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 Memoriam: Robert Bain
May 27, 1960 — May 26, 2025
May 27, 1960 — May 26, 2025
It is with deep sadness that we remember our colleague and friend, Robert Bain, who served as the ESRD Health Information Manager at Alliant Health Solutions for 15 years. Robert passed away May 26 leaving behind a legacy of dedication, compassion, and friendship that touched all who had the privilege of working alongside him.
Robert was not only a talented and respected professional, he was also a remarkable person. His intelligence and quick wit were matched by his kindness and generosity. He brought humor into every conversation, and he never hesitated to share his knowledge and lend a hand to anyone in need. He loved Ole Miss and would share that with you also if he got the chance!
Over the years, Robert became more than a colleague; he became a friend and mentor to many. His contributions to our work were invaluable. Robert made Alliant a better place, and we are forever grateful.
Over the years, Robert became more than a colleague; he became a friend and mentor to many. His contributions to our work were invaluable. Robert made Alliant a better place, and we are forever grateful.
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In This Issue:
- News and Updates
- Change to ESRD Network National Coordinating Center
- EQRS Monthly Stakeholder Calls Suspended, May 28, 202
- Patient Services
- Involuntary Discharge (IVD) Guidelines
- Home Dialysis
- Setting Goals with the MATCH-D Tool (Method to Assess Treatment Choices for Home Dialysis)
- Hospital Admissions and ER Visits
- Preventing Sepsis-Related Hospitalizations: A Guide for Dialysis Facilities
- Transplant
- A Life-Changing Choice: Navigating the Kidney Transplant Decision
- Vaccinations
- Vaccination Strategies to Reduce Infection Risk in Dialysis Patients
- EQRS
- Improving Timeliness of CMS Forms 2728 and 2746: A Quality Improvement Approach
- Patient and Family Engagement
- ESRD Virtual Support Groups
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Change to ESRD Network National Coordinating Center
Effective May 1, 2025, the ESRD NCC contract activities transitioned to CMS. As such, the data required for populating the monthly facility report cards ceased. CMS is working now to determine next steps for data delivery. At this time, we do not know when data will be provided or if the format will allow us to resume monthly reports. We will update you when we have more information about this.
Effective May 1, 2025, the ESRD NCC contract activities transitioned to CMS. As such, the data required for populating the monthly facility report cards ceased. CMS is working now to determine next steps for data delivery. At this time, we do not know when data will be provided or if the format will allow us to resume monthly reports. We will update you when we have more information about this.
EQRS Monthly Stakeholder Calls Suspended, May 28, 2025
As part of ongoing federal budget reduction initiatives, the End-Stage Renal Disease (ESRD) Quality Program Support (QPS) team has been directed to suspend monthly EQRS stakeholder meetings and the EQRS Quarterly Newsletter beginning in May 2025.
CMS understands the importance of providing training and updates to new and existing EQRS users. This support will continue through the distribution of CMS memos, EQRS news flashes, question and answer documents, user guides, and quick start guides. In addition, these and other resources will be added to the MyCROWNWeb.org website shortly after they are distributed.
For assistance with EQRS technical issues, please contact the Center for Clinical Standards and Quality (CCSQ) Service Center. The CCSQ Service Center is open Monday-Friday 8 a.m. to 8 p.m. ET and can be reached via phone at 866-288-8912, email at qnetsupport-esrd@cms.hhs.gov or online at the CCSQ Support Center.
For assistance with general EQRS and ESRD QIP questions, please contact the ESRD QIP Team via the QualityNet Q&A Tool.
As part of ongoing federal budget reduction initiatives, the End-Stage Renal Disease (ESRD) Quality Program Support (QPS) team has been directed to suspend monthly EQRS stakeholder meetings and the EQRS Quarterly Newsletter beginning in May 2025.
CMS understands the importance of providing training and updates to new and existing EQRS users. This support will continue through the distribution of CMS memos, EQRS news flashes, question and answer documents, user guides, and quick start guides. In addition, these and other resources will be added to the MyCROWNWeb.org website shortly after they are distributed.
For assistance with EQRS technical issues, please contact the Center for Clinical Standards and Quality (CCSQ) Service Center. The CCSQ Service Center is open Monday-Friday 8 a.m. to 8 p.m. ET and can be reached via phone at 866-288-8912, email at qnetsupport-esrd@cms.hhs.gov or online at the CCSQ Support Center.
