Category: Infection Control

CMS Releases Recommendations on Adult Elective Surgeries, Non-Essential Medical, Surgical, and Dental Procedures During COVID-19 Response

Earlier today at the White House Task Force Press Briefing, the Centers for Medicare & Medicaid Services (CMS) announced that all elective surgeries, non-essential medical, surgical, and dental procedures be delayed during the 2019 Novel Coronavirus (COVID-19) outbreak.

As more healthcare providers are increasingly being asked to assist with the COVID-19 response, it is critical that they consider whether non-essential surgeries and procedures can be delayed so they can preserve personal protective equipment (PPE), beds, and ventilators.

“The reality is clear and the stakes are high: we need to preserve personal protective equipment for those on the front lines of this fight,” said CMS Administrator Seema Verma.

This will not only preserve equipment but also free up our healthcare workforce to care for the patients who are most in need. Additionally, as states and the nation as a whole work towards limiting the spread of COVID-19, healthcare providers should encourage patients to remain home, unless there is an emergency, to protect others while also limiting their exposure to the virus. They should also urge patients to follow the President’s recently issued guidelines to help slow the spread of the virus.

The recommendations provide a framework for hospitals and clinicians to implement immediately during the COVID-19 response. The recommendations outline factors that should be considered for postponing elective surgeries, and non-essential medical, surgical, and dental procedures. Those factors include patient risk factors, availability of beds, staff and PPE, and the urgency of the procedure. This will help providers to focus on addressing more urgent cases and preserve resources needed for the COVID-19 response. The decision about proceeding with non-essential surgeries and procedures will be made at the local level by the clinician, patient, hospital, and state and local health departments.

The recommendations can be found here:  https://www.cms.gov/files/document/31820-cms-adult-elective-surgery-and-procedures-recommendations.pdf

These recommendations, and earlier CMS guidance and actions in response to the COVID-19 virus, are part of the ongoing White House Task Force efforts. To keep up with the important work the Task Force is doing in response to COVID-19 click here www.coronavirus.gov for further information. For a complete and updated list of CMS actions, and other information specific to CMS, please visit the Current Emergencies Website.

President Trump Expands Telehealth Benefits for Medicare Beneficiaries During COVID-19 Outbreak

The Trump Administration today announced expanded Medicare telehealth coverage that will enable beneficiaries to receive a wider range of healthcare services from their doctors without having to travel to a healthcare facility. Beginning on March 6, 2020, Medicare—administered by the Centers for Medicare & Medicaid Services (CMS)—will temporarily pay clinicians to provide telehealth services for beneficiaries residing across the entire country.

“The Trump Administration is taking swift and bold action to give patients greater access to care through telehealth during the COVID-19 outbreak,” said Administrator Seema Verma. “These changes allow seniors to communicate with their doctors without having to travel to a healthcare facility so that they can limit risk of exposure and spread of this virus. Clinicians on the frontlines will now have greater flexibility to safely treat our beneficiaries.”

On March 13, 2020, President Trump announced an emergency declaration under the Stafford Act and the National Emergencies Act. Consistent with President Trump’s emergency declaration, CMS is expanding Medicare’s telehealth benefits under the 1135 waiver authority and the Coronavirus Preparedness and Response Supplemental Appropriations Act. This guidance and other recent actions by CMS provide regulatory flexibility to ensure that all Americans—particularly high-risk individuals—are aware of easy-to-use, accessible benefits that can help keep them healthy while helping to contain the spread of coronavirus disease 2019 (COVID-19).

Prior to this announcement, Medicare was only allowed to pay clinicians for telehealth services such as routine visits in certain circumstances. For example, the beneficiary receiving the services must live in a rural area and travel to a local medical facility to get telehealth services from a doctor in a remote location. In addition, the beneficiary would generally not be allowed to receive telehealth services in their home.

Click here to read more.

