1 Inside this Issue: William Bill Litchfield Missing Forms Report & Saved Status Report News from the NHSN Help Desk KCER and FDA Alerts TEEC Command Center Drill Are You Ready for your Annual Survey 5-Diamond Patient Safety Program Calendar 12 Patient s Corner 13 Involuntary Discharge of a Patient due to Ongoing Disruptive Behavior The Network s Patient Service Department receives many calls from facilities that want to discharge a patient from the facility due to ongoing disruptive behavior. Some of the questions the Patient Services Department staff members will ask the facility staff member are: how long the patient has been displaying the disruptive behavior; what has the facility done to address the patient s behavior; and has the facility contacted the Network for guidance before discharging the patient. The Network invites facilities to contact the Network so that the Network can provide guidance on de-escalating the patient s behavior, improving the patient/provider relationship, and to prevent a potential involuntary discharge of a patient. The Network believes that with appropriate intervention, the involuntary discharge of patients may be avoided. The Network encourages facilities to address the patient s disruptive behavior immediately after the patient displays the disruptive behavior by holding a patient care conference to obtain information regarding issues that may be contributing to the patient s disruptive behavior and to re-educate the patient on the facility s policy regarding patient s rights and responsibilities, facility s expectations of the patient, along with informing the patient on the consequences of his/her disruptive behavior. Facilities may want to issue a behavioral agreement to the patient, in which the Network encourages the facility to include the issues the patient has discussed that are hindering the patient/provider relationship. A common issue that facilities may need to address with disruptive patients is the patient s mental health status. Facilities do not need to be afraid to discuss this issue with the patient. Be prepared to discuss with the patient the frequency of depression in ESRD patients along with the symptoms of depression and the availability of counseling. Behavioral agreements are time sensitive, in which facilities will need to revisit the behavioral Continued on page 2... The Network 14 is created and published under CMS contract number: HHSM NW014C End Stage Renal Disease Network of Texas, Inc. (aka: Network 14) 4040 McEwen Road, Suite 350 * Dallas, Texas * *
2 Page 2 William Bill Litchfield The renal community lost a long tenured patient advocate last month with the death of Bill Litchfield. He was 74. Bill was born in Pittsburgh, PA. on June 1, 1940, and started dialysis when he was 28. He was truly a pioneer in patient-centered dialysis, having done dialysis at home for more than 20 years and had renal replacement therapy for more than 46 years. An engineer by training, he started as the first home patient in Texas and was one of the patients who testified before Congress for the passage of Medicare legislation to cover dialysis in the 1970s. The original vice president for legislative affairs for the National Association of Patients on Hemodialysis (now called the American Association of Kidney Patients), he understood very early the importance of patient efforts and patient advocacy in chronic diseases. He is the author of several publications, holding several patents in the renal field, and has been honored by many renal organizations such as the National Kidney Foundation, ESRD Network of Texas, and the University of Texas Medical Branch. He was given tribute several years ago by DaVita, which developed a video of his experiences available at https://vimeo.com/user /review/ /ea93cc50ef. He spent more than 30 years in the oil and gas industry including international operations posts in Asia and beyond, and retired from Ariel Corporation. His life was celebrated at a memorial service on Saturday, October 4, at St. Philip Presbyterian Church, in Houston, Texas. No flowers please, but contributions can be made to Dialysis Patient Citizens at: https://dpcedcenter.thankyou4caring.org/ or St. Philip Presbyterian Church, 4807 San Felipe, Houston, TX at Article from Nephrology News Today with permission from Ms. Litchfiled to reproduce....continued from page 1 agreement with the patient on a monthly basis if the facility wants the behavioral agreement to be extended for any length of time. In addition, facilities shouldn t forget to offer positive reinforcement to patients when observing improved behavior. Facilities should provide the patient a copy of the behavioral agreement so that the patient can review the agreement at home. For more tips on the development of a behavioral agreement please visit the Network s website. If all avenues of intervention have been exhausted and the patient continues with his/her disruptive behavior, then contact the Network. If a facility decides to involuntary discharge a patient from the facility, the Network will require documentation of all of the efforts the facility has made to address the disruptive behavior along with other patient specific documentation. For a complete list of all of the required documentation to be sent to the Network, visit the ESRD Network 14 website. Please note: Always contact the ESRD Network before issuing a discharge notice for ongoing and disruptive behavior. Although the reason is valid per CMS federal guidelines, the discharge may be invalid for not initiating proper and federally-mandated efforts/paperwork. All invalid discharges are reported to the Texas Department of State Health Services and to CMS.
