficiaries have choices for affordable, high-quality care that fit their needs," said CMS Administrator Seema Verma.


The following resources have been created to assist patients with understanding health coverage options:
For more information about the CMS health coverage announcement, please visit:
For information on proposed policy changes and updates for Medicare Advantage and the Prescription Drug Benefit Program for 2019, please visit:
Data Management
Posting of Payment Year 2018 Performance Score Certificates

CMS color logo
CMS regulations state that each facility's Payment Year (PY) 2018 Performance Score Certificate (PSC) must be printed and posted in a prominent patient area within 15 business days of its availability.  PSCs are expected to be available on or about December 15, 2017.  
Click on the link for instructions to download and print the certificate.
For information on how ESRD QIP affects patients, please visit:
If you have any questions or concerns, please contact the ESRD-QIP team at  If you have any questions for the Network staff, please send an email to
Kidney Community Emergency Response (KCER) Alerts and Information
  • Click here for up-to-date KCER Alerts and Recalls.
  • For professional and patient KCER resources, please click here.
Season's Greetings
The staff members of IPRO ESRD Network of New England want to take this opportunity to say, "thank you" for the tireless efforts of ESRD healthcare professionals.  We applaud your commitment and dedication in providing quality of care to the patients you serve.  As our partners in the renal community, your collaboration and hard work helps to ensure the realization of our goals for improved quality and safety for all ESRD patients in the New England states.

Wishing you a season of joy and looking forward to continued success in 2018.  Happy Holidays!

IPRO ESRD Network of New England

IPRO End-Stage Renal Disease Network of New England, the ESRD Organization for Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, and Vermont, prepared this material under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The contents presented do not necessarily reflect CMS policy. CMS Contract Number: HHSM-500-2016-00019C.
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IPRO ESRD Network of New England
1952 Whitney Avenue, 2nd Floor, Hamden, CT 06517
PH 203-387-9332 · FAX 203-389-9902