Guid Guidelines elines - Role Role Of Of The The Facilities - PowerPoint PPT Presentation

CROWNWeb CROWNWeb Data Manage Data Management ment Guid Guidelines elines - Role Role Of Of The The Facilities Facilities And The N And The Network etwork IPRO Data Department 03/01/2016

Agenda  Data Submission Requirements  CROWNWeb Data Management Guidelines  “Data Managing” by Facilities  “Data Monitoring” by Network 2 2

Conditions For Coverage 494.180(h) ‐ Standard: Furnishing data and information for ESRD program administration. Effective February 1, 2009, the dialysis facility must furnish data and information to CMS and at intervals as specified by the Secretary. This information is used in a national ESRD information system and in compilations relevant to program administration, including claims processing and reimbursement, quality improvement, and performance assessment.  Be submitted at the intervals specified by the Secretary;  (2) Be submitted electronically in the format specified by the Secretary;  (3) Include, but not be limited to —  (i) Cost reports;  (ii) ESRD administrative forms;  (iii) Patient survival information; and  (iv) Existing ESRD clinical performance measures, and any future clinical performance standards developed in accordance with a voluntary consensus standards process identified by the Secretary . The Conditions for Coverage for End‐Stage Renal Disease Facilities (http://www.cms.hhs.gov/CFCsAndCoPs/downloads/ESRDfinalru le0415.pdf) published in April 2008 outline the need for CROWNWeb on page 20484 3 3

CROWNWeb Data Submission  CROWNWeb is “National ESRD patient registry”  Facilities to follow Centers for Medicare and Medicaid Services’ (CMS) requirements for data submission into CROWNWeb using “Data Management Guidelines”  ESRD Networks are to monitor CROWNWeb data submission compliance by facilities 4 4

CROWNWeb Supports CMS Goals  Optimize health outcomes as part of the CMS Quality Strategy  Promote high‐quality patient care  Support ESRD Quality Incentive Program (ESRD QIP) 5 5

CY 2016 and PY 2018 NHSN Claims/CW Claims CW ICH CAHPS Claims CW NHSN Claims Claims Claims CW 6

Data Management Guidelines  Standardized data management Processes  Separated by tasks and tiers  Three tasks  Data Monitoring (Data quality - accuracy, timeliness etc)  Data Measuring (Data comparison to a criteria)  Data Managing (Data collection)  Three tiers  Tier 1 – enter data directly into CROWNWeb, Facilities, Batch, NRAA-HIE  Tier 2 – provide technical data reporting assistance , Networks  Tier 3 – support CMS data reporting needs, Help desk 7 7

“Data Managing” Tasks – Tier 1 (Data Entry)  Facilities  Patients  Personnel  Clinical  Action Lists  Form 2744 8 8

Commonly Used Abbreviations in CROWNWeb  What is a CCN?  CMS Certification Number (CCN) =  6-digit ESRD Medicare Provider assigned to facility (xxxxxx)  What is UPI?  Unique Patient Identifier  A unique number assigned to a patient record in CROWNWeb when a patient is admitted 9 9

Facilities  Tier 1  Tier 2 • Network Monitors Facility Attestations Send general email • Send emails to facilities missing data • Facility details Enters new facility • Updates changes 10 10

Facilities  Network can create a Facility  Demographics  Facility Details  Certification Information  Facility can review and edit limited information  Is the facility information accurate? 11 11

Patient Data  Tier 1 12 12

Patient Data- Batch and Manual Submission  Tier 1 - Data Managing DaVita DCI FMC NRAA Independent HIE Facilities Patent Data Every Mon Every Tues Every Mon submitted- and Thu and Wed Batch Patent Data Daily submitted- Manually Electronic data Any Time interchange (EDI) PART Verification 5 th Business day of the following month  Tier 2 - Data Monitoring: Send email / call “Unverified PART” to facilities that did not verify PART 13 13

PART Verification  Tier 1 - Verify “PART” by 5 th Business day of following month PART verification for all patients should be completed by the end of each month – no later than the 5 th business day of the following month 14

Benefits of PART Verification  Balances 2744 surveys  Allows smooth clinical data submission by batch  Problems related to “First event not new to ESRD” resolved  Allow timely submission of 2728 and 2746 forms 15 15