3 Page 3 Missing Forms Report and Saved Status Report Available in CROWNWeb!!! Missing Forms Report and Saved Status Report Available in CROWNWeb!!! Facility-level users are required to run the Missing Forms Report and Saved Status Report in CROWNWeb. Network 14 requests units to run the reports weekly and to submit forms due in By doing so, your facility will reduce the number of notices from the Network and will ensure your facility will be compliant with CMS guidelines. The reports will assist dialysis units with data submission and management efforts. 1. Missing Forms Report: - Used by facilities to obtain a list of patients that are missing specified CMS-2728 and CMS-2746 forms. - Facilities can obtain a list of open or past due forms. 2. Saved Status Report: - Used by facilities to obtain a list of patients with forms in SAVED status. Note: A form is not considered complete until in Submitted status - Helps to minimize submission delays and activate patient benefits. Note: Network 14 will no longer fax the Missing Forms Report or the Saved Status Report to dialysis units; instead, we will send monthly reminders via fax and all QIMS users. If you encounter any problems with the results of the report or are unable to run the reports, please contact the QualityNet Help Desk at to report the issue. How to obtain the Missing Forms Report or Saved Status Report in CROWNWeb? Step 1: The CROWNWeb Facility Editor will login to CROWNWeb Step 2: Click the Reports tab to view available facility reports Step 3: Click the Missing Forms Report hyperlink OR the Saved Status Report hyperlink Step 4: Make selections for each required field Step 5: Click Finish Step 6: Click Ok for the Report Confirmation Step 7: Click Update Table button, after a minute or two, to update the report status Step 8: Click the report type hyperlink (i.e. XLS, 4KB) when the report status shows to be completed The CMS-2728 is due within 45 days of the Date Patient Started Chronic Dialysis at Current Facility (field 25) and the CMS-2746 is due within 2 weeks of the Date of Death. For assistance on how to complete a CMS form, download the CROWNWeb Tasks guide from the Network 14 website. If you need further assistance with CMS forms, please contact Magdalena Sanchez at
4 Page 4 News from the NHSN Help Desk! What to Do When You Have No Events to Report for a Month Confused about reporting to NHSN when you don t have any dialysis events to report? DO NOT select the No NHSN Reporting This Month checkbox on the Dialysis Monthly Reporting Plan! Outpatient dialysis users often us wondering why they don t meet QIP criteria during months when they have no events to report. So, we are here to provide some clarification! By selecting the No NHSN Reporting This Month checkbox on the Monthly Reporting Plan (shown below), you are saying that your facility is not conducting dialysis event surveillance for that month. As a result, your ESRD QIP Line Listing Report will indicate that your facility does not meet QIP criteria for that month and your QIP score will reflect this! Continued on page 5...
5 P a ge 5...Continued from page 4 A facility should only check this box in a few, rare instances: 1. when the facility is closed or non-operational for a given month (see example below); 2. when the individual in charge of dialysis event surveillance is out of the office for a given month and no surveillance can be conducted; or 3. when the facility will not be adhering to the Dialysis Event Protocol for a given month. Rather than selecting the No NHSN Reporting this Month checkbox on the monthly reporting plan when no antimicrobial starts, positive blood cultures, or pus, redness, or increased swelling events occurred during the month, you should select the appropriate Report No Events checkbox for each corresponding dialysis event type on the Denominators for Outpatient Dialysis Census Form. Easy! Have more questions? Contact us at with Dialysis in the subject line and we will respond to your inquiry within 5 business days. Thank you for your continued support of NHSN Dialysis!
