This ESRD facility monthly newsletter highlights the latest ESRD insights and resources. Our goal is to provide you with a resource that makes it easy for you to stay on top of trends and support you in providing the best possible care for those you work with and serve.
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In This Issue:
- Behavioral Health
- Home Dialysis
- Hospital Admissions, Readmissions and Emergency Visits
- Transplant
- Vaccinations
- Patient and Family Engagement
- EQRS News You Need to Know
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“Spring is the time of year when it is summer in the sun and winter in the shade.”
—Charles Dickens
A quick look back:
- On April 11, 1970, Apollo 13 was launched and ran into difficulties about two days later. It was then that the famous line “Houston, we’ve had a problem here” was said, and is today usually misquoted.
- Ford unveiled their first Mustang on April 17, 1964, costing $2,368!
National Donate Life Month is observed in April. It helps raise awareness about donation, encourage Americans to register as organ, eye and tissue donors, and honors those who saved lives through the gift of donation. Click here to access resources.
National Minority Health Month is also celebrated in April, highlighting the importance of improving the health of racial and ethnic minority communities and reducing health disparities. Click here for information about health literacy and culturally and linguistically appropriate services.
New websites are up! Our communications team has worked diligently to update websites for Network 8 and Network 14. Take a look!
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Behavioral Health
Why is the Plan of Care important in dialysis settings? As noted in the CMS Conditions for Coverage, the interdisciplinary team must use a comprehensive assessment to develop an individualized plan of care. Not only is the plan of care a Condition of Coverage, but it plays an integral part in the treatment process. Looking at the plan of care as a tool, rather than a burden of repetitive paperwork, provides a framework for a collaborative, individualized, and informed decision-making approach to goal setting. The plan of care ultimately is a road map for the patient and team to establish realistic goals and identify steps for improved overall well-being.
A patient-centered approach to care planning can help patients feel more comfortable setting goals and making changes. Transitioning from a problem-based approach to a priority-based approach can help empower patients to feel like they have more control over their health outcomes. Often, dialysis teams focus more on the medical aspects of care, such as lab values, blood pressure, access flow rates etc.; however, patients may indicate priorities and outcomes that are more relevant to them, such as being active, not feeling tired, or spending more time with family.
It is important to include what the patient’s understanding is in the plan of care and let that guide the decision-making process. The resources below offer valuable tools for helping facilities to create a culture of patient-centered care planning.
A patient-centered approach to care planning can help patients feel more comfortable setting goals and making changes. Transitioning from a problem-based approach to a priority-based approach can help empower patients to feel like they have more control over their health outcomes. Often, dialysis teams focus more on the medical aspects of care, such as lab values, blood pressure, access flow rates etc.; however, patients may indicate priorities and outcomes that are more relevant to them, such as being active, not feeling tired, or spending more time with family.
It is important to include what the patient’s understanding is in the plan of care and let that guide the decision-making process. The resources below offer valuable tools for helping facilities to create a culture of patient-centered care planning.
Behavioral Health Contact:
Network 8: ericka.webb@allianthealth.org
Network 14: gloria.delagarza-rios@allianthealth.org
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Home Dialysis
Dr. Richard Gibney, from Waco, Texas, is the founder of Empowered Kidney Care and has done great work spreading the news about dialysis self-care. Based on his work, we created a new resource titled A Day of Self-Care In-Center Dialysis.
Home Dialysis Contact:
maryam.alabood@allianthealth.org or nakisha.stewart@allianthealth.org
maryam.alabood@allianthealth.org or nakisha.stewart@allianthealth.org
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Hospital Admissions, Readmissions and ER visits
In working with facilities to address high ER utilization rates, many staff reported that they are often unaware that patients have been to the ER, especially if the ER visit occurred over a weekend. We have refreshed our Help Us Help You resource to prompt patients to discuss doctor visits, ER visits, and new medications.We recommend posting this resource in areas highly visible to patients, such as restrooms, treatment room doors, or by the scales.
Hospitalization Contact:
sheila.mcmaster@allianthealth.org or mary.albin@allianthealth.org
sheila.mcmaster@allianthealth.org or mary.albin@allianthealth.org
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Transplant
The transplant waitlist process can take a long time for patients to complete. Waitlisting delays caused by incomplete testing requirements such as health maintenance exams and cancer screenings slow the transplant process for patients. These types of tests can be completed before the patient’s initial transplant evaluation appointment. Share the flyer below with patients to learn how to avoid waitlisting delays to move the process faster and get on the waitlist quicker.
