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:
- News You Can Use
- Screening for Social Determinates of Health
- Home Dialysis
- Hospital Admissions, Readmissions and Emergency Visits
- Transplant
- Vaccinations
- Patient and Family Engagement
- EQRS
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“February is the border between winter and spring.”
― Terri Guillemets, quotation anthologist
― Terri Guillemets, quotation anthologist
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News You Can Use
February is American Heart Month
According to the Centers for Disease Control and Prevention (CDC), over 60 million women (44%) in the United States are living with some form of heart disease. Heart disease is the leading cause of death for women in the United States, and it can affect women at any age. Click Here for resources to educate patients on this topic. It's important to understand the risk factors for heart disease in both men and women, and taking steps to manage those risks is the first step toward better heart health. Click Here for risk reduction resources for patient education.
Free Infection Control Assessments
The Healthcare Safety Unit of the Texas Department of State Health Services offers free infection control assessment and response visits (ICARs) to dialysis facilities. These visits are non-regulatory and aim to educate facilities on practices that can reduce the risk of healthcare-associated infections. ICARs are conducted separately from survey and certification (S&C) visits, and the results are not shared with S&C staff. In 2023, 47% of the top 10 citations given during Texas facility surveys were related to infection control. By availing of an ICAR, your facility can receive feedback and resources tailored to your needs, potentially preventing survey citations.
NW 14 facilities: To schedule your free assessment, email ICAR@dshs.texas.gov today! Put “Dialysis ICAR” as the email subject line. In the body of the email, include the facility name, address, county and point of contact.
NW 8 facilities: ICARs are available through state departments of health. Email sheila.mcmaster@allianthealth.org to connect with your state agency to request an ICAR visit.
According to the Centers for Disease Control and Prevention (CDC), over 60 million women (44%) in the United States are living with some form of heart disease. Heart disease is the leading cause of death for women in the United States, and it can affect women at any age. Click Here for resources to educate patients on this topic. It's important to understand the risk factors for heart disease in both men and women, and taking steps to manage those risks is the first step toward better heart health. Click Here for risk reduction resources for patient education.
Free Infection Control Assessments
The Healthcare Safety Unit of the Texas Department of State Health Services offers free infection control assessment and response visits (ICARs) to dialysis facilities. These visits are non-regulatory and aim to educate facilities on practices that can reduce the risk of healthcare-associated infections. ICARs are conducted separately from survey and certification (S&C) visits, and the results are not shared with S&C staff. In 2023, 47% of the top 10 citations given during Texas facility surveys were related to infection control. By availing of an ICAR, your facility can receive feedback and resources tailored to your needs, potentially preventing survey citations.
NW 14 facilities: To schedule your free assessment, email ICAR@dshs.texas.gov today! Put “Dialysis ICAR” as the email subject line. In the body of the email, include the facility name, address, county and point of contact.
NW 8 facilities: ICARs are available through state departments of health. Email sheila.mcmaster@allianthealth.org to connect with your state agency to request an ICAR visit.
Health Equity Change Package
Many facilities have used the ESRD National Coordinating Center’s change packages as quality improvement resources. In addition to these change packages, the Health Equity change package can also support your work.
Many facilities have used the ESRD National Coordinating Center’s change packages as quality improvement resources. In addition to these change packages, the Health Equity change package can also support your work.
FDA Adds Boxed Warning: Prolia (denosumab)
The FDA will be adding a Boxed Warning to the Prolia prescribing information to warn patients about the significant risk of developing severe hypocalcemia, especially in those with advanced CKD. The new warning and labeling will contain information to help reduce this risk, including appropriate patient selection for Prolia treatment, increased monitoring of blood calcium levels, and other strategies. It is important to pay special attention to this medication when completing monthly medication reconciliation, especially for new patients who may be taking this medication.
The FDA will be adding a Boxed Warning to the Prolia prescribing information to warn patients about the significant risk of developing severe hypocalcemia, especially in those with advanced CKD. The new warning and labeling will contain information to help reduce this risk, including appropriate patient selection for Prolia treatment, increased monitoring of blood calcium levels, and other strategies. It is important to pay special attention to this medication when completing monthly medication reconciliation, especially for new patients who may be taking this medication.
New ESRD QIP Resources
Last month, the Centers for Medicare & Medicaid Services (CMS) published the End-Stage Renal Disease Quality Incentive Program (ESRD QIP) Successful Reporting Guide on the Education page at MyCROWNWeb.org. The ESRD QIP Successful Reporting Guide is a new resource to assist individuals with ESRD QIP data reporting activities and provides information on:
Last month, the Centers for Medicare & Medicaid Services (CMS) published the End-Stage Renal Disease Quality Incentive Program (ESRD QIP) Successful Reporting Guide on the Education page at MyCROWNWeb.org. The ESRD QIP Successful Reporting Guide is a new resource to assist individuals with ESRD QIP data reporting activities and provides information on:
- Submitting ESRD QIP data
- Meeting ESRD QIP data deadlines for the current reporting year
- Accessing ESRD QIP reports
Click Here to access the Payment Year (PY) 2026 ESRD QIP Fact Sheet to review all measures for the 2024 performance period. Click Here to view the finalized performance standards for PY 2026 ESRD QIP clinical measures.