For assistance with general EQRS and ESRD QIP questions, please contact the ESRD QIP Team via the QualityNet Q&A Tool.
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Involuntary Discharge (IVD) Guidelines
An involuntary discharge (IVD) should be considered only as a last resort when managing challenging patient situations. All IVDs must comply with the CMS Conditions for Coverage.
Facilities must notify the Network at least 30 days prior to involuntary discharge unless the patient poses a severe and immediate threat. In such urgent cases, the Network and State Survey Agency must be notified within 48 hours.
An involuntary discharge (IVD) should be considered only as a last resort when managing challenging patient situations. All IVDs must comply with the CMS Conditions for Coverage.
Facilities must notify the Network at least 30 days prior to involuntary discharge unless the patient poses a severe and immediate threat. In such urgent cases, the Network and State Survey Agency must be notified within 48 hours.
Patients must not be discharged solely for noncompliance with facility policies unless such behavior significantly disrupts clinic operations. Additionally, patients cannot be discharged for missed or shortened treatments or for failing to meet clinical outcome targets.
Key Steps in the IVD Process:
Key Steps in the IVD Process:
- Ensure full involvement of the Interdisciplinary Team (IDT), including the Medical Director and Nephrologist.
- Conduct a comprehensive assessment of the situation.
- Maintain thorough documentation of all incidents, concerns, and interventions.
- Review and follow organizational policies and procedures related to IVDs.
- Develop a clear plan to address identified barriers and issues.
- Contact the Network for guidance and support throughout the process.
***Applicable for both NW 8 & NW 14***
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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Setting Goals with the MATCH-D Tool (Method to Assess Treatment Choices for Home Dialysis)
If setting a home conversion goal or reviewing your list of potential home dialysis candidates feels overwhelming, the MATCH-D Tool is here to help. Developed by the Medical Education Institute for Home Dialysis Central, this tool is designed to identify suitable patients for a home modality and address key barriers to home dialysis.
If setting a home conversion goal or reviewing your list of potential home dialysis candidates feels overwhelming, the MATCH-D Tool is here to help. Developed by the Medical Education Institute for Home Dialysis Central, this tool is designed to identify suitable patients for a home modality and address key barriers to home dialysis.
While it may seem like a chore at first, the benefits far outweigh the effort. The MATCH-D Tool supports:
- Identifying suitable candidates
- Addressing barriers
- Improving patient outcomes
- Enhancing patient-centered care
- Facilitating home dialysis expansion
- Improving clinic efficiency
Use the MATCH-D Toolto empower patients to choose the treatment that best fits their needs.
Home Dialysis Contact: katherine.buntin@allianthealth.org
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Tools and Tips for Addressing High Hypertension Rates
Preventing Sepsis-Related Hospitalizations: A Guide for Dialysis Facilities
Sepsis consistently ranks as the number one reason for inpatient admissions among dialysis patients.Many of the cases were not dialysis related. Most cases of sepsis were reported as infected wounds, surgical site infections, foot ulcers, bed sores, pneumonia, and urinary tract infections.
Sepsis consistently ranks as the number one reason for inpatient admissions among dialysis patients.Many of the cases were not dialysis related. Most cases of sepsis were reported as infected wounds, surgical site infections, foot ulcers, bed sores, pneumonia, and urinary tract infections.
Although these diagnoses are not dialysis-related, they most certainly impact your patient's overall health and your facility's hospitalization rate. Providing patient education, staff education, implementing a proactive screening process, providing consistent monitoring, and proactively making referrals to necessary care providers is essential to decreasing these types of hospitalizations.
One extremely helpful resource to utilize is your state's ICAR (Infection Control Assessment and Response Visit) program. These visits educate dialysis facilities on practices to reduce the risk of healthcare-associated infections. An ICAR can provide feedback and resources tailored to your facility. This service is free and non-regulatory.
ICARs are not conducted by survey and certification (S&C) staff, and the results are not shared with them. If participating in a regulatory staff visit, showcasing your participation in this program will reflect positively on your facility. See below for contact information for your state's ICAR program.
