Monthly Status Check - Home
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Facility-Reported Metrics
How many patients were screened for depression during this reporting month?
Of the patients that were screened, how many were found to be positive for depression during this reporting month?
Of those patients who screened positive for depression, how many were referred to a mental health professional during this reporting month?
Of patients referred to a mental health professional, how many actually started receiving treatment during this reporting month?
Does your facility use telemedicine to support patients in accessing a home modality?
If yes, which of the following does your facility offer via telemedicine for home dialysis patients:
(Select All That Apply By Clicking in Box)
How many patients dialyze in-center that could be eligible for home dialysis (PD or HHD) during this reporting month?
Of those identified above, how many are incident (less than 90 days on dialysis) patients during this reporting month?
Of those patients identified as potential candidates, how many were referred to home dialysis during this reporting month?
How many patients in your facility are potential candidates for kidney transplant during this reporting month?
Of those patients identified as potential candidates, how many were referred to a transplant center for work-up during this reporting month?
How many patients in your facility have received the Influenza vaccine during this reporting month?
How many patients in your facility have received the pneumococcal vaccine (PCV 13)?
How many patients in your facility have received the pneumococcal vaccine (PPSV 23)?
Does your facility have a process in place to track the occurrence of the following among your patient population: 1. Hospital admissions 2. 30-day unplanned readmissions 3. ER Visits
If yes, please specify the occurrences you are tracking:
(Select All That Apply By Clicking in Box)
Did the facility review all unplanned hospitalizations, readmissions, ER visits during this month’s quality committee meetings?
How many patients did your home dialysis facility serve in the nursing home setting during this reporting month?
How many patients receiving home hemodialysis in the nursing home setting have catheters as their vascular access during this reporting month?
How many patients reported above were identified as having a hemodialysis catheter infection during this reporting month?
How many patients receiving dialysis in the nursing home setting utilize peritoneal dialysis?
How many patients reported above were identified as having peritonitis during this reporting month?
Which social determinants of health (social needs) are most likely to prevent your patients from pursuing a home modality? (select all that apply)
(Select All That Apply By Clicking in Box)
Other (please specify)
If none, please explain how you have mitigated these barriers.
Next Step: Barriers
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Barriers and Mitigations
Which of the following domain(s) remains the most influential barrier impeding performance on the areas of opportunity topics this reporting month?
(Select All That Apply By Clicking in Box)
What actions did your team take this reporting month to address identified barriers?
Please share any barriers/educational needs for which you would like the Network to assist the facility in identifying solutions?
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