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Click here to download and print the webinar flyer.

The IPRO ESRD Network Program is excited to announce the new and innovative virtual platform, IPRO Learn, to connect the ESRD provider community to the quality improvement initiatives the Centers for Medicare & Medicaid Services (CMS) is requiring of all dialysis facilities. To access IPRO Learn, a Network generated Login and Password has been sent to your Facility Administrator, Head Nurse, Social Worker, Medical Director, and EQRS Data Contact. The same facility username and password can be shared and used by staff members within the facility that may be assigned to support a specific quality improvement focus area work. This way all activities required to be performed by your facility by different staff members are associated with your facility log in.

This new platform, known as IPRO Learn, will become a one stop shop to:

ACTION ITEM: Submit a ticket through the Customer Support Portal if you have not received a user name and password for your facility. Facility staff are expected to log into IPRO Learn on a monthly basis, at a minimum, to access educational tools and

Please do not include PHI or PII (patient name, date of birth, SSN, MBI) in any emails sent to IPRO Staff, IPROESRDHelp@iproesrdnetwork.freshdesk.com, as well as through the IPRO ESRD Network Program Customer Support Portal. Please include the End Stage Renal Disease Quality Reporting System (EQRS) Patient UPI instead.

To learn more about Health information Privacy, please visit the U.S. Department of Health & Human Services website at https://www.hhs.gov/hipaa/index.html.

On July 12, 2021, the Centers for Medicare & Medicaid Services (CMS) reopened the End Stage Renal Disease (ESRD) Quality Reporting System (EQRS) for September-December 2020 Clinical Data, In-Center Hemodialysis Consumer Assessment of Healthcare Providers and Systems (ICH CAHPS) Attestations, and Clinical Depression Screening and Follow-Up Plan reporting. The clinical closure date for September-December 2020 has been extended to September 15, 2021 at 11:59 PM Pacific Time (PT).

ACTION ITEM: Effective September 20, 2021, all ESRD facilities can submit January-September 2021 EQRS Clinical Data, ICH CAHPS Attestations, and Clinical Depression Screening and Follow-Up Plan reporting in EQRS. Additionally, all subsequent months in 2021 will open for data submission on the first day of each month (i.e., October opens October 1; November opens November 1; and December opens December 1). The clinical closure date for all months in 2021 will be February 28, 2022 at 11:59 PM PT.

Dialysis facilities must follow the Clinical Closure Submission Deadlines listed below to meet CMS reporting requirements. Clinical closure dates apply to all collection types (Hemodialysis and Peritoneal Dialysis). Additionally, clinical data submissions apply to all submission methods. CMS highly recommends that facilities complete large data submissions and audit batch submitted data prior to the official clinical closure dates.

If you batch submit or use the Health Information Exchange (HIE)/Electronic Data Interchange (EDI) methods, please follow the guidance provided by your HIE/EDI batch team within your organization.

The Centers for Medicare & Medicaid Services (CMS) Federal Register, HHS § 405.2110 to 405.2113, cites the ESRD Network responsibilities regarding formulation of Network-specific goals and the dialysis and transplant facility’s responsibility toward achieving these goals. The State Survey Agencies utilize Network goals and initiatives as a guideline during their evaluation process.

In keeping with the legislative mandate for the ESRD Network program, the strategic goals of IPRO ESRD Network Program are to:

The Network shall achieve its goals through the development and implementation of the work requirements outlined in the CMS ESRD Statement of Work (SOW), which include projects and Quality Improvement Activities (QIAs) to be launched at the dialysis facility and transplant center level, and tracked and reported to CMS.

Thank you for your ongoing support and cooperation with the Network.

The first IPRO ESRD Network Program and Patient Facility Representative (PFR) orientation meeting is scheduled for Thursday, October 7, 2021 from 5:30-7 pm. During the call the Network will welcome all nominated PFRs members into the Alliance group. The Network will talk about the new scope of work and the patient’s resources being developed, upcoming events, and provide an opportunity for open discussion about what’s going on in your dialysis facilities. All participants are encouraged to log on to the Webinar through the web address provided below. However, anyone can participate in the meeting via telephone if they do not have internet access.

