Quality Insights Renal Network 4 
A Periodic Newsletter from Quality Insights Renal Network 4 | www.qirn4.org
In This Issue
Alerts and Recalls
Quick Links
QIRN 4 Staff
Executive Director
Quality Improvement Director

Jeannette Shrift
Quality Improvement Coordinator
Paul Gordon
Patient Services Director
Patient Services Coordinator
Data Manager
Office Manager
February 5, 2015 
Our Commitment to You
Quality Insights Renal Network 4 (QIRN 4) is committed to providing valuable resources like this e-newsletter that help improve the quality of renal care in Pennsylvania and Delaware. Please contact us with any questions, concerns or suggestions. 
QIRN 4 Gets Social
QIRN 4 is now on Facebook and Twitter. Check out our social media feeds for news and updates regularly. 

Like us on Facebook    Follow us on Twitter
QIRN 4 Releases 2015 Network Goals
QIRN 4 is providing each facility with 2015 Network 4 Goals. If you have any questions after reviewing these goals, please feel free to contact the Network.  

We ask that you attest here by February 27, 2015 after reviewing these goals. If you oversee more than one facility, please attest individually for each facility.

ANNA to Host 46th National Symposium in April
The American Nephrology Nurses' Association (ANNA) will be hosting its 46th National Symposium on April 19-22, 2015 at Disney's Coronado Springs Resort in Lake Buena Vista, Florida. ANNA's National Symposium provides opportunities for nephrology nurses to expand their knowledge, enhance clinical skills and widen professional networks. For more information about ANNA's 46th National Symposium, please visit www.annasymposium.org or download this flyer

Webinar Opportunity: Coalition for Supportive Care of Kidney Patients
The Mid-Atlantic Renal Coalition (MARC) is sponsoring a webinar for the Coalition for Supportive Care for Kidney Patients on February 17, 2015, from 4:00 to 5:00 p.m. ET.  Dr. Diane Meier, Director of the Center to Advance Palliative Care (CAPC) and Professor of Geriatrics and Palliative Medicine at the Icahn School of Medicine at Mt. Sinai, will be sharing her knowledge about "Connecting the Institute of Medicine's Dying in America report with CSCKP's Strategic Goals" and Dr. Alvin Moss and Dr. Dale Lupu will discuss "Coalition Updates".  Learn more and/or participate in the webinar.

Mark Your Calendars: Upcoming Events
Save the Date: Update on Kidney Disease  
Update on Kidney Disease
Sponsored by the Kidney Foundation of Central Pennsylvania (KFCP) and Penn State College of Medicine    
April 21, 2015
8:00 a.m. to 3:30 p.m.
The Hershey Hotel 
Hershey, PA
Cost: $85 (Non-Physicians)
$110 (Physicians) 
Save the Date: QIRN 4 Annual Meeting 
QIRN 4 Annual Meeting 
October 27, 2015
Seven Springs, PA 
Facility Status Reporting Tool

In the event of inclement weather that causes an alteration in your treatment schedule, please report your facility's status here. For questions, please contact the Network at (610) 265-2418.

CMS National Provider Call: Payment of Chronic Care Management Services Under CY 2015 Medicare PFS
The next Centers for Medicare & Medicaid Services (CMS) National Provider Call is scheduled for Wednesday, February 18 from 1:30 to 3:00 p.m. EST.

In CY 2015, CMS will begin making separate payment under the Medicare Physician Fee Schedule (PFS) for Chronic Care Management (CCM) services under Current Procedure Terminology (CPT) code 99490. CCM services are non-face-to-face care management/coordination services for certain Medicare beneficiaries having multiple (two or more) chronic conditions. Call participants are encouraged to review the following rules (links found here) prior to the call:
  • The 2014 PFS final rule (CMS-1600-FC), pages 74414-74427
  • 2015 PFS final rule (CMS-1612-FC), pages 67715-67730

Register here


Continuing Education Credit Information 


2015 Federal Poverty Guidelines
The 2015 Federal Poverty Guidelines were released January 22, 2015. View them in the Federal Register here.
Explore Transplant Unveils Initiatives to Support Live Kidney Donation Consensus Conference Recommendations
Explore Transplant, the nonprofit organization that helps kidney patients, their family and friends learn about transplant and living donation as treatment options, unveiled a new education program and website that underscore the organization's commitment to support the recommendations of last June's Live Kidney Donation Consensus Conference in Rosemont, Ill.

Read the full release or visit the new Explore Transplant website.