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Screening for Social Determinates of Health
CMS has introduced a new Health Equity Attestation in EQRS, which must be reported for Calendar Year 2024 and will impact Payment Year 2026. To be eligible for this attestation, you need to screen your patient population for Social Determinants of Health (SDOH).
This data will help you offer personalized care to your patients and gather crucial data about your patient population. The data will also help you identify and address specific health disparities faced by your patients when developing improvement plans for clinic outcomes. CMS provided three options for SDOH screening tools and has not mandated using any particular tool. For more information, email the Network contacts listed below.
This data will help you offer personalized care to your patients and gather crucial data about your patient population. The data will also help you identify and address specific health disparities faced by your patients when developing improvement plans for clinic outcomes. CMS provided three options for SDOH screening tools and has not mandated using any particular tool. For more information, email the Network contacts listed below.
Contacts:
Network 8: ericka.webb@allianthealth.org
Network 14: cassandra.hanna@allianthealth.org
Network 8: ericka.webb@allianthealth.org
Network 14: cassandra.hanna@allianthealth.org
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Home Dialysis
Home dialysis is a great option for many patients, but some clinics struggle to provide adequate education on home modalities. One issue that often leads to patients refusing home therapy is the lack of a care partner. To address this concern, it is important to provide personalized education and collaboration between the patient, physician, and interdisciplinary team members. Some modality options do not require a care partner, and it is crucial to communicate this to the patient to alleviate their fears and build their confidence.
Home Central Dialysis has developed a tool for modality comparisons, which can help patients who are suitable candidates for home therapy. The comparison tool provides both the advantages and disadvantages of home therapies, enabling patients to make an informed decision. Use this tool to promote independence and a better option for many dialysis patients.
Home Central Dialysis has developed a tool for modality comparisons, which can help patients who are suitable candidates for home therapy. The comparison tool provides both the advantages and disadvantages of home therapies, enabling patients to make an informed decision. Use this tool to promote independence and a better option for many dialysis patients.
Home Dialysis Contact: grace.robbins@allianthealth.org
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Hospital Admissions, Readmissions and ER Visits
Many medical facilities are working diligently to help patients remain healthy and decrease unnecessary hospitalizations, re-admissions, and ER visits. After speaking with facilities that made great progress, some common themes emerged.
The successful ones focus on pre-hospital education, have a consistent post-hospitalization process, maintain good communication with the nephrologist, and have access to hospital EMRs. Pre-hospital education involves educating patients on appropriate levels of care, contacting the dialysis facility before going to the hospital for triage, and closely monitoring patients at risk for hospitalization.
The successful ones focus on pre-hospital education, have a consistent post-hospitalization process, maintain good communication with the nephrologist, and have access to hospital EMRs. Pre-hospital education involves educating patients on appropriate levels of care, contacting the dialysis facility before going to the hospital for triage, and closely monitoring patients at risk for hospitalization.
The post-hospitalization process involves obtaining hospital records, new diagnoses, medication reconciliation, providing support, education, and resources to patients, and ensuring patient follow-up with appropriate post-hospital appointments. Facility staff meet with the patient and discuss the hospitalization from the patient's perspective, including what led to it, what happened in the hospital, and if there were any signs they can now be aware of to avoid a future hospitalization. Having the patient's perspective can illuminate their understanding and provide an opportunity for individualized support and education.
Hospitalization Contacts:
Network 8: sheila.mcmaster@allianthealth.org
Network 14: koby.guthrie@allianthealth.org
Network 8: sheila.mcmaster@allianthealth.org
Network 14: koby.guthrie@allianthealth.org
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Transplant
The Panel Reactive Antibodies (PRA) test is a lab draw for patients who are active on the kidney transplant waitlist. PRAs are critical and used to monitor the patient’s antibody levels in the blood. They are the final test for compatibility to match listed patients with deceased donor kidneys. If a PRA sample is missed, drawn incorrectly, or not packed according to the instructions, it can be a missed opportunity for the patient to be cross-matched for a kidney.
Some transplant centers require the PRAs to be drawn monthly at the dialysis center, while others draw them at the patient’s annual evaluation appointment. Every transplant center is different, so check with your transplant center to ensure your staff is drawing the PRA samples accordingly. Ensure your facility has a plan to track the PRA monthly lab for each patient and that all staff are educated on how to draw the blood sample correctly.
