March/April  2017
Nominate a Patient Leader:
Annual Kathe LeBeau Patient Advocate Award
Deadline to Submit: April 21, 2017 (FAX ONLY)
Please print copies of this  flyer and share with other staff and patients, at your facility... and consider nominating a patient leader for this award!

In recognition of the life and achievements of PAC Chair/IPRO Board Member Kathe LeBeau, the Patient Advisory Committee has created the Annual Kathe LeBeau Patient Advocate Award, to be presented at the Network's Annual Meeting  (May 23, 2017 in Garden City, NY).
Benchmarked by the extraordinary patient advocate work of Kathe LeBeau, this Award recognizes a single patient's accomplishments both within and outside of the dialysis clinic.

To be considered for the 2017 Annual Kathe LeBeau Patient Advocate Award, nominations must be submitted via FAX to the Network by April 21, 2017. (PHI/PI can only be sent via fax)

Award Criteria
In keeping with the spirit of Kathe's work, we ask that each nominee:
  • Be a resident of New York State, living with ESRD (dialysis or transplant);
  • Currently serve as a member of the Network's Patient Advisory Committee (Chair or Representative) or as a Network Subject Matter Expert; and
  • Be an active patient advocate whose work has a positive impact on the ESRD community
Study: Dialysis Patients with Depressive Symptoms Often Turn Down Anti- depressant Treatment
In 2016, the Centers for Medicare & Medicaid Services (CMS) ESRD Quality Incentive Program (ESRD QIP) mandated that all dialysis facilities report individual patient screening and treatment plans for depression

Many patients with kidney failure who are receiving chronic hemodialysis have depressive symptoms; however, according to a study published in the 
Clinical Journal of the American Society of Nephrology , few wish to receive aggressive treatment to alleviate these symptoms.  The study, led by Steven Weisbord, MD, MSc and Julio Pena-Polanco, MD, VA Pittsburgh Healthcare System and University of Pittsburgh School of Medicine, surveyed 101 hemodialysis patients in a clinical trial. Patients were asked to complete a monthly questionnaire about depressive symptoms. The study found that the primary reason patients refused the recommendations was that they felt their depression was attributable to an acute event, chronic illness, or dialysis. The study also found that when patients are willing to accept treatment for depression, kidney specialists commonly do not prescribe it.

To read the full article, published in Nephrology News & Issues, about the effectiveness of anti-depressant treatment in the ESRD patient population,  click here.
How is your facility capturing Clinical Depression Screening:
CMS is Requesting Feedback
A request by the ESRD National Coordinating Center of behalf of Renee Dupee, ESRD Team Lead, ESRD Network Program, Population and Community Health, Quality Improvement Group, Office of Clinical Standards and Quality.
CMS would like to gather information on how facilities are capturing Clinical Depression, they are especially interested in hearing from facility staff that have identified barriers, recommendations, or "best practices" on ways to optimize the Clinical Depression measure.

Examples of needed information include:
* Who administers the Clinical Depression screening?
 * Is the Clinical Depression screening administered at a particular time after patient admission?
 * How do Clinical Screening results influence the patient's ongoing plan of care?
 * Have best practices been identified? If so, how were they identified, and have those practices been communicated to affiliated facilities?
 * Have facilities seen any changes as a result of these actions (such as reduction in hospitalization or improvement in compliance with regimens)?
 * Do you have any other additional feedback regarding the collection and use of Clinical Depression information?

To provide VOLUNTARY feedback on any/all of these items, please send your information to or complete the online form: . Feedback will be tracked through these email addresses, and CMS will receive a summary report of all feedback provided.
Advanced Care Planning: New Tools Available
Richmond, VA, March 20, 2017 The Coalition for Supportive Care of Kidney Patients (CSCKP) has released two new tools to assist patients and their kidney care teams with advance care planning
  • The brochure, Planning Today for Tomorrow's Healthcare: A Guide for People  with Chronic Kidney Disease, introduces patients and their kidney care teams to the advance care planning process. It details the five steps of planning that allow patients to have control over their healthcare in the event that they cannot speak for themselves.
  •  The companion Curriculum Guide for Advance Care Planning is designed to assist facility staff in having advance care planning discussions with patients.
These tools were developed as part of the MY WAY Project, which seeks to test the impact of advance care planning coaching on outcomes and health service utilization of patients with chronic kidney disease. 

To learn more about CSCKP, visit .
Are you discussing Transplant as a Treatment Option?
Patients with ESRD have several options for renal replacement therapy that include in-center or home hemodialysis, peritoneal dialysis, and transplantation. While options such as dialysis offer life-sustaining treatment,  transplantation offers the opportunity for better clinical outcomes .

Transplant criteria, eligibility, and referral options vary and are dependent on the transplant facility, patient health status, and availability of donors. Improving the referral process to clarify these pieces and close the gaps sometimes seen between providers and patients could help to increase transplantation referrals, wait listing, and ultimately the number of transplants.