Complete 2728 and 2746 Forms  Tier 1 - Data managing Complete CMS‐2728 and CMS‐2746 within 10 business days of Forms Date Regular Chronic Dialysis Began; no later than 45; CMS‐2746: within 14 days of the date of death  Tier 2 - Data monitoring  The Network sends emails with “Missing Forms Report” to facilities on monthly basis 16 16

Save & Submit Save: Can make changes to 2728 and 2746 forms Submit:  Review before the forms are submitted.  Once the form is submitted it cannot be changed by facility staff or network staff.  A help desk ticket has to be submitted.  If the information that is being requested changes the benefits period, CMS contractor can request for records Save: Clinical data is not considered reported if it is in saved format Submit: Once submitted it can be changed until the month is closed 17

ICD-10-CM List of Primary Causes of Renal Failure 18

Action List Action List Consists of Notifications and Accretions  Notifications: A discrepancy in patient data between CROWNWeb and other the Centers for Medicare and Medicaid Services (CMS) data systems.  Accretions: A patient from another CMS data source that is not in CROWNWeb Network and Facilities work on action list on a monthly basis 19

Action List  Tier 1 - Data managing Resolve Notifications and within 15 days of Accretions issuance; Under Investigation: within 30 New or Reassigned: days of issuance  Tier 2 - Data monitoring : The Network sends emails with “Outstanding Action Items Report” to facilities on monthly basis 20 20

About Action Items….. Updating facility data systems when CROWNWeb “Action Items” are processed leads to less errors on Rejected Data received from your corporation Fix in your facility data system Submitted Data Action Items Dialysis CROWNWeb LDO’s Facility Data System Fix in your facility Rejected Data data system Other CMS DATA SYSTEMS Rejected Data Reports DaVita = Fix it report FMC = Batch Error Report NRAA HIE = CROWNWeb Errors DCI = BRES 21 21

Tier 2 - Patient Data Network Monthly Data Management Cycle Week Task Facilities Verifies Network Monitors (NW recommendation) 5 th Business day 1 PART Network sends “Unverified PART Report” Emails 2 Missing Verified by 10 th Network sends “Missing Forms Report” Emails forms (see DMG) 3 Action list Process Weekly to meet Network sends “Outstanding Action Items Report” Emails 15 day compliance – update LDO data system (see DMG) 4 Data Clean First admission not new Network Sends “Data Clean Up Report” Emails Up to ESRD, transient and (specially during survey period) system discharges etc 4 Clinical Verifies last week of the Network sends missing clinical data reports data month 22 22

Personnel  Tier 1 - Data managing Add Key Personnel Within 5 business days of staff changes  CROWNWeb is the authoritative source of emails for Network  It is provider responsibility to keep the information current  Personnel information can be updated in CROWNWeb under “Personnel” tab  Anyone with access to CROWNWeb can update facility personnel information.  Information regarding key staff members (name , Job Description, JOBCODE , job title, e-mail, and phone number) has to be entered in CROWNWeb.  Tier 2 - Data Monitoring: The Network reminds facilities 23 23

View Personnel Screen Facilities Verify Personnel information 24

Key staff members with JOBCODE JOBCODE Job Description FHNNS Facility Head Nurse/Nurse Supervisor FSW Facility Social Worker FDIET Facility Dietitian FMD Facility Medical Director FADM Facility Administrator FNEPH Facility Nephrologist FDC Facility Data Contact Key personnel Info – complete all the information Positions – create as many positions as required. For Personnel with scope over several facilities, remove the position. Do not delete the personnel or inactivate them. One can add and remove as many positions as possible. Personnel Contact Info – Email is required. 25 25

Personnel Details Screen 26

Clinical And Vascular Access Data  Hemodialysis clinical data  Peritoneal dialysis clinical data  Vascular access data  Data for each month is due in CROWNWeb by the end of the 2 nd month  Batch data submitted by Large Dialysis Organizations 27 27

Tier 1 - Clinical Data Batch and EDI data submission DaVita DCI FMC NRAA HIE Independent Facilities Clinical Data Uploaded Full clinical Full clinical Full clinical As soon as By last day /submitted manually data data data facilities of the submission on submission submission submit data month 15th day of on Second on 2nd to NRAA the following Tuesday in Monday in HIE. month or next the following the following business day month month After 25 th Clinical data Last week Last week Last week Last week completeness verified by every facility 28 28