40
End Stage Renal Disease Quality Reporting System 2.0 Training With EQRS Outreach, Communication and Training (OCT) 2018

EQRS 2.0 Training - MyCROWNWeb...OCT D!o(i,-sis {l U0'3iib4208} OvPrview Form 2728 Oat.a is ~1nporarH:1 unavait.:blc. Please~/ ag.:in later. Past due 0 0 Notifit'alion" & A

  • Upload
    others

  • View
    0

  • Download
    0

Embed Size (px)

Citation preview

Page 1: EQRS 2.0 Training - MyCROWNWeb...OCT D!o(i,-sis {l U0'3iib4208} OvPrview Form 2728 Oat.a is ~1nporarH:1 unavait.:blc. Please~/ ag.:in later. Past due 0 0 Notifit'alion" & A

End Stage Renal Disease Quality Reporting System 2.0 Training

With EQRS Outreach, Communication and Training (OCT)

2018

Page 2: EQRS 2.0 Training - MyCROWNWeb...OCT D!o(i,-sis {l U0'3iib4208} OvPrview Form 2728 Oat.a is ~1nporarH:1 unavait.:blc. Please~/ ag.:in later. Past due 0 0 Notifit'alion" & A

Submitting Questions

Type questions in the “Q&A” section, located in the top right corner of your screen. Send all Q&A questions to “All Panelists”

Note: Some questions may require additional research. Unanswered questions may be submitted to

[email protected].

Page 3: EQRS 2.0 Training - MyCROWNWeb...OCT D!o(i,-sis {l U0'3iib4208} OvPrview Form 2728 Oat.a is ~1nporarH:1 unavait.:blc. Please~/ ag.:in later. Past due 0 0 Notifit'alion" & A

Today’s Host and Presenters

P. Nicole Crenshaw, MPA Contract Officer’s Representative (COR) Head of EQRS

Kirsten Keating Communications Manager

Michael Seckman Training Manager

Connecting the Pieces

3

Page 4: EQRS 2.0 Training - MyCROWNWeb...OCT D!o(i,-sis {l U0'3iib4208} OvPrview Form 2728 Oat.a is ~1nporarH:1 unavait.:blc. Please~/ ag.:in later. Past due 0 0 Notifit'alion" & A

EQRS Dashboard

Page 5: EQRS 2.0 Training - MyCROWNWeb...OCT D!o(i,-sis {l U0'3iib4208} OvPrview Form 2728 Oat.a is ~1nporarH:1 unavait.:blc. Please~/ ag.:in later. Past due 0 0 Notifit'alion" & A

OCT D!o(i,-sis {l U0'3iib4208}

OvPrview

Form 2728

Oat.a is ~1nporarH:1 unavait.:blc. Please ~/ ag.:in later.

Past due

0 0 Noti fi t'al ion" & A<·< rt-tions

9 System Discharges

2018 2017

0 0 PART

A Add hours and shifts to you r faci lity Pl~11.o;P. r.nmri~t~ ho11~ 11nr1 i;h itr~ tor your rncil it>' hy n(lvic,ati ne to t;1p I lour~ 11nrl .i:hitrs !Y.o!d i( I U .

Facil ity Dashboard Ove rv iew

Upcoming Reminders

o 05/31/2018 • (:linir.lll 011t 11 ~uhmi.o;...i; i<ln <'I P.11d l in~ tor th~ M:::tr( h >Ol A r.linir.111 pPrio<t. o 06/30/ 2018 • Clinical Data submission dQadline tor the April 20 1& dinical p;riod. ·· 07/31/2018 Clinical Data submission deadline tor the May 2018 clinicJl period.

EQRS 2.0 Dashboard

Page 6: EQRS 2.0 Training - MyCROWNWeb...OCT D!o(i,-sis {l U0'3iib4208} OvPrview Form 2728 Oat.a is ~1nporarH:1 unavait.:blc. Please~/ ag.:in later. Past due 0 0 Notifit'alion" & A

Overvie\'+'

Forrn 27 28

Ou~ 11ri'i l duf'

0 0 7 Form 1746

Uu~

0 0 Notifications & Acc.:retions

9 System Discharges

1018

0 PART

Unvclificd

11

1 01 (

0

Clinical Depression Screenings

Upt o 111i11):1. Scrccn'.n2s

Facility Da shboa rd Overview

Click Facilities

Page 7: EQRS 2.0 Training - MyCROWNWeb...OCT D!o(i,-sis {l U0'3iib4208} OvPrview Form 2728 Oat.a is ~1nporarH:1 unavait.:blc. Please~/ ag.:in later. Past due 0 0 Notifit'alion" & A

Search Facilities0

Facility Lookup

Search by tacillty ID, facility name, facility OBA. facility CCN, facility NPI, phone number, fax number

0.