Transplant Contact: arlandra.taylor@allianthealth.org
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Vaccinations
This month, we want to highlight the vaccination work from DaVita Green County in Eutaw, Alabama. This facility improved the pneumococcal vaccination rate by 50% in four months. The clinical coordinator, Melony Smithson, attributes this success to updating vaccination records and providing education on Prevnar 20.
Melony stated: “We had a concentrated focus on our pneumococcal vaccines for two-three weeks that helped our rate increase. We started with getting access to the state Immunization Registry, which I didn’t know was available before you informed us. I then looked up each of our patients individually in the registry to capture any vaccines they had received from other providers we weren’t aware of and documented them in our electronic medical record. We then reviewed the information/educational sheets regarding the Prevnar 20 vaccine with each patient and obtained their consent or refusal. We received consent from DaVita to order as many Prevnar 20 vaccines as needed to vaccinate all patients willing to take them. We were ready to vaccinate when the shipment came in since we had obtained their written consent beforehand. I feel like one reason the number of patients agreed to take the Prevnar 20 vaccine was that when we were educating and encouraging them, we informed them that it is a ‘one and done’ vaccine. They liked that it protects against 20 strands of the bacteria that can cause pneumonia and that they wouldn’t have to keep getting re-dosed to stay protected.”
See below for more information on accessing your state’s Immunization Registry.
See below for more information on accessing your state’s Immunization Registry.
Alabama
Alabama’s Immunization Registry is called ImmPRINT (Immunization Patient Registry with Integrated Technology). To create an account, Click Here and select New User Registration on the left sidebar.
- For questions during the process, email immprint@adph.state.al.us.
- Additional information can be found here.
Mississippi’s Immunization Registry is called MIIX (The Mississippi Immunization Information Exchange). Click Here to create an account.
- For questions during the process, email MIIXHelpDesk@stchome.com.
- Additional information can be found here.
Tennessee’s Immunization Registry is called TennIIS. Click Here to create an account.
- For questions during the process, email tenniis.registration@tn.gov or call (615) 741-7247.
- Additional information can be found here.
The Texas Immunization Registry is called ImmTrac. Click Here to request ImmTrac enrollment.
- Additional information can be found here.
Vaccination Contacts:
Network 8: sheila.mcmaster@allianthealth.org
Network 14: koby.guthrie@allianthealth.org
Network 8: sheila.mcmaster@allianthealth.org
Network 14: koby.guthrie@allianthealth.org
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Patient and Family Engagement (PFE)
Vocational rehabilitation is a series of services designed to help people with disabilities or those who have recently acquired an injury or disability get back to work. These services include vocational assessment and evaluation, training, upgrading of general skills, refresher courses, on-the-job training, career counseling, employment searches, and consulting with potential or existing employers for job accommodations and modifications. These services vary depending on the needs of the individual.
Below are resources about the Social Security Ticket to Work program, which helps dialysis and kidney transplant patients return to the workforce. We also included a link to the Network’s Life Plan template to use when working with patients interested in returning to work, moving to home dialysis, or getting a transplant. In addition, the Network created a Process for Screening Patients for Vocational Rehabilitation flowchart. We hope these tools will benefit you and your patients.
Below are resources about the Social Security Ticket to Work program, which helps dialysis and kidney transplant patients return to the workforce. We also included a link to the Network’s Life Plan template to use when working with patients interested in returning to work, moving to home dialysis, or getting a transplant. In addition, the Network created a Process for Screening Patients for Vocational Rehabilitation flowchart. We hope these tools will benefit you and your patients.
Resources
- Ticket to Work Program
- ESRD Life Plan Template - English | Spanish
- Process for Screening Patients for Vocational Rehabilitation
Patient and Family Engagement Contacts:
Network 8: casey.rich@allianthealth.org
Network 14: debbie.odaniel@allianthealth.org
Network 8: casey.rich@allianthealth.org
Network 14: debbie.odaniel@allianthealth.org
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EQRS
It's time once again to submit your 2744 report. From January 15 to March 31, ESRD Networks will be helping facilities with their report submission. Keep an eye on your emails and follow the instructions to generate, complete, and review the report before submission to avoid errors that may lead to the report's rejection.
You will receive more information about the 2024 training event via email.
You will receive more information about the 2024 training event via email.
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Our mailing address is:
ESRD Network 8
775 Woodlands Parkway, Suite 300
Ridgeland, MS 39157
ESRD Network 14
4099 McEwen Rd., Suite 820
Dallas, TX 75244
Our mailing address is:
ESRD Network 8
775 Woodlands Parkway, Suite 300
Ridgeland, MS 39157
ESRD Network 14
4099 McEwen Rd., Suite 820
Dallas, TX 75244