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Welcome to the June 9 edition of the Quality Insights Renal Network 4 (QIRN4) e-newsletter. In this issue, we bring you information about the ESRD Measures Manual, CDC guidelines for infection control for Hepatitis C, the application process for the CEC model, ESRD events, resources and much more. We encourage you to contact us with any questions, concerns or suggestions. 
ESRDManualCMS Releases ESRD Measures Manual 
The Centers for Medicare & Medicaid Services' (CMS) ESRD Measures Manual contains the detailed specifications that underwrite clinical performance measures in the ESRD Quality Incentive Program (QIP) and Dialysis Facility Compare (DFC). In this way, CMS provides a transparent and detailed description of how CMS ESRD measures are calculated, offering the public a comprehensive understanding of how CMS evaluates the quality of care provided by dialysis facilities.

In order to provide a forum for the public to pose questions and provide feedback about these measure specifications, CMS designated a section on the Office of the National Coordinator (ONC) Issue Tracking System's JIRA platform for this purpose. CMS also developed a User Guide for the JIRA feedback system.

The Manual and the JIRA User Guide are available on the ESRD QIP section of CMS plans to provide training in the coming weeks that will explore the Manual and the methods for the public to comment on its contents. That training will be the subject of a future CROWN Memo, which also will specify the date and method of registration for attendees.

The Network encourages facilities to explore the Manual and submit comments on the detailed measure specifications by registering for a user account on the JIRA platform and creating issues in the Manual section.

CDCHepCCDC urges dialysis providers and facilities to assess and improve infection control practices to stop hepatitis c virus transmission in patients undergoing hemodialysis 
The Centers for Disease Control and Prevention (CDC) has received an increased number of reports of newly acquired hepatitis C virus (HCV) infection among patients undergoing hemodialysis. Infection control lapses in dialysis care could expose patients to HCV. Any case of new HCV infection in a patient undergoing hemodialysis should prompt immediate action. CDC is urging dialysis providers and facilities to:
  1. Assess current infection control practices and environmental cleaning and disinfection practices within the facility to ensure adherence to infection control standards;
  2. Address any gaps identified by the assessments;
  3. Screen patients for HCV, following CDC guidelines, to detect infections, determine treatment potential, and halt secondary transmission; and
  4. Promptly report all acute HCV infections to the state or local health department. 

State agencies will be looking for the dialysis facilities to:

  • Follow CDC recommendations for HCV screening of hemodialysis patients and management of patients who test positive: 
    • CDC recommends that chronic hemodialysis patients be screened for HCV antibody (anti-HCV)
      upon admission to the dialysis clinic and every six months thereafter if susceptible to HCV infection.
    • For those patients with a positive anti-HCV test result, the test should be followed with a Nucleic Acid Test (NAT) for HCV RNA. Follow CDC recommendations for interpretation of test results and further actions. Ensure patients identified to have HCV infection are aware of the diagnosis and are referred to appropriate care and evaluation. Persons with chronic HCV infection, including those with end-stage renal disease, may benefit from treatment.
  • Immediately report any case of new HCV infection among patients undergoing hemodialysis to the state or local health department. 
    • New HCV infection can present as a change in anti-HCV status from negative to positive, in the absence of signs or symptoms.
    • Communicate test results to the patient and arrange for clinical evaluation for possible treatment of HCV infection.
    • Determine the HCV infection status of all other patients receiving care in the facility.
  • Be transparent. Inform patients if HCV transmission is suspected to have occurred within the facility, and explain steps being taken to address the problem.

Read the full CDC Health Advisory distributed by the CDC Health Alert Network on January 27, 2016.

CMSCECModelCMS Requests Applications for the comprehensive esrd care model 
The Centers for Medicare & Medicaid Services (CMS) is officially announcing a Request for Applications (RFA) for the Comprehensive ESRD Care (CEC) Model. Applicants will have the opportunity to apply to join the Model starting in its second year, on January 1, 2017.

