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DQM Guidelines Review Process

DQM Guidelines Review Process

Medicare certified dialysis facilities receive weekly and month CROWNWeb DQM (Data Quality Management) emails with a list of actions that must be taken to cleanup missing or incorrect data in CROWNWeb. It is CMS' (The Centers for Medicare and Medicaid Services) plan to use CROWNWeb data exclusively for calculating the ESRD Quality Incentive Program (QIP) scores within the next few years. Therefore there is a financial incentive for dialysis facilities to maintain accurate and timely data in CROWNWeb. 

Each month dialysis facilities, and their regional managers, will receive a DQM Dashboard that shows how they are doing in meeting the DQM Guidelines. The Network working with the State Survey Agencies and the CMS Regional Office in Kansas City will follow this process below.

The January-February 2016 dashboard will be emailed by March 4th, 2016 to your CROWNWeb designated Facility Administrator and Facility Representative.

 

DQM Review Process 

Heartland Kidney Network monitors the DQM (Data Quality Management) Guideline performance of Medicare certified dialysis facilities weekly to ensure the accuracy and timeliness of data entry into CROWNWeb. Heartland Kidney Network will publically recognize high performers at least twice a year, and annually at our Education Conference.  We are currently analyzing the data to determine where the bar is this year for performance recognition. We are also working closely with the Centers for Medicare and Medicaid Services (CMS), the State Survey Agencies, and dialysis organization regional management to alert them to facilities that are struggling to meet the guidelines using the following three level process.

Depending on the measure in question the period to show improvement in each level will range from 30 to 60 days.

Level 1 Process Improvement Plan or “PIP” - this notice goes to the local and regional dialysis manager(s) and seeks improvement in a set period of time.

Level 2 Corrective Action Plan or “CAP” - facilities advance to this level when the PIP/Level 1 has failed to show improvement. CMS, the State Survey Agencies, and your Medical Director are now notified with the need to improve in a set period of time.

Level 3 Referral to CMS for further action – Actions will result in a letter from the CMS Regional Office and may include referral to the State Survey Agency for action.

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