Webinar Access: https://ipro.webex.com/meet/IPROESRD

Meeting ID: 178 506 9205

Toll Free Dial In #: 1-855-797-9485

Participant Code: 178 506 9205

ESRD patients are invited to attend a virtual Patient Facility Representative (PFR) Alliance Conference Call to collaborate with peers about enhancing the quality of life for patients with End Stage Renal Disease.

ACTION ITEM: Please print copies of the Monthly PFR Conference Call Flyer to distribute to your PFR nominated patient (formerly known as PAC) and encourage them to attend the call. The Network will host monthly PFR calls, every first Thursday of each month from 5-6:30 PM.

If you have any questions, please contact Danielle Andrews, MPH, MSW, GCPH, Community Outreach Coordinator at 516-209-5549.

As part of patient and family engagement, Centers for Medicare and Medicaid Services (CMS) certified facilities are encouraged to implement a peer mentoring program within their facility. The Kidney Connection Patient Peer Mentoring Program, developed by the National Coordinating Center (NCC), offers a structured environment for people with kidney disease to develop one-on-one relationships while providing experiential support from peer mentors to peer mentees. In addition, it advocates for patient education through the Kidney Learning Hub, the program’s learning management system, and encourages patient peers to engage one another to remain active by sharing the lived experiences of their ESRD journey.

Want to get started? Here’s what you need to know and how to promote the program and gain interest at your facility.  Discuss the Kidney Connection Patient Peer Mentoring Program with patients at chairside, during care plan meetings, and engage the PFRs and SMEs to help promote the program. Refer the materials to help your facility promote the program. These can be adapted to meet individual facility needs.

• Why Your Facility Should Participate flyer

• Dialysis Facility Role

• Interested in Becoming a Peer Mentor?

• Interested in Being Paired with a Peer Mentor?

• Dialysis Facility Poster

• Dialysis Facility Flyer

ACTION ITEM: Nominate a peer mentor or mentee today by submitting the referral form, which can be downloaded and printed HERE. Once completed, fax the form to the Network’s Patient Services Department at (516) 231-9767. Please contact the Network with any questions.

According to the article, Education Improves Public Health and Promotes Health Equity, health inequities have been frequently associated with educational attainment. Education is a process that intentionally engages the receptive capacities of individuals to imbue them with knowledge, skills of reasoning, values, socio-emotional awareness and control, and social interaction. An Overview of the Funding of Public Schools further explains how schools in the United States receive resources and funding from the local, state, and federal governments. “Approximately 48 percent of a school’s budget comes from state resources, including income taxes, sales tax, and fees. Another 44 percent is contributed locally, primarily through the property taxes of homeowners in the area. The last eight percent of the public education budget comes from federal sources.” Essentially, the community and property taxes determine resource allocation (poorer communities receive fewer resources in comparison to wealthier schools). Limited resources have had an inverse effect on the academic achievement among students living in low socioeconomic areas.

Additionally, the Centers for Disease Control and Prevention (CDC) has associated good health with previous academic success. There has been a strong correlation between the development of protective health behaviors and higher levels of education. Whereas higher levels of high health risk behaviors have been associated with low academic achievement. The educational attainment of patients varies. As health care professionals, we have to use various techniques to make sure they understand their healthcare status. These techniques can include eliminating the usage of medical jargon and utilizing the teach-back method. The teach-back method can help ensure the patient's understanding by having them repeat in their own words what they heard during their healthcare appointment.

ACTION ITEM: To learn more about Social Determinants of Health (SDOH), please visit https://health.gov/healthypeople/objectives-and-data/social-determinants-health.

A study by Slaven, A; Hsu, J; et al shows that CKD patients with a strong social support network are typically associated with better quality of life and health compared to their peers with limited to no social support. Social workers can help patients grow and activate their social support networks by coaching patients how to involve their caregivers and friends in their healthcare goals.

Read the complete abstract HERE to learn more about the connections of social support and emotional wellness for improved health outcomes.

Telehealth as a practice for reaching patient with behavioral health concerns has grown over the past year due to the COVID-19 pandemic. Providers are continuing to learn about telehealth options to extend their reach to patients to provide care from their homes.

