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Welcome to the February 26 edition of the Quality Insights Renal Network 4 (QIRN4) e-newsletter. In this issue, we bring you important updates about public comment deadlines, QIP reporting measures, implementing the extraordinary circumstances exemption and much more. We encourage you to contact us with any questions, concerns or suggestions. 
CMSExtendsDeadlineCMS extends deadline for public comment on proposed changes to comorbidity adjustments
The Centers for Medicare & Medicaid Services (CMS) has extended the deadline for public comment on proposed changes to comorbidity adjustments in the Standardized Mortality Ratio (SMR) and Standardized Hospitalization Ratio (SHR) from February 22 to February 29, 2016.  Learn more

CMS is now also seeking public comment on revisions to the Standardized Transfusion Ration (STrR) and to the DFC Star Ratings. Comments on the STrR may be submitted between February 19 and March 4, 2016, and on the DFC Star Ratings until March 16, 2016. 

Learn more: 
DepressionScreeningCMS QIP Reporting Measure for depression screening may now be entered into crownweb
The new CMS QIP Reporting Measure for Depression Screening may be entered into CROWNWeb at any time prior to February 1, 2017.  Depression, underdiagnosed and undertreated in people on dialysis, can lead to skipped and shortened treatments, fluid overload, medication omission, and substance abuse, increasing the risks of hospitalization and death.  Home Dialysis Central has created a concise but thorough summary of the Reporting Measure for your review. 
ImplementingECELearn about implementing the extraordinary circumstances exception in the esrd qip
In 2014, CMS finalized (79 FR 66189) that, for PY 2017 and beyond, it would exempt a facility from all ESRD QIP requirements during the time that the facility was forced to close temporarily due to a natural disaster or other extraordinary circumstances beyond the facility's control. In order to receive consideration for such an exception, the facility would need to submit a CMS Disaster Extension/Exception Request Form through within 90 calendar days of the date of the disaster or extraordinary circumstance.
As of January 2016, the ECE request form is still under review for compliance with the Paperwork Reduction Act and until further notice it is not available for use by ESRD facilities. CMS has implemented a process for use by facilities requesting an exemption until the form is available on Read the CROWN memo to learn the process.

NHSNnhsn users participating in dialysis event surveillance must complete training and read protocol
The Centers for Medicare & Medicaid Services (CSM) ESRD QIP mandates that all National Healthcare Safety Network (NHSN) users who participate in Dialysis Event Surveillance must complete Dialysis Event Surveillance training and read the NHSN Dialysis Event Surveillance Protocol at least once, annuallyTherefore, start the year off right by taking the online, self-paced NHSN Dialysis Event Surveillance training at your earliest convenience.

After completing the training, users may be eligible to receive FREE Continuing Education Credits. Pass the post-test to receive 1.5 CME or 1.3 CNE credits, or 0.1 CEUs.

If you have questions about the annual training, please email the NHSN helpdesk and enter "Dialysis Training" in the subject line.
OTCTrainingOTC offers training on cms-2744
The Outreach, Communications, and Training Team (OCT) for CROWNWeb will provide CMS-2744 training on Wednesday, March 2, 2016 at 2:00 p.m. During this webinar session, attendees will gain an understanding of the purpose of the CMS-2744 form and how it impacts facilities, how to complete the CMS-2744, and how to utilize CMS-2744 reports to resolve errors. Attendees can register here.

PreparingWinterWeatherget prepared for winter weather
When a winter storm or the possibility of one is approaching your geographical area: 

Patients: Make sure you stay in communication with your facility for updates and stay current with local news updates via radio, television, the internet or social media.

Facility Staff: Encourage your patients to stay in communication with the facility for updates and stay current with local news updates via radio, television, the internet or social media. Report all alternative treatment schedules or facility closures due to inclement weather to the Network. 

Learn the Signs of Hypothermia
Winter is just around the corner, and it's time to think about cold weather safety; specifically hypothermia. Hypothermia is a dangerous drop in body temperature, usually caused by prolonged exposure to cold temperatures.

According to the Centers for Disease Control and Prevention (CDC), hypothermia is particularly dangerous because a person may not know it's happening. Some signs of hypothermia include shivering, exhaustion, and slurred speech.

The CDC offers tips for helping someone who may be experiencing hypothermia, including:
  • Get the victim into a warm room or shelter;
  • If the victim has on any wet clothing, remove it;
  • Warm the center of the body first using an electric blanket, if available; and Get medical attention as soon as possible

KCERKCER Coalition provides information on the zika virus
Learn more about the Zika virus with this information update provided by the Kidney Community Emergency Response (KCER) Coalition.  

WorldKidneyDayMarch 10 is world kidney day
Contact your local National Kidney Foundation (NKF) office for events related to World Kidney Day. Check out the official World Kidney Day website for additional ideas and information.

NKFSpringMeetingsNKF's spring clinical meetings
The National Kidney Foundation's (NKF) Spring Clinical Meetings present a unique opportunity for busy renal health care providers to learn new developments related to all aspects of nephrology. National registration is now open. 

ESRDResourcesESRD resources  
Forum of ESRD Networks' MAC Publishes a Series of Toolkits for Dialysis Providers
The Medical Advisory Council (MAC) of the Forum of ESRD Networks has published a series of MAC Toolkits for dialysis providers on various topics that include Vaccination, Catheter Reduction, Diabetes Care Coordination, QAPI, Medication Reconciliation, Medical Director Responsibilities, and a newly minted toolkit on Transitions of Care.  These toolkits can be effective starting places for root cause analysis in your Quality Improvement Activities.  For instance, Chapter 8 of the new Transitions Toolkit covers hospitalization issues and how important it is to provide communication and coordination of care from the dialysis facility to the hospital and back, particularly when a patient goes to the ER on their own.  Access the new toolkit
Check out the 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 or visit the ESRD NCC website

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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.

This material was prepared by Quality Insights Renal Network 4 under contract with the Centers for Medicare & Medicaid Services (CMS). The contents do not necessarily reflect CMS policy.

Publication No. ESRD4-022516