The CEC Model is designed to identify, test, and evaluate new ways to improve care for Medicare beneficiaries with End-Stage Renal Disease (ESRD). Through the CEC Model, CMS will partner with health care providers and suppliers to test the effectiveness of a new payment and service delivery model in providing beneficiaries with person-centered, high-quality care. Dialysis providers, nephrologists, and other providers form ESRD Seamless Care Organizations (ESCOs), which are responsible for coordinating care and improving health outcomes for aligned beneficiaries, and are eligible for shared savings when total cost of care is reduced and quality is improved.

The CEC Model currently has 13 ESCOs participating in the model, including 12 ESCOs from Large Dialysis Organizations (LDOs) and 1 from a non-Large Dialysis Organization (Non-LDO).

Deadline to apply is July 15, 2016.


Roadmap to Integrated Care/ESCO Webinar and Workshop
Renal Services Exchange is excited to host a Webinar on June 10 and Workshop on June 23 and 24 in Chicago, IL to prepare providers for the ESCO Application. The webinar will provide an overview of the ESCO Application and the role of integrated kidney care in the ESCO.

The workshop will lead a review of each item in the ESCO Application.

Please hold these dates if you are a provider considering forming an ESRD Seamless Care Organization (ESCO).

Additional information and program details can be found on
ESRDCoreSurveyESRD core survey data worksheet
Use the ESRD Core Survey Data Worksheet to prepare for your DOH visit. The worksheet ESRD Core Survey Data Worksheet has been updated for FY 2016 with current clinical indicators and corresponding national thresholds for facility comparison. The Centers for Medicare & Medicaid Services (CMS) has provided the revised worksheet to ensure consistent administration of a standardized ESRD survey process and is requiring surveyor's use of the ESRD Core Survey Data Worksheet for all recertification surveys of ESRD facilities.  Find the worksheet here under the Download Section.  

The CAHPS In-Center Hemodialysis Survey asks adults with end-stage renal disease about their experiences with care from dialysis facilities. Both dialysis facilities and End-Stage Renal Disease Networks (known simply as Networks) can use this tool to measure and improve the patient-centeredness of their care. Find out more.
SpanishICHCAHPSSpanish ICH CAHPS Frequently Asked Questions now available
CMS has translated the ICH CAHPS Frequently Asked Questions (FAQs) into Spanish. These Spanish FAQs can be provided to your bilingual customer service toll-free number staff and bilingual interviewers. View the Spanish FAQsPlease contact the ICH CAHPS Coordination Team via email at or call (866) 245-8083 if you have any questions.
TakePledgeTake the QIRN4 pledge for catheter removal
QIRN4 is encouraging all facilities to take a pledge to remove at least three catheters every month from now through September 30. Learn more about this campaign and take the pledge.

RSNEssayContestRSN Invites people with kidney disease to enter 14th annual essay contest
The Renal Support Network (RSN) announces its 14th Annual Essay Contest. This year's theme is "What Do You Know Now About Chronic Kidney Disease That You Wish You had Known When You Were Diagnosed?"

"People who live successfully with a chronic illness like kidney disease know firsthand the importance of having an innovative perspective not only toward their illness, but also toward life in general. There is an abundance of talent within the renal patient community, and the RSN Essay Contest provides people who have CKD with a forum where they can share their experiences, strength, and hope, as well as inspire others."

- Lori Hartwell, RSN President and Founder

A total of $900 in prizes will be awarded. Essayists must have been diagnosed with CKD. The deadline for submitting essays is August 1. 

Read past winning essays.

AAKPAAKP National Patient Meeting registration now open
Registration is now open for the American Association of Kidney Patients (AAKP) National Patient Meeting on September 23-25 in Nashville, TN. Three major themes at this year's Convention will be:
  • Increasing Living Organ Donation (including a workshop on "Having Your Donor Find You" on September 22)
  • Engaging Patients: How Voices and Choices Shape Your Future
  • Food, Drugs and Safety
Eight Continuing Education credits are available for social workers, dietitians, and registered nurses. Scholarships, covering only the conference fees, are available to patients, but you must apply before July 31, 2016.  Learn more and register