ACTION ITEM: Review best practices collected by The US Department of Health and Human Services for an “Introduction to telehealth for Behavioral Healthcare”.

The choice of dialyzing at home has been shown to enhance a patient’s quality of life and improve patient outcomes. Patients with kidney disease need education and support to determine the appropriate dialysis modality to fit their lifestyle. Currently, only 2% of hemodialysis patients receive treatment at home even though 85 percent are eligible. Additionally, studies have shown up to 40% of patients would have chosen home dialysis had they received appropriate education. A clear opportunity exists to provide patients with information on home modality choices thus increasing the number of patients who choose to dialyze at home.

The ESRD National Coordinating Center (NCC) Change Package to Increase Home Dialysis Use is intended to support dialysis facilities in increasing the number of patients using home modalities, including both peritoneal dialysis (PD) and home hemodialysis (HHD). The Change Package includes actionable change ideas, collected from top-performing dialysis facilities, who have been identified as leaders in the field of home dialysis. The change ideas presented are intended as a menu of interventions from which program leaders can choose to implement within their facilities.

ACTION ITEM: Please review the following Change Package supporting resources, and share broadly within your facility:

Studies have shown that low health literacy in ESRD patients impact kidney transplantation, due to patients not understanding the education provided about their treatment options. Many times, providers have a standardized way of approaching transplant education. For example, this can happen when organizations have an educational track or program for all incident patients to follow. However, patients might at times not understand transplant as a treatment option because the education has not been provided in a way that person is ready to comprehend. Performing a health literacy assessment can help providers understand where their patients are at, what education should be provided and how. This also would allow for a customized educational plan that can help build a patient’s understanding about kidney transplant over time. Several articles about health literacy regarding kidney transplantation include:

ACTION ITEM: Consider implementing the Health Literacy Assessment REALM-SF Score Sheet to assess your patients Health Literacy Level in your practice. These results can guide you as a provider to understand the level and readiness your patients have to educate about kidney transplant. Here is a short video that can walk you through how to use this tool and how to proceed with the information gathered.

This month your "Transitions Champion" should have completed reviewing the role description and duties, and selected a patient facility representative to assist in the work.

ACTION ITEM: Please submit the name and contact for your facility Transitions Champion in IPRO LEARN.

Have you included the patient representative in creating a huddle board/bulletin board or visual display to interest staff and patients in the work to reduce hospitalizations/ readmissions and ER visits:?  The outcomes for patients whom are readmitted within 30 days of a hospitalization are tragic.

Sadly, 10% of patients greater than 65 years of age that are readmitted for a second time following an initial diagnoses will die that same year.  The Transitions Champion and quality improvement team can use the strategies in this article to reduce. Reducing Hospital Readmission: Current Strategies and Future Directions.

Nursing home patients are frail, and one of the most vulnerable populations of the ESRD community. During the height of the pandemic the Network noticed an increased interest in caring in place for the dialysis patient, which includes providing dialysis services in the nursing home. While the Network recognizes that dialysis in the nursing home is not a widespread practice at this time, the Network has been tasked to identify barriers and gather educational resources to help dialysis facilities and nursing home staff improve the quality of care and outcomes for this population.

ACTION ITEM: For additional information to support education on the opportunity of dialysis services in the nursing home, please review As COVID-19 Puts New Focus on Caring in Place, Skilled Nursing Facilities Continue to Explore Dialysis.

The IPRO ESRD Network Program has expanded the use of the ESRD Network Customer Support Portal to include support for IPRO Learn and quality improvement interventions and activities in addition to support for various systems such as the ESRD Quality Reporting System (EQRS), National Healthcare Safety Network (NHSN), Dialysis data or Quality Incentive program.

Visit the Customer Support Portal and search the Frequently Asked Questions in our Knowledge Base. You can browse different knowledge items and if you still need help, submit a support ticket. Based on the topic, category and description provided in the support request, the ticket will be assigned to one of our quality improvement, patient services, or data team members. They will return an email providing information or send a request to schedule a phone call at a time that works well for you.

To learn more, visit the portal by going to help.esrd.ipro.org and selecting "Sign Up".