Resources:
Resources:
Transplant Contact: arlandra.taylor@allianthealth.org
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Vaccinations
The following information was provided in the March EQRS Quarterly Newsletter. Please review to stay informed regarding updates to data reporting requirements.
Beginning in PY 2025 (CY 2023), CMS added the NHSN COVID-19 Vaccination Coverage among Healthcare Personnel (HCP) measure to the ESRD QIP Reporting Measure Domain. The Reporting Measure Domain represents 10% of the Total Performance Score.
The measure tracks the percentage of a facility’s health care workforce that has been vaccinated through data reported via NHSN. More specifically, dialysis facilities are required to report at least one self-selected week of data each month in the Weekly COVID-19 Vaccination Module by the quarterly NHSN COVID-19 HCP Vaccination reporting deadlines. (See table below.) To ensure successful reporting to NHSN, facilities must ensure that the self-selected week reported to NHSN ends in the month the facility intends to report.
Beginning in PY 2025 (CY 2023), CMS added the NHSN COVID-19 Vaccination Coverage among Healthcare Personnel (HCP) measure to the ESRD QIP Reporting Measure Domain. The Reporting Measure Domain represents 10% of the Total Performance Score.
The measure tracks the percentage of a facility’s health care workforce that has been vaccinated through data reported via NHSN. More specifically, dialysis facilities are required to report at least one self-selected week of data each month in the Weekly COVID-19 Vaccination Module by the quarterly NHSN COVID-19 HCP Vaccination reporting deadlines. (See table below.) To ensure successful reporting to NHSN, facilities must ensure that the self-selected week reported to NHSN ends in the month the facility intends to report.
For additional details regarding the NHSN COVID-19 HCP Vaccination measure and related reporting requirements, refer to the following resources:
Vaccinations Contact: kristi.durham@allianthealth.org
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Patient and Family Engagement (PFE)
Does your facility have standards and criteria to assist patients looking to return to work? Do you share Voc Rehab resources with patients transitioning to home dialysis or getting a transplant? Do you use a Life Plan to assist patients to return to work or change modality? Below are resources to assist you with learning more about the Social Security Ticket to Work program. This program helps dialysis and kidney transplant patients to return to the workforce.
We also included a link to the Network’s Life Plan template, which is useful when working with patients interested in returning to work, moving to home dialysis or getting a transplant. Finally, the Network has created a Process for Screening Patients for Vocational Rehabilitation flowchart. We hope these tools will benefit you and your patients.
Resources:
Social Security - Ticket to Work Program
Network Life Plan Template -English, Spanish
Network -Process for Screening Patients for Vocational Rehabilitation
Also, the PFE monthly calendar handout for April is about National Donate Life Month.
We also included a link to the Network’s Life Plan template, which is useful when working with patients interested in returning to work, moving to home dialysis or getting a transplant. Finally, the Network has created a Process for Screening Patients for Vocational Rehabilitation flowchart. We hope these tools will benefit you and your patients.
Resources:
Social Security - Ticket to Work Program
Network Life Plan Template -English, Spanish
Network -Process for Screening Patients for Vocational Rehabilitation
Also, the PFE monthly calendar handout for April is about National Donate Life Month.
PFE Contact: debbie.odaniel@allianthealth.org
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EQRS News for You
Do I need to do this 2728? There are several questions that come up about whether a CMS 2728 needs to be completed.
Q: I have an AKI patient being treated in my clinic. Do I need to do a 2728?
A: No. The 2728 form is only completed for ESRD patients or patients who receive a preemptive transplant.
Q: I have an ESRD patient from a foreign country who is being treated at our clinic. Do I need to do a 2728?
A: Yes. A CMS 2728 is required for foreign patients being treating in the United States at a Medicare-certified dialysis facility. If the patient is not already in EQRS, you should admit them and then complete the CMS 2728. Be sure to mark Box 10 (Is patient applying for Medicare?) No, and then indicate in the remarks that the patient is from a foreign country and is being treated here temporarily. Only one CMS 2728 is required to be completed in this situation.
Q: I have a patient that was AKI at a previous clinic but is now ESRD. Do I need to do a 2728?
A: Yes. If the patient was deemed “acute” but is now considered “chronic,” then your facility is the first Medicare-certified facility to treat the patient for ESRD. So, your clinic is responsible for the CMS 2728.
Q: I have a patient that’s a new patient, but EQRS isn’t asking me for a 2728. Why?