6 Page 6 KCER and FDA Alerts and Recalls The ESRD Network of Texas, Inc. is notified by both KCER and the FDA when there is a product alert or recall. You can access information concerning recalls and alerts from our website at: under Special Alerts. Like us on Facebook. To access go to and log in to your account. Look under liked pages, and type in ESRD Network of Texas. Follow us on TEEC Command Center Drill On August 12, TEEC held a Command Center Drill at the Dallas Medical Operations Center (DMOC). This drill included a review of Command Center policies and procedures, an EMSystem demonstration, patient placement procedures, communication with the State Medical Operations Center (SMOC), and a simulated event. During this meeting, a statewide disaster drill was sent out to all facilities in EMSystem. Results of the drill showed that approximately 50 percent of facilities participated properly in the drill. We want to thank all facilities that participated in the drill. While participation could have been much higher, the TEEC members did recognize a need for more detailed training regarding the capabilities of EMSystem. TEEC and Network 14 are currently working on plans for recorded webinars that would be placed on our websites for easy viewing for those in need of a refresher in EMSystem, or in the case of facility turnover. Also keep in mind that there is a free EMSystem app for Apple and Android products. Simply go to the app store and search for EMResource. Once again, thanks to all those that participated in the TEEC Command Center Drill!
7 Page 7 CMS-2744 Are you ready for the Annual Survey? It s almost time for the 2014 CMS-2744 Annual Survey. Are you ready? Is your data up-to-date and accurate? The things you should do to ensure your data is as accurate as possible: Verify your PART Enter the Misc. Info data for your patients on the patients attributes pages PART Your PART should be verified every month by the 8th of the month. You must verify every patient on the PART. Misc Info The Misc Info data is entered on the Patient Attributes Page in CROWNWeb. It is located in the Misc Info box at the bottom of the screen and includes Citizenship, Medicare Enrollment, Current Employment, School, and Voc Rehab statuses. Please be aware that low Voc Rehab activity may result in your unit participating in a Vocational Rehabilitation Improvement Plan. Network 14 encourages you to enter this information now. To enter the information: 1) Click on the Patients tab 2) Click on the PART tab in the blue sub-menu 3) Click on a patient s name in the Patient Name column 4) Click on the Edit Patient tab in the gray sub-menu on the patient s attributes page 5) Scroll down to the bottom of the screen and select the patient s Current Employment Status from the drop-down menu Continued on page 8...
8 Page 8...Continued from page 7 6)Enter the Effective Date of the patient s current employment status (this date should be the actual date the employment status went into effect; if the status has been the same since the patient was admitted to your unit, you may put the patient s admit date) 7) Select the patient s Current School Status 8) Enter the Effective Date of the patient s current school status (this date should be the actual date the school status went into effect; if the status has been the same since the patient was admitted to your unit, you may put the patient s admit date) 9) Select the patient s Current Vocational Rehabilitation Status 10) Enter the Effective Date of the patient s current Voc Rehab status (this date should be the actual date the Voc Rehab status went into effect; if the status has been the same since the patient was admitted to your unit, you may put the patient s admit date) 11) Make sure the patient s Medicare Enrollment Status is correct; if not, select the patient s Current Medicare Enrollment Status Continued on page 9...