NW 14 facilities: to schedule your free assessment, email ICAR@dshs.texas.gov. Write “Dialysis ICAR” as the email subject line. Include in the body of the email: facility name, facility address, county, and point of contact.
NW 8 facilities: ICARs are available through State Departments of Health. Send an email to sheila.mcmaster@allianthealth.org if you would like to be connected to your state agency to request an ICAR visit.
One extremely helpful resource to utilize is your state's ICAR (Infection Control Assessment and Response Visit) program. These visits educate dialysis facilities on practices to reduce the risk of healthcare-associated infections. An ICAR can provide feedback and resources tailored to your facility. This service is free and non-regulatory.
ICARs are not conducted by survey and certification (S&C) staff, and the results are not shared with them. If participating in a regulatory staff visit, showcasing your participation in this program will reflect positively on your facility. See below for contact information for your state's ICAR program.
NW 14 facilities: to schedule your free assessment, email ICAR@dshs.texas.gov. Write “Dialysis ICAR” as the email subject line. Include in the body of the email: facility name, facility address, county, and point of contact.
NW 8 facilities: ICARs are available through State Departments of Health. Send an email to sheila.mcmaster@allianthealth.org if you would like to be connected to your state agency to request an ICAR visit.
Resource: CDC Engaging Patients Comic (For Staff)
Hospitalization Contact: koby.guthrie@allianthealth.org
Hospitalization Contact: koby.guthrie@allianthealth.org
A Life-Changing Choice: Navigating the Kidney Transplant Decision
Choosing a kidney transplant is a big decision and one that can profoundly change a patient’s life. For many patients on dialysis, a transplant can offer the best chance at living a longer, healthier, and more independent life.
Choosing a kidney transplant is a big decision and one that can profoundly change a patient’s life. For many patients on dialysis, a transplant can offer the best chance at living a longer, healthier, and more independent life.
On average, a transplanted kidney can last up to 15 years or more, especially when patients follow recommended care and lifestyle guidelines. Every patient’s situation is different, and it is natural to have questions.
The Forum of ESRD Networks Kidney Patient Advisory Council (KPAC) created “Is a Kidney Transplant Right for Me?” with the help of actual transplant recipients to walk patients through the transplant journey from the patient’s point of view. Patients will find answers to common concerns, honest insights about life before and after transplant, and tools to help them decide what is best for them.
If your patients are thinking about transplant as an option or unsure if a kidney transplant is right for them, this guide can help provide support every step of the way.
The Forum of ESRD Networks Kidney Patient Advisory Council (KPAC) created “Is a Kidney Transplant Right for Me?” with the help of actual transplant recipients to walk patients through the transplant journey from the patient’s point of view. Patients will find answers to common concerns, honest insights about life before and after transplant, and tools to help them decide what is best for them.
If your patients are thinking about transplant as an option or unsure if a kidney transplant is right for them, this guide can help provide support every step of the way.
Resource: Is a Kidney Transplant Right for Me?
Transplant Contact: arlandra.taylor@allianthealth.org
Transplant Contact: arlandra.taylor@allianthealth.org
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Vaccination Strategies to Reduce Infection Risk in Dialysis Patients
Patients with ESRD are at a significantly increased risk for infections due to immune system compromise. This vulnerability is compounded by frequent healthcare exposures and multiple comorbidities.
Patients with ESRD are at a significantly increased risk for infections due to immune system compromise. This vulnerability is compounded by frequent healthcare exposures and multiple comorbidities.
Among the most serious infectious threats is pneumococcal disease, particularly invasive pneumococcal disease (IPD) which can result in pneumonia, bacteremia, and meningitis. Vaccination remains a critical preventive strategy to reduce morbidity and mortality in this high-risk population.
- ESRD patients have a 25- to 50-fold increased risk of IPD compared to the general population.
- Pneumococcal infections in this population are associated with higher morbidity, hospitalization rates, and mortality.
- Pneumococcal:
- Network 8 – 61.38%
- Network 14 – 56.86%
- Influenza:
- Networks 8 & 14 – 80%
- Audit and update vaccination records regularly.
- Be sure to document any vaccinations administered outside your facility to ensure accurate reporting and receive appropriate credit for the patient’s immunization status.
- Incorporate vaccination reviews into monthly patient assessments and QAPI meetings.