Search Facilities

Page 8: EQRS 2.0 Training - MyCROWNWeb...OCT D!o(i,-sis {l U0'3iib4208} OvPrview Form 2728 Oat.a is ~1nporarH:1 unavait.:blc. Please~/ ag.:in later. Past due 0 0 Notifit'alion" & A

Search Facilities· Facility Lookup

Search byt2'.cility ID, tacility name, tacility DOA, facility CCt~. lacility NPI, phone number~ tax number

UCI

2HJUUUO~ti1. KIUNCY <.;.AJ~C CCM tl~S VI GOSHOCTOM. OHi:.>. KJUNCY CA.l~t G=N I C1~$ 01 GOSHOCTVM. OHi\) , 3tS:!l85. 10~3E:llY423. 11i'tt. l\l'a, rt;'a, n:a, n1a. Dia~1$is, Open

403000101 , OCT Ohl~is OCT Dialysis, 082G83, ·10028(i42D8, n:a, n/3, n.'a . n1a, n1a, Dia!y:;i:.. Op~o

1 &30000213, Z-C_OSEO-Oocl•:ir~ Ho:;prta of Lat.cwood, Z-CLOSED-Ooctors Hospital of Lo::kC\\'OC•j, nla, n.:a, 1\13, n.'a. n.'a. n.'a, ri a , Oia'ysis, Clo<"...cd

1&'.l0000\ 53, Z-C_OSEO-USH/ .. \IVL. rnc.-Doctors Z-CLOSED-USHA\'v'l, lnc-Ooctct"S, 05251G, l'\l'a, n'a n.'a. li.'<3 , r~··a . rv'J, Qi3fy:.is, C~o~·j

30)0001 \ 4, ZZ-Clo~j-Doctor-;. Center Hosp~JI, ZZ-Glosc'\1-Doctcr:. Genter ~os.p'.bl, 40230[', n/3, n.'a, n:a, n1a, 1Va., n1a., Oial~s :;, Clo-:.od

Q

A

Auto Search When Three Letters are Entered

Page 9: EQRS 2.0 Training - MyCROWNWeb...OCT D!o(i,-sis {l U0'3iib4208} OvPrview Form 2728 Oat.a is ~1nporarH:1 unavait.:blc. Please~/ ag.:in later. Past due 0 0 Notifit'alion" & A

Search Facilities· Facility Lookup

Search byt2'.cility ID, tacility name, tacility DOA, facility CCt~. lacility NPI, phone number~ tax number

UCI

l\l'a, nla, n:a, n1a. Dia~1$is, Open

40)000101, OCT OW~is OCT Dialysis, 082G83, 10028(14208, n:a, n/3, n.'a . n1a, 013, Oio!y:;i:.. Op:n

1 &J0000213, Z-C_OSED-Oocl•:ir~ HCJ:;prta of Lat.cwood, Z-CLOSEO-Ooctors Hospital of Lo::kC\\•ocd, n.ia, n.:a, n.'a, n.'a. n.'a. n.'a. ria. Oia'y:;is. Clo<"...cd

1&JOOOO\ S3, Z-C_OSED-USH/"\11/l. rnc.-Doctors Z-CLOSED-USHl\\'v'L, l nc-Ooctc.-s, 052S1D, lli'a, n'a n.'a. n.'a. r~i.J, rv·J, Oi3fy:.is, C~o~d

30)0001 \ 4, ZZ-Clo~j-Ooctor<;. Center Hosp~JI, ZZ-Glosc'\1-0octcr:. Genter ~os.p'.bl, 40230(•, n/3, n.'a, n:a, n1a, 1V3., n1a., Oialys :;, Closed

Q

A

Show All Results

Page 10: EQRS 2.0 Training - MyCROWNWeb...OCT D!o(i,-sis {l U0'3iib4208} OvPrview Form 2728 Oat.a is ~1nporarH:1 unavait.:blc. Please~/ ag.:in later. Past due 0 0 Notifit'alion" & A

• t ll h1y1Ht·,N. tn •

:":A.-:01:11:.0l'i +:;..TOCTIN P.CCfON.• •• (~.TOCTIN RtC.!Ott.l.L

1)11,l ':>l">f>~ Ht Ol!•I 1'SIS t:HI I Hi

( t)~i) f)/\\o1T/+ 011~~n ")1\VIT1\ li'Jc: ... 1oo:ii;11

CCSHOC.-011 011'1. YSIS OOSHOCTOI'. CIALYS!S

l i!l.1 ' :\lli;Sl-""·0 1'.1 1:\I S Ol .!ol 1'S1S ;.-'H:tol.11...:1 s fOCOG026~ or .:c:;i 1oc·o1<1 o·co~11c.:1or1