9 Page 9...Continued from page 8 12) Medicare Enrollment Status is needed for the CMS Make sure that the Effective Date accurately reflects when these changes took effect (the date Medicare Part B was entitled); if the patient is only entitled to Medicare Part A, put that entitlement date; if the patient is not currently enrolled in Medicare, put the patient s admit date to your unit as the Effective Date 13) Click Submit at the bottom of the screen 14) Click the PART Verification hyperlink in the breadcrumb trail located beneath the gray sub-menu 15) Repeat these steps for all of your permanent patients aged Network 14 also strongly urges you to enter the other values in the Misc Info box: 1) Citizenship (this info is needed should your patient receive a transplant in the US) Note: If inaccurate effective dates have already been entered in these fields on the patient s attributes page, navigate to the patient s Attributes History page by clicking the View Patient Attribute History tab in the gray sub-menu and make your corrections to the effective dates by clicking Edit Patient Attribute History in the gray sub-menu. Make your changes to the dates and click Submit. These preparation tasks should be done by all Network 14 facilities, whether they are part of a Batch Submitting Organization (BSO) or not (Non-BSO). BSOs are: DaVita, FMC, DCI, and NRAA. If you have questions about editing the attributes page, you can contact the Network 14 Information Management Department at ext 318, 326, or 312 or DO NOT patient information (Name, SSN, DOB, etc.) to the Network 14 office. PATIENT ENGAGEMENT MATERIALS FOR NOVEMBER & December Materials for the Patient Engagement Calendar for the month of November and December can be located on our website at: Our Network Patient Centered Care/Patient Engagement
10 Page 10 4th Annual Creating A Culture of Quality Conference Achieving Quality: Reconciling Competing Goals Guidelines, Incentives, Patient Centered Care, Shared Decision Making... How do we judge quality? March 23-24, 2015 Baltimore, Maryland For more information go to: March 25-29, 2015 Gaylord Texan Dallas, Texas Nominations are now open for World Kidney Day 2015 Reception Honors To nominate a patient for the Nancy L. Scott Award for Patient Education & Public Service, go to https://docs.google.com/forms/d/1o6kenv2iwq_zkuqqbd1uzdzdrpvhunspd31ed_qk-qo/formresponse
11 Page 11 Network 14 s 5-Diamond Patient Safety Program 5 DIAMOND STATUS Ameri-Tech Kidney Center-Arlington Ameri-Tech Kidney Center-Bedford Childress Regional Medical Center Dialysis Christus Children s Kidney Center DaVita East DaVita Weslaco DCI Nacogdoches FMC Austin South FMC Greenway Kidney Center FMC New Braunfels Kidney Disease Clinic FMC Village II Dialysis FMC West Seguin Grand Prairie Dialysis Center Moncrief Dialysis Center New Century Dialysis Center of Jasper NNA Marble Falls Plaza Drive Dialysis RCG Center Dialysis Reeves County Hospital Dialysis Renal Center of Carrollton Renal Center of Frisco Renal Center of Lewisville Renal Center of Nederland Renal Center of North Denton Renal Center of Orange Renal Center of Plano RSA Schertz Kidney Center Satellite Dialysis Kyle Satellite Dialysis Manor Satellite Dialysis Metric Satellite Dialysis Round Rock Satellite Dialysis Southwood South Arlington Dialysis Center South Austin Dialysis Texas Children s Hospital Dialysis USRC Delta Dialysis UTSW Dallas Dialysis Wilbarger General Hospital Dialysis of Vernon 4 DIAMOND STATUS Kidney Treatment Center East 3 DIAMOND STATUS Stafford Dialysis University Dialysis West USRC Rio Grande Dialysis USRC Mid Valley Weslaco Dialysis 2 DIAMOND STATUS Angelo Kidney Connection DSI Bryan Dialysis Harlingen Dialysis Renal Center of North Dallas 1 DIAMOND STATUS Dialysis Services of West Texas DSI South Laredo FMC Medical Center Home Therapy Suites Global Dialysis Plus, Inc. University Dialysis Northwest 5-Diamond Patient Safety Program This program year will end on December 31, If you have not yet completed the program requirements, your facility will be dropped, and you will have to register again and start from the beginning on January 1, 2015.
