Month: December 2017

Strategies for Preventing Catheter-Related Bloodstream Infections in Hemodialysis Patients

A 2016 article in the International Journal of Nephrology and Renovascular Disease evaluates management strategies for preventing catheter-related bloodstream infections, with recognition that many patients begin hemodialysis (HD) with a catheter. The authors conclude that “Early efforts must be directed toward preventative care emphasizing placement of other vascular accesses or initiating an alternative dialysis modality, such as timely peritoneal dialysis (PD) to avert HD catheter placement before it becomes necessary.”

Findings include:

  • “Urgent start PD” programs are a safe alternative to HD in patients without an established AV fistula or graft.
  • Should no options exist outside of catheter placement, proper catheter care and infection control procedures implemented through educating and auditing dialysis unit staff as well as patients, are the first step in preventing infections.
  • In high-risk groups for whom all other conservative measures to prevent infection have failed, the authors recommend consideration of antimicrobial lock (AML) therapy.

“Prevention of catheter-related bloodstream infections in patients on hemodialysis: challenges and management strategies,”Int J Nephrol Renovasc Dis. 2016; 9: 95-103. Published online 2016 Apr 18. doi: 10.2147/IJNRD.S76826

Posting of Payment Year 2018 Performance Score Certificates

CMS regulations state that each facility’s Payment Year (PY) 2018 Performance Score Certificate (PSC) must be printed and posted in a prominent patient area within 15 business days of its availability. PSCs are expected to be available on or about December 15, 2017.

Click on the link for instructions to download and print the certificate.

For information on how ESRD QIP affects patients, please visit:

If you have any questions or concerns, please contact the ESRD-QIP team at If you have any questions for the Network staff, please send an email to

News for Your Patients: CMS Announces Improved Access to High-Quality Health Coverage Choices; Decreased Premiums for 2018

The Centers for Medicare & Medicaid Services (CMS) recently released 2018 benefit and premium information as well as Star Ratings for Medicare health and drug plans. Changes announced represent more health coverage choices, improved access to high-quality health choices, and decreased premiums in 2018. “Medicare’s top priority is to ensure that beneficiaries have choices for affordable, high-quality care that fit their needs,” said CMS Administrator Seema Verma.

The following resources have been created to assist patients with understanding health coverage options:

For more information about the CMS health coverage announcement, please visit:

For information on proposed policy changes and updates for Medicare Advantage and the Prescription Drug Benefit Program for 2019, please visit:

The Grievance Process: Do You Know Your Facility’s Responsibilities?

Dialysis facilities are required to ensure a process has been implemented for patients to express concerns about their care without reprisal or denial of services.

According to CMS, a grievance is defined as “a written or oral communication from an ESRD patient, and/or an individual representing an ESRD patient, and/or another party, alleging that an ESRD service received from a Medicare-certified provider did not meet the grievant’s expectations with respect to safety, civility, patient rights, and/or clinical standards of care.” The grievant is not required to explicitly state that the care did not meet professionally recognized standards.

Federal regulations at 42 CFR §405.2112(g) specify “evaluating and resolving patient grievances” as one of the Network’s functions. The Network’s case review responsibilities include investigating grievances filed with the Network and addressing non-grievance access to care cases. However, some concerns do not fall under the jurisdiction of the Network; in these cases patients would be referred to a more appropriate agency, such as the state health department.

The following resources provided by the Network can help educate staff and patients about grievances:

For more information, or assistance with patient grievances, please contact the Patient Services Director in your Network.

Empower Your Patients: With your help, we can make a difference!

Have any of your patients or their caregivers/family members shared with you their feelings about not being heard?

Has a patient ever shared an idea they felt would be useful for others with ESRD?

If so, we know you’ll understand the value of engaging such individuals in efforts to improve patient care. We need your help!

The Network has convened a group of Patient Subject Matter Experts (SMEs) to provide patient perspective and feedback to the Network on educational materials, quality improvement projects and other issues that relate to our work in improving care to ESRD patients. Please consider nominating patients, transplant recipients, and family members/care partners who are interested in sharing their talents and ideas with other SMEs in the Network.

What do SMEs do? Ultimately, they help Network staff understand what is important to patients, share useful ideas and experiences, and foster Network initiatives at their own dialysis facility and transplant center. Their efforts focus on providing feedback on Network quality improvement activities related to infection prevention, transplant referrals, home dialysis training, vocational rehabilitation, and patient engagement.

For more information, please contact your local Network.

How Does the ESRD Network Partner with Facilities to Improve Patient Care?

Under contract with CMS, ESRD Networks are charged with achieving healthcare transformation, promoting the National Quality Strategy, and supporting the Health and Human Services Secretary’s priorities, by working with dialysis providers, government agencies, ESRD stakeholders, patients, family members and care partners to reach CMS set goals. The Network strives to achieve these goals through activities that include:

  • conducting directed quality improvement activities focused on patient care,
  • maintaining a patient registry,
  • assisting with emergencies,
  • providing educational materials, and
  • investigating patient grievances.

On December 1, 2017, all 18 ESRD Networks across the country began a new contract year.

Do you want to learn more about the work of the Network?