cms 2744 esrd facility survey
DESCRIPTION
CMS 2744 ESRD Facility Survey. Instruction for Completing the Survey. Materials Mailed. Packet mailed on 01/22/2008 Materials include: Memo CMS 2744 Survey Instructions CMS 2007 Survey (on yellow paper) Facility Roster for 01/01/2007 to 12/31/2007 - PowerPoint PPT PresentationTRANSCRIPT
CMS 2744 ESRD Facility Survey
Instruction for Completing the Survey
Materials Mailed Packet mailed on 01/22/2008 Materials include:
Memo CMS 2744 Survey Instructions CMS 2007 Survey (on yellow paper) Facility Roster for 01/01/2007 to 12/31/2007 List of vocational rehabilitation patients ages
18 – 54 Blank Network Patient Activity Report (NPAR)
Facility Information Facility Information
Verify information at the top of the form
Make any corrections on the form
Used to update Dialysis Facility Compare (DFC)
Patients Receiving Care at the Beginning of the Survey Period
Fields 01- 03 Use Beginning Population data on Roster to
complete these fields Field 01
Use the number in unit Field 02
Use the number in home Total
Use the number after “total beginning population”
Additions During Survey Period Fields 04A- 07B
Additional incenter and home dialysis patients
Add missing patients on the patient event list to the Network Patient Activity Report (NPAR)
Losses During Survey Period Fields 08A – 13B
Includes losses for both incenter and home patients
Patients Receiving Care at End of Survey Period Fields 14 - 25
Do not count a patient in more than one field Incenter Dialysis
Patients dialyzing incenter without staff assistance Self-Dialysis Training
Patients in a training program Home Dialysis
Patients dialyzing at home with the assistance of staff provided by a dialysis supplier of facility
Total Patients, field 26 Sum field 20 + 25
Patient Eligibility Status End of Survey Period Fields 27 - 29 Counts reflect entitlement only,
not based on reimbursement Example, a Department of Veterans
Affairs patient whose reimbursement made by the VA, but is Medicare entitled should be counted in field 27
Hemodialysis Patients Dialyzing More Than 4 Times Per Week
Fields 30A – 31B Report patients dialyzing more
than 4 times a week on 12/31/2007 Nocturnal defined as hemodialysis
while the patient sleeping for approximately 8 hours
Vocational Rehabilitation Fields 32 - 35 Use patients living and between the
ages of 18 – 54 on 12/31/2007 A list of vocational rehabilitation
patients was included in the packet as a guide
Can count patients as both attending school and employed, etc.
InCenter Dialysis Treatments Fields 36 – 37 Include all outpatient treatments
from 01/01/2007 – 12/31/2007 Include transient treatments Do not include acute treatments
Staffing Fields 38 – 41 Information based on staff
positions opened or vacant on 12/31/2007
Signatures Provides information for the
Network or CMS contact to discuss the Survey Name Date Title Telephone Number
Patients Who Received Transplant at This Facility Field 42 Count every kidney transplant
even if the transplant never functioned If patient received more than one
transplant count the patient once
Eligibility Status of Patients Transplanted at This Facility During the Survey Period
Fields 43 – 46 Based on patients actually
transplanted during 01/01/2007 – 12/31/2007
US. Res and Other Refers to foreign nationals
Defined as any person who is not a U.S. citizen
Includes permanent resident aliens
Transplant Procedures Performed at This Facility Fields 47 – 50 Enter the number of transplant
performed at the facility for each category
Patients Awaiting Transplant Fields 51 – 52 Enter the number of transplants
recipients awaiting a transplant
Signatures Provides information for the
Network or CMS contact to discuss the Survey Name Date Title Telephone Number
Remarks/Comments Include any remarks or additional
information Use for dialysis and transplant
Need Additional Help Call 919-855-0882 ask for:
Wanda Boddie ext 29 Margo Clay ext 27 Deborah Jackson ext 16 Dee Tyburski ext 30
Thank You for Your Attention