12 Page 12 December 2014 Sun Mon 1 Tue 2 Wed 3 Thu 4 HAI CDC audits due 7 8 Fri 5 Sat 6 NSHN responses due PARTs and EMSystem updates due Infection Watch webinar Network office closed 25 Happy Holidays!!! Network 14 Office will be closed Jan 1, 2015 Happy New Year!!!! Network 14 Office will be closed 26 27
13 Page 13 Patient s Corner Written for patients ESRD Network of Texas, Inc. has entered the Social Media world!!! Like us on Facebook and see what is happening at the Network and renal community. https://www.facebook.com/pages/esrd-network-of-texas/ National Kidney Foundation The National Kidney Foundation provides patients and their caregivers with a monthly electronic newsletter. Some of the articles for October were 5 Tips to Avoid the Flu, To Juice or Not to Juice, Picture Perfect Pumpkin Pancakes, and Do You Need a Kidney Health Check. For these and other articles and educational materials go to To learn more about DPC and what this organization can offer you, go to: To contact the Network for assistance or to file a grievance: Patient Toll Free #: (patients only please) Facility staff: Facility staff post both the English and Spanish pages by the patients scales as well as near the sink that the patients use to wash their accesses and in the lobby/waiting room.
14 CENTERS FOR MEDICARE & MEDICAID SERVICES Getting Medical Care and Prescription Drugs in a Disaster or Emergency Area If you live in an area that s been declared an emergency or disaster, the usual rules for your medical care may change for a short time. Affected areas are ones where either: The President has declared it an emergency or disaster. Visit the Federal Emergency Management Agency (FEMA) online, at or call FEMA ( ) to see if your area is affected. TTY users should call A governor has declared it an emergency or disaster. Visit your state government s official Web site to find out if your area is affected. The Secretary of the Department of Health and Human Services (HHS) has declared a public health emergency. Visit HHS online, at or call MEDICARE ( ) to find out if your area is affected. TTY users should call Seeing doctors or other providers If you re in Original Medicare, you may always see any doctor who accepts Medicare. Some rules may change for an emergency or disaster area in certain instances for example, you may be able to get Medicare-covered services at an airport from a military provider. If you re in a Medicare Advantage Plan (like an HMO or PPO) or other Medicare health plan, contact your plan to see if it temporarily changes its rules during an emergency or disaster. You may be able to see certain doctors or go to certain hospitals that accept Medicare patients, even if the doctor or hospital isn t in your plan s network and your health care need isn t an emergency. If you have problems using an out-ofnetwork doctor or provider, contact your plan for help. You may not have to meet your plan s prior authorization rules for out-ofnetwork services. If you usually pay more for out-of-network or out-of-area care, your plan may apply the in-network rate during the emergency or disaster period. If your plan agrees to apply the in-network rate and later on you go to an out-of-area or out-of-network provider and pay more for the service, save the receipt and ask your plan if it will give you a refund for the difference.
15 Getting your prescription drugs If you have a Medicare Prescription Drug Plan and your state has issued a warning of a potential emergency or disaster: In general, you won t be required to go to your usual network pharmacy to replace your prescription drugs if you had to leave your home without your prescription drugs, or your prescription drugs have been damaged or lost because of the emergency or disaster. Contact your Medicare drug plan to find another network pharmacy nearby. If you can t reasonably get to a network pharmacy, your plan can help you get drugs during an emergency or disaster at an out-of-network pharmacy. You may pay more for prescription drugs you get at an out-of-network pharmacy. Using in-network pharmacies You ll be able to move most prescriptions from one network pharmacy to another, and back to your regular pharmacy when the emergency or disaster ends. If you need help finding the closest network pharmacy, call your Medicare drug plan. You ll need to tell the new pharmacy the name of your regular pharmacy and which drugs you need refilled. If you lost your Medicare drug plan card and don t know your plan s phone number, call MEDICARE ( ) to get your plan s contact information. TTY users should call Using out-of-network pharmacies Contact your plan for information about their out-of-network rules. When you buy your drugs at an out-of-network pharmacy, you ll probably have to pay full cost for the drugs at the time you fill your prescriptions. To get a plan payment, submit a paper claim to your plan. Ask your plan where you should send your claim. If you paid full cost for the drugs, save your receipts so you can ask your prescription drug plan if it will refund you for the out-of-network cost sharing amount. Additional (extended-day) supplies If you think you won t be able to return home for a long time, you may want to get an extended-day supply (a 60- to 90-day supply) of your prescription drugs. Ask your plan whether it offers extended-day supplies and which pharmacies you can use to get them.