PKDPKD National Convention to be Held in June
The Polycystic Kidney Disease (PKD) National Convention will be held June 24-26 in Orlando, FL. The registration fee is reduced if you register by May 5. For ongoing details, visit the PKD Foundation website
CMSDialysisCompareWebinarCMS to host webinar on 2016 dialysis facility compare/star ratings
CMS invites you to learn about improvements to the Dialysis Facility Compare website and updates to the methodology for calculating dialysis facility star ratings through the following webinar: 2016 Dialysis Facility Compare - Star Ratings Refresh Overview on Wednesday, June 22 from 1:00 - 2:00 p.m. ET. In this webinar, CMS will provide an overview of the updated methodology for calculating Dialysis Facility Compare star ratings. CMS subject matter experts will discuss the addition of the Pediatric PD Kt/V measure and the National Healthcare Safety Network Standardized Bloodstream Infection Ratio. CMS will also review the addition of information from patient experience surveys, such as the In-Center Hemodialysis Consumer Assessment of Healthcare Providers and Systems (ICH-CAHPS) Survey, to supplement existing quality information reported on Dialysis Facility Compare.
Attendees are invited to share initial comments or questions during the question and answer period via phone by entering their audio pin and using the hand-raising icon to enable CMS to unmute their lines, they may also use the chat feature. A CMS representative will respond in the order questions are received. For any questions about registration, please e-mail

CROWNWebTrainingScheduleCROWNWeb Training Schedule Announced for EIDM and QARM Conversion
CrownWeb CROWNWeb has announced its training schedule for the conversion to EIDM and QARM. In July, EIDM and QARM are replacing the current QIMS user authentication and validation system. You will need it to access CROWNWeb, QIP 1.0.0, and other CMS systems. Registration for EIDM/QARM begins June 6, 2016. Training sessions will be repeated twice each day, once at 10 a.m. ET and again at 2 p.m. ET:
  • For Security Officials and LDO representatives, June 14 and 21, 2016
  • For ESRD QIP Points of Contact, June 28, 2016
  • For CROWNWeb end users, July 6, 7, and 12, 2016

For more information, see the June CROWNWeb Newsletter

ESRDResourcesESRD resources  
NCC Resources for Vascular Access
The ESRD National Coordinating Center (NCC) has developed a series of resources for vascular access education. Check out the "Ready, Set, Go" campaign to learn more about the steps to catheter freedom.
CDC Provides Overview of Standards for Adult Immunization Practice
The Centers for Disease Control and Prevention (CDC) has developed a one-page overview of standards for adult immunization practice. View the document.

Overcoming a Key Barrier to Home Dialysis: The Art of Teaching Buttonhole Self-Cannulation
Check out this free manual written by Stuart Mott and compiled by the non-profit Medical Education Institute for its Home Dialysis Central website

HAI Webinar Recording Available
A recording is now available for the HAI BSI QIA Q&A Session #1, presented on May 18. View the recording.  

NRAA Webinar Series on Pediatric Dialysis
The NRAA is developing a series of educational webinars on pediatric dialysis. Webinar topics include:
  • Quality of Life Measurement to Intervention in Pediatric Dialysis
  • Leadership Communication: Practical Skills for Growth in Your Role in Pediatric Dialysis
  • Education for the Pediatric Patient and Family
  • How to Build a Successful Staffing Model Strategy for Pediatric Dialysis Providers
The first one is available now, and the others will be added over the course of 2016. One contact hour will be available for each webinar. Learn more

CROWNWeb Special Edition Newsletter Now Available
A Special Edition of the CROWNWeb Newsletter that focuses on CMS' new Enterprise Identity Management (EIDM) and QualityNet Authorization and Role Management (QARM) systems is now online. Stories included in this Special CROWNWeb Newsletter:
  • What is EIDM?
  • What is QARM?
  • Training
  • EIDM/QARM Training Schedule Click the image or link below to learn more about EIDM and QARM. 

View the Special Edition CROWNWeb Newsletter.  

New Patient Engagement Resource Available 
Does the term "Patient Engagement" have you confused? The book See Me as a Person: Creating therapeutic Relationships with Patients and their Families by Mary Koloroutis and Michael Trout is a book that speaks about how to sustain relationship-based care and get to the heart of patient engagement. Learn more and read online.

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. ESRD4-053116