A facility can request an exception or extension (if applicable) to various quality reporting requirements due to extraordinary circumstances beyond the control of the facility. Such circumstances may include (but are not limited to) natural disasters (such as a severe hurricane or flood), systemic problems with CMS data collection systems that directly affected the ability of facilities to submit data, or extreme circumstances preventing facilities from electronic clinical quality measure (eCQM) or electronic health record (EHR)-based reporting (e.g., extraordinary infrastructure challenges or vendor issues outside of the facility’s control). This also includes temporary closure of the facility. To request an exception or extension, facility administration must complete and submit the “ECE request form”, found here, to the ESRD QIP mailbox at ESRDQIP@cms.hhs.gov. In order for a facility to prevent loss of points under QIP this form must be submitted within 90 calendar days of the extraordinary circumstance following the end of the last reporting period.