16 Paying your plan s premium If you re in a Medicare Advantage Plan, other Medicare health plan or Medicare Prescription Drug Plan: And you pay your plan s premium directly to the plan each month, you re still responsible for paying your premium on time each month. Generally, plans don t change their normal rules for payment of monthly premiums during an emergency or disaster. Many plans have rules about disenrolling customers if they don t pay their premiums on time. To make sure you re still making timely payments on your monthly premiums during an emergency or disaster, ask your plan about signing up for premium withholding from your Social Security check or paying the plan by electronic funds transfer through your bank. If your plan disenrolls you for not paying your monthly premiums and you didn t pay on time because of the emergency or disaster, you may be able to ask Medicare to reconsider the decision and get your coverage back. Contact MEDICARE ( ) for more information. TTY users should call Getting dialysis treatments If you re in Original Medicare, your End-Stage Renal Disease (ESRD) Network can help you: Get your dialysis treatments. Find out who to contact for your supplies, drugs, transportation to dialysis services, and emergency financial assistance if you need it. Call MEDICARE to get your ESRD Network s contact information. If you re in a Medicare Advantage Plan or other Medicare health plan and have ESRD, contact your plan first to see if it temporarily changes its rules in an emergency or disaster. Even though your ESRD Network can help you find facilities that give dialysis services, your plan may not have a contract with an ESRD facility in the area where you re staying temporarily. Getting chemotherapy or other cancer treatments If you re in Original Medicare, the National Cancer Institute (NCI) can help you find other cancer care providers. Call CANCER ( ) between 9:00 a.m. and 4:30 p.m., Monday through Friday. TTY users should call If you re in a Medicare Advantage Plan or other Medicare health plan, contact your plan to see if it temporarily changes its rules in an emergency or disaster.
17 Replacing a lost Medicare card or Medicare plan membership card If you re in Original Medicare, you can replace a lost or damaged Medicare card by visiting Social Security online, at or by calling TTY users should call Also, contact Social Security if you temporarily or permanently change your address. If you re in a Medicare Advantage Plan, other Medicare health plan, or a Medicare Prescription Drug Plan, contact your plan to replace a lost or damaged membership card. You can get your plan s contact information by calling MEDICARE ( ). TTY users should call Replacing lost or damaged durable medical equipment or supplies that Medicare paid for If you have Original Medicare and it already paid for durable medical equipment (like a wheelchair or walker) or supplies (like diabetic supplies) damaged or lost due to an emergency or disaster: In certain cases, Medicare will cover the cost to repair or replace your equipment or supplies. Generally, Medicare will also cover the cost of rentals for items (such as wheelchairs) during the time your equipment is being repaired. If you re in a Medicare Advantage Plan or other Medicare health plan, contact your plan directly to find out how it replaces durable medical equipment or supplies damaged or lost in an emergency or disaster. For more information If you have Original Medicare and want more information about getting care from doctors or other providers during an emergency or disaster, call MEDICARE. If you re in a Medicare Advantage Plan or other Medicare health plan, contact your plan to get more information about getting care from doctors or other providers during an emergency or disaster. You can get your plan s contact information by calling MEDICARE. If you have a Medicare Prescription Drug Plan and want more information on getting prescription drugs during an emergency or disaster, contact your plan, or call MEDICARE. You can also call your State Health Insurance Assistance Program (SHIP) for free personalized health insurance counseling. To get the phone number for your SHIP, visit or call MEDICARE. CMS Product No Revised February 2012