- Engage interdisciplinary teams—including nurses, techs, social workers, and dietitians—to reinforce vaccine education and address hesitancy.
Vaccination Contact: hayley.errington@alllianthealth.org
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Improving Timeliness of CMS Forms 2728 and 2746: A Quality Improvement Approach
In May, Networks 8 & 14 restructured its efforts to improve 2728 and 2746 forms timeliness, moving to a focused quality improvement activity (QIA) approach rather than facility specific emails each day/week.
Form 2728 needs to be submitted within 45 days of admission. The best practice is to start this form as soon as possible to avoid any issues that may arise, ideally obtaining the patient’s signature on admission.
If you’re experiencing challenges with physicians forgetting to sign required forms, consider implementing a consistent reminder process. Options may include sending a reminder email in advance, setting up a designated physician folder or drop box, placing a laminated color strip on the patient’s machine as a visual cue, or involving the IDT by bringing forms for signature to the monthly QAPI meeting.
Be sure to engage your physician in any process changes to ensure they are aware of the new expectations and can support your efforts.
CMS Form 2746 must be submitted within 14 days of a patient’s death. The most common barrier to timely submission is obtaining the cause of death. To ensure the form is completed on time, it’s essential to use all available communication channels—contact the hospital, the attending physician, and the family as needed. This form is critical, as it notifies Medicare to terminate the patient's coverage.
Please note: if a patient discontinues dialysis, the clinic is responsible for completing Form 2746 for up to 30 days. After that period, the clinic is no longer accountable for submission.
Home therapy departments must also adhere to this timeline. If you need guidance on completing the form, please refer to the resources linked below.
In May, Networks 8 & 14 restructured its efforts to improve 2728 and 2746 forms timeliness, moving to a focused quality improvement activity (QIA) approach rather than facility specific emails each day/week.
Form 2728 needs to be submitted within 45 days of admission. The best practice is to start this form as soon as possible to avoid any issues that may arise, ideally obtaining the patient’s signature on admission.
If you’re experiencing challenges with physicians forgetting to sign required forms, consider implementing a consistent reminder process. Options may include sending a reminder email in advance, setting up a designated physician folder or drop box, placing a laminated color strip on the patient’s machine as a visual cue, or involving the IDT by bringing forms for signature to the monthly QAPI meeting.
Be sure to engage your physician in any process changes to ensure they are aware of the new expectations and can support your efforts.
CMS Form 2746 must be submitted within 14 days of a patient’s death. The most common barrier to timely submission is obtaining the cause of death. To ensure the form is completed on time, it’s essential to use all available communication channels—contact the hospital, the attending physician, and the family as needed. This form is critical, as it notifies Medicare to terminate the patient's coverage.
Please note: if a patient discontinues dialysis, the clinic is responsible for completing Form 2746 for up to 30 days. After that period, the clinic is no longer accountable for submission.
Home therapy departments must also adhere to this timeline. If you need guidance on completing the form, please refer to the resources linked below.
Resources:
EQRS Data Quality Contact: grace.robbins@allianthealth.org
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Patient and Family Engagement
ESRD Virtual Support Groups
The following is a list of support groups to provide to patients for support outside of the facility. If you would like to know more about how to increase patient involvement at the facility level, reach out to the contacts listed below.
The following is a list of support groups to provide to patients for support outside of the facility. If you would like to know more about how to increase patient involvement at the facility level, reach out to the contacts listed below.
- Dialysis Patient Citizens – Meets on the second Tuesday of the month at 3:00 p.m. ET for one hour. Dial 866-808-5953, meeting code 253 841 3353
- Renal Support Network - https://www.rsnhope.org/rsn-events/rsn-zoom-room-meetings/
- National Kidney Foundation (peer mentoring program) – https://www.kidney.org/peers
- American Association of Kidney Patients –List with dates and times
Patient and Family Engagement Contacts:
Network 8: casey.rich@allianthealth.org
Network 14: ericka.webb@allianthealth.org
Network 8: casey.rich@allianthealth.org
Network 14: ericka.webb@allianthealth.org
Copyright © 2025, All rights reserved.
Our mailing address is:
ESRD Networks 8 & 14
P.O. Box 105337
Atlanta, GA 30348