, .. ):2!~574 OX TOF.SHOSFl1J.L E>OCTORS HCSPIT.b.l

r, n1n i-i flCRTM

i t<t<ll!UC114 / O,_:t¢ots0 1t'.!y.sls C!nt~ [ IVctcf .S Olal'JSIS (~ :i :er

f')f~,:;\f I C">\Al'lj'"PIA<; <1ft~U I l'l~AAP.;:i.f•\

ll-: ~:hl' •:Oi: :r.;:.i•: t"::'l•I •" D•·i 11)1:: 1i:11·r:i: • • ; H, ( 'I J3(')COC213

»f ).lor.tetellc of Mcn::iel>:lb

Hl:NKltOOC.H.: l<J~ H::Nl>'.IOC· JOCIUl>'.S

!4!•)CV20! I IO<;rllAl.· llO~rlTA!.·

11-1.:.r.iSl'l l.f" I lk~~JSl'I Jo ~JI

!.: ONl=Yf:l,A .: <:i:~1FP.~ Kll':'~ ";'i(/!Rf l"l="HTIR.;; i1'')'0C9~1

or ccsi 1oc-01.i, 0110 o-co~l lOCTON,01 110

10t'JC1J:1.•! 0 (..1 u )\"i S&S (J\;I 01~{\>.$1~

I 1:1 ( J .~1 ; U:x u:. •; I i:I :>~~I) O l •! 'IUO!; J0'0'0~2!J

rosp·tEldL.akewood 110.Splt:a. ofUik.:\\"OOd

l OC•)CVClSj ( · t.:L<J:)tl,;·USH.t..'NL, L·t.:L{Y.)::l).tlSHA\\'1.,

l1 1~·Dvctv1:» lrM..·0..x..c.;r ~

?..1iC(IC1i' 14 IZ< lo.s! cl·OX-.cn . ZZ-CloSEiJ.Oc.:IOIS (l'l lC'I H U •:p ! ;:I Cl'Ol l"f H >t!;p 11:1

Pas_e Si~

Showing : t., l~ ~f:a 1·e!.•lu 25 lvl

I 11111•• ........... ._;., UMl\'•;1-.; ,

;W.lV.i:i l~:C!:..~:\I:.? 1)1){)'> > • )62!<~6 191203$090 Dl~t)·sis 9

DiJts:;':; • :l! /.' I'.':> 1011: .. .ic:im1;: .,,_, ..... ,, .. '" ~~27S: 1:"6Qi'1JO'S ()!){)'>!> JS

1194781294 TIM':tJ,lhflll

l C·27S& 10!iS67'1-'l ()J )l)"S!~ • :Jl(l!..-:l3 lOll~U-·:..'t•S l)1 )l\"S\~ •

()1 )~'3{) a

:is·2s1e C>i ~t)·~i:i; " 4(f.\?lll'.- f')i.11\··:\: '

,.,utl'"rt:~d cndi Suluro~ I ir .. ,

Org~nll3ti¢r II • :l•tt;t ~I

t,;•) 'l !tl, • .. 1ose1

Clo.s«I

Ch. ... ..;-..:,1

!;')' ,'tf;"j • )j')fi1

Dl'l!U Opfn

0).l<:ll

Opfn

IJPfn

ci·)$~

Cl<.»~J

•°lllMd

~Frc·v ~ext._

Search Results – Click Facility ID

Page 11: EQRS 2.0 Training - MyCROWNWeb...OCT D!o(i,-sis {l U0'3iib4208} OvPrview Form 2728 Oat.a is ~1nporarH:1 unavait.:blc. Please~/ ag.:in later. Past due 0 0 Notifit'alion" & A

OCT Ola4ysls

~ Netv1ork Information

Contact 1nrornu1tion

C'Ytification

0 Services lnforml'ltlon

~ Ovmership

~ Hours and shiflS

Facility summ1ry

Facility summary BPrlntpage

Actions

Alleslali<>ns ~

Network information

Hetworlc.:

Network 4

Program type:

Oialy1is

F•ciUty leg•l n•nle:

OCT Dialysis

Certification

FACILITY INFORMA-ION

Provider use type:

Mtl!ICARt

Facility NPI:

100la64208

You have ~rrors ii~ sectioos of the forn1. Please update and fesol"e the following:

• Contact lnlormation • Backup hlcillty

• Certification • Servi,es 1nfo1nl3llon

oerault preferences G" Personnel r&'

Network facility code:

oaooim

Facility OBA n•me:

OCT Dialysis

Medkare status:

~1tified

Faclllly type:

°c> View Lo edit

°c>Viewtoedit

lnde-pendent Hen!I 01a1ys.1s Fadlftles

Facility Summary Screen (Top)

Page 12: EQRS 2.0 Training - MyCROWNWeb...OCT D!o(i,-sis {l U0'3iib4208} OvPrview Form 2728 Oat.a is ~1nporarH:1 unavait.:blc. Please~/ ag.:in later. Past due 0 0 Notifit'alion" & A