18 Page 18 Save The Date! Kidney Day at the Capitol Tuesday, Feb 10, 2015 THE AMERICAN ASSOCIATION OF KIDNEY PATIENTS AMONG PARTICIPANTS IN 21ST CENTURY ROUNDTABLE DISCUSSION HOSTED BY CONGRESSMAN GUS BILIRAKIS On Tuesday, August 19, the American Association of Kidney Patients (AAKP) participated in the 21st Century Cures roundtable discussion held in Tampa, FL, hosted by Representative Gus Bilirakis(R-FL), member of the House Energy and Commerce Committee s Health Subcommittee. The roundtable focused on strategies to accelerate the development and delivery of better treatment options, medications and devices for America s chronically ill. For patients with kidney failure, there are two treatments: a transplant, which is the most optimal therapy, and dialysis. Dialysis is the other option. While dialysis keeps people alive, the therapy has seen only incremental improvements since it was invented. Tragically, on average, half of the people who start dialysis are not alive three years later (USRDS 2014). This was the first of two roundtable discussions in which patients were able to discuss the personal challenges they face each day. AAKP Member Janice Starling was among the 10 patient panelists. Unfortunately, there have been fewer clinical trials in kidney disease than in any other field of internal medicine. As a result, there are very few new breakthrough drugs and devices that treat kidney disease, Starling told the panel. Starling also told the panel about AAKP being a part of a public-private partnership with the FDA called the Kidney Health Initiative. Through this initiative, AAKP is working with the FDA to host a public workshop where the FDA, the device industry, and patient advocacy groups can come together to discuss incorporating patient preferences into product development and regulatory decisions for kidney therapies. We appreciate Representative Bilirakis listening to the challenges our patients face. We need friends in Congress to help us get past barriers so that development of potential treatments or cures can move forward, stated AAKP Executive Director Gary Green. To read Janice Starling complete testimony, visit correspondence.html.
19 Página 19 noviembre /diciembre 2014 Rincón del paciente Escrito por pacientes ESRD Network of Texas, Inc. se introduce al mundo de Medios Sociales!!! Diga que le gustamos en Facebook y observe lo que sucede en la Red y dentro de la comunidad de pacientes renales. https://www.facebook.com/pages/esrd-network-of Texas/ La Fundación Nacional del Riñón La Fundación Nacional del Riñón provee un boletín electrónico mensual a los pacientes y sus cuidadores. Algunos artículos para octubre eran 5 Pistas para Evitar la Influenza, Se debe tomar Jugo o No, Imagine los Panqueques Perfectos de Calabaza, y Necesita un Reconocimiento Médico de los Riñones? Para leer estos y más artículos y materiales educativos consulte: Ciudadanos Pacientes de Diálisis (DPC) El Fortalecimiento de Uno Mismo Mejora la Vida! Para obtener mayores informes sobre DPC y lo que esta organización le puede ofrecer, consulte: Apunte la Fecha! "El Día de los Riñones al Capitolio" Martes, el 10 de febrero de 2015 Para solicitar ayuda a la Red: Número gratuito para pacientes # (solo para pacientes) Personal del centro Instrucciones al Personal de las Instalaciones- cuelgue las paginas en inglés y español cerca de las basculas de los pacientes y el fregadero que usan los pacientes para lavar sus accesos y en el vestíbulo/sala de espera.
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Reflexive verbs In this presentation, we are going to look at a special group of verbs called reflexives. Let s start out by thinking of the English verb wash. List several things that you can wash. Some
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Nombre: Fecha: Clase: Hora: Título (slide 1) Las cosas _ Capítulo 2 1 (Chapter Two, First Step) Objetivo: You will be able to You will be able to First look at the other sheet of vocabulary and listen,
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