Quality Improvement
CMS ESRD Measures Manual Available for Public Review and Comment
The 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, the Centers for Medicare & Medicaid Services (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.

We encourage dialysis facilities to explore the Manual, and to submit comments and questions about the measure specifications using the CMS ESRD Measures Manual JIRA Feedback System available at the following link:
Facility Staff will need to sign up for an account on the feedback system in order to submit comments and questions. CMS developed this User Guide for navigating the feedback system.
CMS plans to provide training in the coming weeks that will explore the Manual and how to submit comments and questions. The Network will send out an email to facilities specifying the date and method of registration for attendees.

More information about the Manual and the ESRD Quality Incentive Program can be found at the following link:

ESRD News and Alerts
FDA MedWatch:
  • May 19, 2016 - Drug Safety Communication - Clinical Trial Results Find Increased Risk of Leg and Foot Amputations. FDA is alerting the public about interim safety results from an ongoing clinical trial that found an increase in leg and foot amputations, mostly affecting the toes, in patients treated with the diabetes medicine canagliflozin (Invokana, Invokamet). FDA has not determined whether canagliflozin increases the risk of leg and foot amputations. FDA is currently investigating this new safety issue and will update the public when we have more information. For the full FDA Announcement, click here.
Patient Services
Patient Essay Contest
Help your patients share their story! The Renal Support Network's (RSN) 14th Annual Essay Contest.

This year's theme is: "What Do You Know Now About Chronic Kidney Disease That You Wish You'd 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 

All entries must be postmarked or received by 12:00 PM (ET) on August 1, 2016. 
For more information visit the Renal Support Network website.

Talk to Your Patients about Mental Health
Mental Health Month raises awareness about mental health conditions and the importance of good mental health for everyone. Medicare covers several preventive services to help monitor your patients' mental health, including the Initial Preventive Physical Examination, Annual Wellness Visit, and depression screening. Click the links below for helpful patient resources.
Visit the Preventive Services website to learn more about Medicare-covered services.
American Association of Kidney Patients (AAKP) Webinar on Social Media
On Tuesday, May 31, 2016, AAKP Health Line will repeat the popular program on Mastering Social Media as a Patient Advocate, presented by dialysis patient, James Myers. Social media has become a useful advocacy resource and this webinar will cover how to get started, how to tap into your networks, and how to advocate for yourself. 
Date: Tuesday, May 31, 2016

Time: 7:00 p.m. - 8:00 p.m. ET

Speaker: James Myers, dialysis patient and social media expert
Registration: Click here to register!
*Please share with patients who may be interested in participating*
Data Management
Network Data Knowledge Base and Customer Portal!
With the increase in data that must be submitted, as well as systems through which the data is collected, the ESRD Network is excited to announce expanded support. There are multiple ways in which you can reach the Network Data Support Team. Please see the information below on how to access the portal and contact the Network.

1. New Knowledge Base and Customer Portal
  • Browse knowledge and articles on a multitude of frequently asked questions. This is a "one stop shop" for information on various systems and initiatives such as CROWNWeb, NHSN, the Quality Incentive Program (QIP), and more.
  • If you are unable to resolve your questions with the Knowledge Base, register for the portal through the "Sign Up" feature and enable yourself to quickly and easily submit questions or requests for assistance directly from the website.
2. Updated Email Contact

3. Phone

  • Network staff members are still available by phone to answer questions and assist with data management. The Network data team can be reached at 203-387-9332.
*Please remember that you should NEVER include any patient-specific information such as Name, Date of Birth, Social Security Number, Medicare Claim Number, etc. The only patient identifier that can safely be communicated is the Unique Patient Identifier (UPI) from CROWNWeb.*
NHSN Dialysis Event Surveillance Deadline: June 30, 2016
The Quarter 1 deadline for the CMS End Stage Renal Disease (ESRD) Quality Incentive Program (QIP) rule for calendar year 2016 (payment year 2018) is right around the corner!
To meet CMS' ESRD QIP National Healthcare Safety Network (NHSN) reporting requirements for Payment Year 2018, outpatient hemodialysis clinics must submit their first quarter 2016 Dialysis Event data collected from January 1, 2016 through March 31, 2016, by Thursday, June 30, 2016. New or revised first quarter data entered into NHSN after June 30 will not be sent to CMS. Therefore, please be aware that any changes or corrections to first quarter 2016 data should be made prior to the reporting deadline.
For more information click here.

National Healthcare Safety Network (NHSN) 21 Day Rule
What is the 21 day rule?
The 21 day rule is a reporting rule to reduce over-reporting of dialysis events that are likely to be related to the same patient problem. It states that 21 or more days must exist between two dialysis events of the same type for the second occurrence to be reported as a separate dialysis event. If fewer than 21 days have passed since the last reported event of the same type, the subsequent event of the same type is NOT considered a new dialysis event and therefore, it is not reported. The 21 day rule applies across calendar months and is applied differently to each dialysis event type.
To learn more about the 21 day rule and its application, read the Dialysis Event Surveillance Protocol and take the 2016 online Dialysis Event Surveillance training.
The Centers for Disease Control and Prevention (CDC) has published an NHSN "News from the Help Desk" bulletin describing the 21 day rule and its importance in accurate infection reporting. Click here to read the bulletin.

Important Updates
Comprehensive ESRD Care (CEC) Model
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). These organizations are responsible for coordinating care and improving health outcomes for beneficiaries; they are also eligible for shared savings when total cost of care is reduced and quality is improved.

Deadline to apply is July 15, 2016.

For more information about the CEC Model and how to apply, please visit:

Roadmap to Integrated Kidney Care Series
The National Renal Administrators Association (NRAA) is providing critical education and dialogue in response to the CMS Request for Applications for the Comprehensive ESRD Care (CEC) Model.

The Roadmap to Integrated Kidney Care Series sponsored by the Renal Services Exchange (RSE) includes a webinar overview as well as an in-person workshop reviewing each step in the application process. 
When: June 10, 2016
Time: 1:00 pm ET
Registration required at

An overview and discussion on the ESCO application process, benefits to the providers, and the overall role within integrated kidney care. 
 Open to all - FREE to attend. 

When: June 23 & 24, 2016
Where: Chicago, IL
Registration required at

A hands-on workshop where each item of the ESCO application will be reviewed. A discussion led by those who are already participating in the ESCO and have gone through the application process. 
Open to all - FREE for NRAA members, $300 for non-NRAA members to attend.

 Additional information and program details can be found on 
Upcoming Meeting & Events
Thursday, June 2, 2016 - Educational Technician Meeting, hosted by IPRO ESRD Network of New England at the Sheraton Hotel in Portsmouth, NH. *Registration Now Closed*
Friday, June 17, 2016 - 3rd Annual Dialysis Unit & Transplant Program Social Worker Conference, hosted by Hartford Hospital Transplant Program in Hartford, CT. Register Now.
June 24-26, 2016 - PKD National Convention 2016, at the Walt Disney World Resort in Orlando, Florida

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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