CMS Announces Actions to Address Spread of Coronavirus

CMS calls on all health care providers to activate infection control practices and issues guidance to inspectors as they inspect facilities affected by Coronavirus

Today, the Centers for Medicare & Medicaid Services (CMS) is announcing several actions aimed at limiting the spread of the Novel Coronavirus 2019 (COVID-19). Specifically, CMS is issuing a call to action to health care providers across the country to ensure they are implementing their infection control procedures, which they are required to maintain at all times. Additionally, CMS is announcing that, effective immediately and, until further notice, State Survey Agencies and Accrediting Organizations will focus their facility inspections exclusively on issues related to infection control and other serious health and safety threats, like allegations of abuse – beginning with nursing homes and hospitals. Critically, this shift in approach, first announced yesterday by Vice President Pence, will allow inspectors to focus their energies on addressing the spread of COVID-19.

As the agency responsible for Medicare and Medicaid, CMS requires facilities to maintain infection control and prevention policies as a condition for participation in the programs. CMS is also issuing three memoranda to State Survey Agencies, State Survey Agency directors and Accrediting Organizations – to inspect thousands of Medicare-participating health care providers across the country, including nursing homes and hospitals.

Click here to read more.

Mac Toolkits; Transplant, Transitions, Medications

The National Forum of ESRD Networks has introduced or updated several Medical Advisory Council (MAC) Toolkits. Two new Kits include the Transplant Toolkit and the Medication Conversion Toolkit. The Transitions of Care Toolkit was updated in mid-April. Find them all at http://esrdnetworks.org/resources/toolkits/mac-toolkits-1, along with the existing Home Dialysis Toolkit, Medical Directors Toolkit, QAPI Toolkit, Medication Reconciliation Toolkit, Catheter Reduction Toolkit, Vaccination Toolkit, and Assurance of Diabetes Care Coordination Toolkit.

Making Dialysis Safer for Patients: Optimal Vascular Access

Register now for a free one-hour webinar with continuing education

This World Kidney Day, CDC and the Making Dialysis Safer for Patients Coalition invite you to a webinar presenting the infection risks associated with different vascular access types. Discussion will include strategies and recommendations for successful catheter reduction to prevent bloodstream infections.

Webinar: Making Dialysis Safer for Patients: Optimal Vascular Access
Date: Thursday, March 14, 2019
Time: 2:00 – 3:00 PM EDT
Registration:  Click Here to Register (at no cost)

Join us this World Kidney Day for a presentation on “Incident Vascular Access and Risk of Bloodstream Infection Among New ESRD Patients Receiving Hemodialysis” followed by a conversation about achieving optimal vascular access for patient safety.

Featured Speakers:
Sophia Kazakova, MD, MPH, PhD; Division of Healthcare Quality Promotion, CDC.

Discussants:
• Vandana Dua Niyyar, MD, FASN, FNKF, FASDIN; Professor of Medicine, Division of Nephrology, Emory University.
• Tracy Jonelis, MD; Chief of Nephrology, Kaiser Permanente Northern California, San Francisco Medical Center

Moderators:
Priti Patel, MD, MPH and Ibironke Apata, MD; Division of Healthcare Quality Promotion, CDC.

Continuing Education: Accredited for physicians, nurses, pharmacists, certified health educators, public health professionals and other health professions.

Audio: Please note the audio for this webinar will come through your computer speakers. During the webinar, please ensure that your speakers are turned on and the volume is up. Thank you.

 

NHSN Training

Required Annual Training: The Dialysis Event Module annual training has been updated and moved to a new platform called CDC TRAIN. Self-paced training and post-assessment will remain the same as the previous version, but the CDC TRAIN platform requires you to register with the site, and allows you to save your training certificates after completion. NHSN recommends that all users take this training, but at least one user per facility is required to take and pass this training annually. Find the training course and instruction guide at https://www.cdc.gov/nhsn/dialysis/event/index.html. Email NHSN@cdc.gov with “Dialysis” in the subject line with any questions.

Training Needs Assessment: In taking the NHSN Dialysis Event Module Training Needs Assessment, some users experienced a system error which only permitted them to complete the Demographics section of the survey. If you experienced this, please retake the Assessment, at https://www.surveymonkey.com/r/DialysisEventTNA. NHSN apologizes for the inconvenience and truly values your input. If you have not taken the Assessment yet, please do, to help NHSN better understand training needs for the Dialysis Event Module. The Assessment will remain open until May 31, 2019.