According to the CMS Conditions for Coverage (CfC) for End Stage Renal Disease Facilities (2008), dialysis providers are responsible for educating their patients about treatment modalities, including transplant. Despite this requirement, gaps in transplant referrals exist.  To help address this, the Network encourages dialysis staff to discuss transplant as a treatment option, and to share the following resources with patients:
We're Hiring!  Community Outreach Coordinator - BSW required
Join Our Team:  Under the supervision of the Patient Services Director, the Community Outreach Coordinator is responsible for evaluating and resolving patient grievances and providing conflict management strategies to dialysis facility staff in order to avert involuntary discharges.

At the direction of the CMS, the Community Outreach Coordinator will serve as a patient advocate for all dialysis patients in New York and a resource for all outpatient dialysis providers on any ESRD patient questions or concerns. As part of the advocacy role, this position will have a key role in community engagement activities including:

            *coordination of a Patient Advisory Council (PAC),
            *supporting patients at the local level in activating and engaging in patient lead / Network
            *supported activities focused on improving healthcare outcomes.

This position will have a key role in the creation, design and management of quality improvement (QI) activities related to improving grievance outcomes, and the patient experience of care, in addition this position is responsible for the implementation and on going support of the peer mentorship program. Creative and innovative approaches will be needed in the development of interventions designed with patient PAC members in support of overall quality improvement goals for the ESRD program.

For more information and to apply:   Community Outreach Coordinator - BSW req'd (#17057)
Does Your Facility have Saved CMS-2728 Forms in CROWNWeb?
Remember: CMS-2728 forms should be submitted in CROWNWeb within 10 business days from the "date regular chronic dialysis began." 

Dialysis Facility Compare: Share these Social Media Resources
On October 19, 2016, CMS launched the refreshed Dialysis Facility Compare website, and is seeking your help in educating fellow healthcare professionals and their patients about the updated website and the available information on kidney care.
How Can You Help?
To encourage healthcare professionals, dialysis centers and consumers to use Dialysis Facility Compare as a valuable and reliable resource for information relevant to kidney care, CMS developed stakeholder toolkits that include messages tailored to the needs of these key audiences within the end stage renal disease community.
CMS encourages you to use and share the materials included in the toolkits with your peers and patients by:
  • sharing sample Tweets and Facebook posts,
  • downloading and sharing social media graphics, and
  • including an article in your patient newsletter.
If you would like CMS to send you a toolkit, please email
Secondary Hyperparathyroidism in ESRD Patients
Many dialysis patients develop secondary hyperparathyroidism (SHPT) due to complications of their renal disease that cause complex alterations in bone and mineral metabolism.  Patients diagnosed with SHPT are at increased risk of developing hypercalcemia. 
Patients with hypercalcemia may experience the following symptoms and are at increased risk for cardiovascular disease, morbidity, and mortality:
  • Abdomen pain
  • Nausea/ vomiting
  • Constipation
  • Muscle twitching/ weakness
Dialysis providers continuously struggle to manage the calcium levels of patients with chronic kidney disease (CKD) and ESRD. Many patients struggle to adhere to a diet low in calcium and phosphate. Many of the binders prescribed to maintain patients' phosphorus levels are calcium-based binders. Patients who find the aluminum- magnesium based binders costly will often purchase over the counter antacids to replace their binders.
Patients with ESRD typically have lower amounts of vitamin D to help them metabolize calcium properly and may take over the counter vitamins to help boost  vitamin  D levels, while unknowingly increasing their calcium levels as well.
Mineral metabolism is an important consideration for the patient, and it is imperative for the clinic to monitor. The CMS Quality Incentive Program (QIP) uses mineral metabolism as one of its measurement to assess quality outcomes for patients. Depending on the percent of patients in a facility that have hypercalcemia, the facility may experience a reduction in payment from Medicare.

A Call for Nominations: TEP Members Medication Reconciliation
Deadline: April 24, 2017
CMS color logo The University of Michigan Kidney Epidemiology and Cost Center, through its contract with CMS, is convening a technical expert panel (TEP) to inform the development of a quality measure(s) related to medication reconciliation and management in dialysis facilities.

The TEP Charter and Nomination form can be found on the CMS website: CMS Quality Measures TEP Webpage .

If you wish to nominate yourself or other individuals for consideration, please complete by clicking form and email it to  by close of business (5:00pm ET) on April 24, 2017.
ESRD QIP 2020: Q&A Follow-up Now Available
Follow-up questions and answers  for the January 17 call on the ESRD QIP are now available.

During this call, CMS experts discuss the final rule that operationalizes the ESRD QIP for Payment Year 2020.


IPRO End-Stage Renal Disease Network of New York, the ESRD Organization for New York state, 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-500-2016-00020C.