View the Explore Living Donation program components here.
Education Opportunity: PSNA Offers Courses for CEUs
The Pennsylvania State Nurses Association (PSNA) is offering courses for nursing CEUs. Learn more
NHSN Annual Survey - Required
The 2015 version of the Outpatient Dialysis Practices Survey is now available to view and print. The survey should be completed (in NHSN) in February for the current year. Multiple questions pertain to patients and staff present during the first week of February. Data collection should be entered by someone who works in the center and is familiar with current practices within the center. Complete the survey based on the actual practices at the center, not necessarily the center policy, if there are differences. The survey can be saved in progress. This annual survey must be completed before the first week of May 2015 in order to continue reporting.
New Installments of NHSN Dialysis Newsblast Now Available
The National Healthcare Safety Network (NHSN) Dialysis Newsblast series has released two new installments. "How to Update NHSN Access When Staff Change at Your Facility" addresses how to add a new user in NHSN, deactivate an existing user, and make overall updates when there are staffing changes at your facility. "Annual NHSN Requirements - Training and Survey" is also now available.
New AHRQ Toolkit Helps Keep Dialysis Patients Safer
To help prevent infection in people with End-Stage Renal Disease (ESRD), the Agency for Healthcare Research and Quality (AHRQ) has developed a new resource - the AHRQ Safety Program for End-Stage Renal Disease Facilities Toolkit. Dialysis clinics can use this toolkit to prevent healthcare-associated infections in their patients. The toolkit helps clinicians and other health care workers follow clinical best practices, create a culture of safety, use checklists and other audit tools and engage patients and their families in infection prevention practices. This new resource has science-based, practical information-including educational videos-that reflects the experiences of the frontline providers who helped develop the toolkit.
2014 Annual Facility Survey (CMS- 2744)
With the close of the 2014 calendar year, facilities should begin preparing for the 2014 Annual Facility Survey, which all facilities are required to complete in CROWNWeb. All 2014 treatments, admissions, discharges, and CMS forms should be entered before February 15, 2015. Facilities should also create their initial draft of the CMS-2744 in CROWNWeb by February 15. Final submission of the CMS-2744 needs to be completed no later than April 1, 2015.

Here are a few tips to get you started:
  • Get started early. The CMS-2744 process is time-consuming, so getting started early is essential to completing the survey on time.
  • When generating your initial draft of the CMS-2744, be sure that you are selecting 2014 as the year and NOT 2015. Everyone should be completing the 2014 CMS-2744.
  • When entering your treatment information under the appropriate section on the form, you should be entering the total number of hemodialysis and other treatments for the year, NOT the total number of patients.
  • Visit www.projectcrownweb.org for additional information on how to successfully complete your 2014 CMS-2744.
Revision to Performance Standards for the SRR Clinical Measure
CMS has recently determined that a data irregularity led to the publication of erroneous performance standards for the Standardized Readmissions Ratio (SRR) clinical measure in the Payment Year (PY) 2017 ESRD QIP. Finalized policy (79 FR 66182) established that the PY 2017 performance standards would be based on the 90th, 15th, and 50th percentile of national performance in CY 2013.

The following erroneous performance standards were published in the CY 2015 ESRD PPS Final Rule where requirements for PY 2017 - PY 2018 (79 FR 66184) were finalized:

Benchmark (90th percentile) 0.555 
Achievement Threshold (15th percentile) 1.325 
Performance Standard (50th percentile) 0.996 

After resolving the data irregularity, CMS has determined that the following values accurately reflect the "90th, 15th, and 50th percentiles, respectively, of national performance in CY 2013" (79 FR 66182) and that these updated values should replace the above-mentioned values for setting performance standards for the PY 2017 ESRD QIP. CMS will score facility performance on the SRR clinical measure on the basis of the following accurate standards for the PY 2017 ESRD QIP:

Benchmark (90th percentile)   0.648
 Achievement Threshold (15th percentile)  1.261
 Performance Standard (50th percentile)  0.998

Please contact the ESRD QIP mailbox at ESRDQIP@cms.hhs.gov if you have questions.
5-Diamond Patient Safety Program
Join dialysis facilities nationally that are participating in the 2015 5-Diamond Patient Safety Program.  The 2015 program year offers 14 modules designed to help facilities improve both staff and patient awareness of specific patient safety areas. Learn more.


Submit Your Emergency Preparedness Articles
Our focus at QIRN 4 is to "Be Disaster Aware, Take Action to Prepare." If you have any disaster preparedness articles or links, please e-mail your information to dknight@nw4.esrd.net so it may be posted in our bi-weekly newsletter.  

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 ncc@ncc.esrd.net or visit the ESRD NCC Web site. You can also check the QIRN 4 website for updates that include material from the Information Exchange.

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.

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Quality Insights Renal Network 4
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