A: The most common scenario is that the patient is admitted to your clinic as a “Transfer In.” EQRS won’t prompt for a 2728 if the patient is listed as a “Transfer In.” Check the patient’s admission record and change the admission reason to New ESRD patient if your clinic is the first Medicare-certified facility to treat the patient as an ESRD patient.
Q: I had a patient that started dialysis in prison. Do I need to do a 2728 for this patient?
A: Yes. You can rely on the information provided by the prison, but it often does not include the required lab data to support the start date. In that case, draw labs before treating the patient. Use those labs and the date the patient entered your facility as the first date of dialysis. Your clinic is the first Medicare-certified facility to treat the patient as an ESRD patient.
Q: I have an AKI patient being treated in my clinic. Do I need to do a 2728?
A: No. The 2728 form is only completed for ESRD patients or patients who receive a preemptive transplant.
Q: I have an ESRD patient from a foreign country who is being treated at our clinic. Do I need to do a 2728?
A: Yes. A CMS 2728 is required for foreign patients being treating in the United States at a Medicare-certified dialysis facility. If the patient is not already in EQRS, you should admit them and then complete the CMS 2728. Be sure to mark Box 10 (Is patient applying for Medicare?) No, and then indicate in the remarks that the patient is from a foreign country and is being treated here temporarily. Only one CMS 2728 is required to be completed in this situation.
Q: I have a patient that was AKI at a previous clinic but is now ESRD. Do I need to do a 2728?
A: Yes. If the patient was deemed “acute” but is now considered “chronic,” then your facility is the first Medicare-certified facility to treat the patient for ESRD. So, your clinic is responsible for the CMS 2728.
Q: I have a patient that’s a new patient, but EQRS isn’t asking me for a 2728. Why?
A: The most common scenario is that the patient is admitted to your clinic as a “Transfer In.” EQRS won’t prompt for a 2728 if the patient is listed as a “Transfer In.” Check the patient’s admission record and change the admission reason to New ESRD patient if your clinic is the first Medicare-certified facility to treat the patient as an ESRD patient.
Q: I had a patient that started dialysis in prison. Do I need to do a 2728 for this patient?
A: Yes. You can rely on the information provided by the prison, but it often does not include the required lab data to support the start date. In that case, draw labs before treating the patient. Use those labs and the date the patient entered your facility as the first date of dialysis. Your clinic is the first Medicare-certified facility to treat the patient as an ESRD patient.
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Emergency Disaster
Texas State regulations require dialysis and kidney transplant facilities to update their information in EMResource/Juvare by the eighth of each month. Recently Juvare made some changes to the login procedures. Each individual who requires access to update EMResource either monthly or during an emergency disaster event must have their own account. You can no longer use the facility account.
If you need to obtain access to EMResource, submit a service ticket.
If you need to obtain access to EMResource, submit a service ticket.
When setting up your service ticket, use the facility’s Medicare Provider number, which is six digits and will begin with 45, 67, or 74. You have to use your email address to request an account and cannot use the facility’s email address.
If you need access to two to five facilities, send one service ticket and include the facility name, city, and Medicare provider number in the comment section. If you need access to more than five facilities, contact Debbie O’Daniel at debbie.odaniel@allianthealth.org for the next steps.
FRIENDLY REMINDER: For EMResource to capture the facility’s monthly updates, you must make some type of data entry, even if the information is the same. For example, if you have the same number of in-center patients, home hemo, isolation patients, patient capacity, or PD patients from the month before, choose one of the statuses, type in the number of patients, and click Save. If this small step is not completed, then EMResource will not show that you have updated your facility. The information in EMResource is shared with surveyors when entering a facility for an onsite survey.
If you need access to two to five facilities, send one service ticket and include the facility name, city, and Medicare provider number in the comment section. If you need access to more than five facilities, contact Debbie O’Daniel at debbie.odaniel@allianthealth.org for the next steps.
FRIENDLY REMINDER: For EMResource to capture the facility’s monthly updates, you must make some type of data entry, even if the information is the same. For example, if you have the same number of in-center patients, home hemo, isolation patients, patient capacity, or PD patients from the month before, choose one of the statuses, type in the number of patients, and click Save. If this small step is not completed, then EMResource will not show that you have updated your facility. The information in EMResource is shared with surveyors when entering a facility for an onsite survey.
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Our mailing address is:
Alliant Health Solutions
400 Perimeter Center Ter NE
Suite 250
Atlanta, GA 30346
Our mailing address is:
Alliant Health Solutions
400 Perimeter Center Ter NE
Suite 250
Atlanta, GA 30346