CROWNWeb Data Submission Provider Schedule

Grouping Summary Frequency Justification
CROWNWeb – New Facility A new Dialysis Facility must provide a copy of their CMS-3427 survey request to their ESRD Network once it is submitted to the state.The ESRD Network must enter facility information once the CCN number (CMS Certification Number) has been issued. As Necessary and by the end of each month The State Survey Agency certifies compliance with health and safety standards, using the Survey Procedures and Interpretive Guidelines for End Stage Renal Disease Facilities. The End Stage Renal Disease Application and Survey and Certification Report, Form CMS-3427, is used to request a survey for becoming certified. Once certified, CMS issues a valid CCN#.
CROWNWeb – Facility Detail The CROWNWeb system maintains up-to-date facility information for the following:
• Facility Demographics
• Facility Location
• Primary Facility Contact
• Facility Services and Certification Info
• Facility Hours of Operation
By the end of each month, for all new facilities personnel ESRD Conditions Final Rule- April 15, 2008 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. The data and information must—
(1)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.
CROWNWeb – Facility Personnel The CROWNWeb system maintains up-to-date facility information for the following:
• Key Personnel’s Name and ID numbers
• Key Positions within Facility
• Key Personnel’s Contact Information
As Necessary and by the end of each month ESRD Conditions Final Rule- April 15, 2008 494.180(h)
CROWNWeb – Patient Census The CROWNWeb system maintains up-to-date ESRD patient registry information. Facilities are required to verify the following information:
• Patient’s Admit/Discharge status
• Patient’s Transient Status
• Patient’s primary Type of Treatment
By the fifth business day of the month ESRD Conditions Final Rule- April 15, 2008 494.180(h)
CROWNWeb – Patient Admit The CROWNWeb system maintains up-to-date ESRD patient registry information. Facilities are required to enter the following information upon patient’s admission:
• Social Security Number and/or Medicare Claim Number
• Patient Full Name
• DOB and Gender
• Admission Date
• Admission Reason
• Transient Status
• Dialysis Setting
• Primary Type of Treatment
• Sessions per week and time per session
• Attending Practitioner
• Race and Ethnicity
• Patient Contact Info
• General Patient Status Info (Medicare Status)
On the date of first treatment at the facility ESRD Conditions Final Rule- April 15, 2008 494.180(h)
CROWNWeb – Patient Discharge The CROWNWeb system maintains up-to-date ESRD patient registry information. Facilities are required to enter the following information upon patient’s discharge:
• Discharge Date
• Discharge Reason
Upon confirmation of last treatment date of the patient, but no later than the end of the month ESRD Conditions Final Rule- April 15, 2008 494.180(h)
CROWNWeb – Submitting CMS 2728 The CROWNWeb system maintains up-to-date ESRD patient registry information. Facilities are required to submit CMS Patient Entitlement 2728 form when a patient enters the ESRD program. Within 45 days of first treatment ESRD Conditions Final Rule- April 15, 2008 494.180(h)
CROWNWeb – Submitting CMS 2746 The CROWNWeb system maintains up-to-date ESRD patient registry information. Facilities are required to submit CMS Patient Death Notification 2746 form when a patient dies under the facility’s care. Within 14 days of the patient’s death ESRD Conditions Final Rule- April 15, 2008 494.180(h)
CROWNWeb – Patient Treatment Information The CROWNWeb system maintains up-to-date ESRD patient registry information. Facilities are required to submit the following patient treatment information as it changes:
• Treatment Start Date
• Primary Dialysis Setting and Dialysis Time Period
• Primary Type of Treatment
• Attending Practitioner
• Dialysis Training
As treatment changes occur but no later than the end of each month ESRD Conditions Final Rule- April 15, 2008 494.180(h)
CROWNWeb – Patient Clinical Information The CROWNWeb system maintains up-to-date ESRD patient registry information. Facilities are required to submit the following patient’s clinical information (as applicable) each month:
• Medication Allergies
• Anemia Management
• Adequacy
• Mineral Metabolism
• ESA, Iron Management, and Vitamin D Analog
• Fluid Weight Management
Enter the last values for a month by the end of the following month. For example, enter labs drawn in August by the end of September. ESRD Conditions Final Rule- April 15, 2008 494.180(h)
CROWNWeb – Patient Infection / Hospitalization The CROWNWeb system maintains up-to-date ESRD patient registry information. Facilities are required to submit the following patient’s information (as applicable) as it occurs:
• Infections
• Hospitalizations
• Vaccinations
As infections and/or hospitalizations occur but no later than the end of the following month. For example, enter infections and/or hospitalizations that occur in August by the end of September. ESRD Conditions Final Rule- April 15, 2008 494.180(h)
CROWNWeb – CMS 2744 Facility Survey The CROWNWeb system maintains up-to-date ESRD patient registry information. Facilities are required to verify and submit the following patient census information annually:
• Patients Receiving Care at the Beginning of the Survey Period
• Additions During the Survey Period
• Losses During the Survey Period
• Patients Receiving Care at End of Survey Period
• Patients Eligibility Status at End of Survey Period
• Hemodialysis Patients Dialyzing More than 4 Times Per Week
• Vocational Rehabilitation
• Treatment and Staffing
• Transplant Information
Within 60 days of the close of a calendar year or as otherwise directed by CMS ESRD Conditions Final Rule- April 15, 2008 494.180(h)