CDC Webinar on BSI and Incident HD Access

CDC will present a March 14, 2019 World Kidney Day webinar on Incident Vascular Access and Risk of Bloodstream Infection Among New ESRD Patients Receiving Hemodialysis, followed by a conversation about achieving optimal vascular access for patient safety. CME, CNE, CEU, CECH, CPE, and CPH continuing education credits are available. Find more information and register at https://cc.readytalk.com/registration/#/meeting=f8wbng3dtcpm&campaign=vq0d1qix86ac.

QIP News: PSSRs, NHSN Deadline, Pain Assessment

PSSRs: CMS has announced that PY2019 Performance Score Summary Reports or PSSRs are now available. The PSSR is a spreadsheet containing the performance values of each facility for PY2019. It provides information about facility performance on each ESRD QIP measure as well as the Total Performance Score. Find the PSSRs at https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/ESRDQIP/Downloads/PY2019-Performance-Score-Summary-Report-.XLSX. It’s a 12+ megabyte file, so it may take several minutes to download and open.

NHSN: CMS has also announced an extension to the NHSN data entry deadline for the ESRD QIP fourth reporting quarter of 2018 (data for October 1 – December 31, 2018) from March 31, 2019 to April 1, 2019.

Assistance regarding PSSRs or the NHSN deadline can be obtained by contacting the ESRD QIP Support Team using the ESRD QIP Q&A Tool at https://cms-ocsq.custhelp.com/app/homeesrdqip/p/960. For questions or concerns regarding use of the ESRD QIP system, contact the QualityNet Help Desk at qnetsupport-esrd@hcqis.org or 866-288-8912 between 5am and 7pm PT Monday-Friday.

Pain Assessment data submission into CROWNWeb will no longer be required by CMS starting March 1, 2019. The Pain Assessment screen will remain active for facilities to review previously reported data. For details see http://mycrownweb.org/2019/02/pain-assessment-submission/.

NHSN Trainings

NHSN will present four training sessions in March, all at 3-4pm EST. Join any of the four by telephone only at 303.248.0285, Access Code 6393927. To join via computer (including audio):

  • Introduction to the NHSN Dialysis Event Surveillance Protocol: NHSN Dialysis Event Surveillance reporting is required for the CMS ESRD QIP. Complete introduction to the NHSN Dialysis Event reporting requirements and surveillance definitions necessary to complete accurate monthly reporting. Both sessions will be held 3-4pm EST.
    o  March 5, 2019 – pre-register and attend at https://cc.readytalk.com/r/nv7i0guhmafn&eom.
    o  Repeated March 6, 2019 – pre-register and attend at https://cc.readytalk.com/r/is7rdbd8gnym&eom.
  •  Advanced NHSN Dialysis Event Surveillance Reporting and Introduction to NHSN Reports: Applying NHSN Dialysis Event Surveillance definitions via case studies that address common reporting questions. Includes introduction to running and interpreting popular NHSN reports to review your facility’s data, including BSI rates. Both sessions will be held 3-4pm EST.
    o  March 12, 2019 – pre-register and attend at https://cc.readytalk.com/r/avggcki49p0g&eom.
    o  Repeated March 13, 2019 – pre-register and attend at https://cc.readytalk.com/r/yzbfurn4zfm2&eom.

January 2019 Learning and Action Network (LAN) Webinars

The ESRD National Coordinating Council will host four January webinars to introduce 2019 QIA projects, all to be held 3-4 PM EST.  Find more information and register at the links provided:

National QIA Webinars

The ESRD National Coordinating Council will host four January webinars to introduce 2019 QIA projects, all to be held at noon PST. Find more information and register at the links provided:

NHSN Data Deadline for PY2020 QIP

NHSN has advised that NHSN data for July 1-September 30, 2018 must be submitted and corrected by December 31, 2018 in order to be applied to PY2020 QIP scores. NHSN recommends:

Contact the NHSN Helpdesk at nhsn@cdc.gov with subject line “Dialysis” if you have any questions.

The NHSN software was updated to Version 9.2 on December 8, 2018, with many additions and changes, including analysis updates. Please carefully review pages 1 and 7-8 of the Version 9.2 release notes at https://s3-us-west-2.amazonaws.com/nwrn.org/files/NHSN/NHSN9.2.pdf for important details about these changes. To use any of the new analysis output options you must first Regenerate Datasets. Send any questions to the NHSN Helpdesk at NHSN@cdc.gov.