Optndate:

HJ/lJl/198~

c =RTIF (.!>TIO\ I N~0~~1;..T10N

Initial certlflcatlon date:

01/lJl/'.llJl~

Facility CCN:

o.92~s3

Ho•pitol CCN:

Servkes

Ownership

) ·'.01 11 ~ J.. 1 IJ~~ INI u1~r.1A I liJN:

Profit rtatus:

Mon profit

Primary owner:

Vctc-rans t..dmin~tration

Secondary owner:

V c·tc-r ans I ..dJTI in ~tr ati on

Honrs ;ind shifts

lr 1 4.h:'~Ht!enl Rt:ual Oi.::ly::;i::; f ddlili ~:;

Clo-sedate: n/a

Termination date:

n/a

Related facility CCN:

n/a

Skilled nursing fo<ility CCN:

ni ri

Profit stab.ls effKttve s-ta rt date: 10/ 01/1Y88

% ViC\V to edit

% \'i~\V tO Mir

Primary O\Vner effective start date:

10/01/1988

Man aging organization:

n/a

°oViC\V to edit

Facility Summary Screen (Middle)

Page 13: EQRS 2.0 Training - MyCROWNWeb...OCT D!o(i,-sis {l U0'3iib4208} OvPrview Form 2728 Oat.a is ~1nporarH:1 unavait.:blc. Please~/ ag.:in later. Past due 0 0 Notifit'alion" & A

s %View lo edil

st .. lu:. Opc11 li• 11.: (W~lir11c !';l ii l b

t.1onday OPfl t;;t1.1,ll,M li:Ll:ll'r.1 " l•Je.:.day l.k>>ed Q

~\.:..rno."Al;,iy Ope.··• S:CV:\M 8:0,Pf.1 , T1U~('lf.)' Ck»e<:I • J-(ld~y IJJ)f l a;t1.1,ll,M l,i;l)JJ'r.1 " :V.tunhy '"'""' "

< Pre·1icus

Facility Summary Screen (Bottom)

Page 14: EQRS 2.0 Training - MyCROWNWeb...OCT D!o(i,-sis {l U0'3iib4208} OvPrview Form 2728 Oat.a is ~1nporarH:1 unavait.:blc. Please~/ ag.:in later. Past due 0 0 Notifit'alion" & A

OCT Dlatysl~

0 Network Information

Contact Information

C. Certification

0 Se"' ices lnfonnation

0 Ownership

0 Hours and shifts

Backup facility

F1dllty summary

Facility summary QPrint page

Adions

Attestations C?

Network information

Program typo:

Dialysis

You have e1 rors in sections of tile form. Please update and resolw the following:

• ConhKt lnfonnation • Backup faciMy · Certifation • StiVic@s 1.nrormation

Default prefereocesC?

Netwotk facility code:

08002FD

~v ... w1oedi1

Facility Summary Screen (Errors)

Page 15: EQRS 2.0 Training - MyCROWNWeb...OCT D!o(i,-sis {l U0'3iib4208} OvPrview Form 2728 Oat.a is ~1nporarH:1 unavait.:blc. Please~/ ag.:in later. Past due 0 0 Notifit'alion" & A

CXJOt3lysls

C!) Network fnfornu1t'°9:l

contact inform ation

0 Certification

0 $eii.1iCQS lntormation

C!'> O •tNlf'!l 'ihi jt

0 llours aOO -;hitts

P,;u:kup rat ilily

Facility ~ummar>r

Network information NNwork Info Network: f.Jf'! lwork .a

Network fa,itit'y Gode-.:

~'<JOUZfD

Program type: Dialysis

hu:i li ly name

Facility legal name:

<><:I Ui;il ~·:-.i ;;

fa,ility OBA n•me: OC.T Oit!l ~·)t.i ;;

N>:xl )

, Edit

Network Information

Page 16: EQRS 2.0 Training - MyCROWNWeb...OCT D!o(i,-sis {l U0'3iib4208} OvPrview Form 2728 Oat.a is ~1nporarH:1 unavait.:blc. Please~/ ag.:in later. Past due 0 0 Notifit'alion" & A

0 Network Information

0 Cc·1titicatiot1

0 St;rvic H:-> 111ro11r-1tl io 11

Backup tacility

l-111:ilily .'i\J llllfll'U'./

Network information Nclwork Info Network:

Hef.\vcrk4

Network faclUty cod.:

UOUO:lFO

Progr•m typ<:

Oial',«;is

L'adlity name

FJcitity l~i;:.:11 naniC

OCT Olal)'Sls

r adlily ORA 1n Hfh '

I ~ .. ,,.. ~:i l q:.i!ln111n 11:

OCT Dial)"'is

Cancel il§§li

N1!1.l)

x

• CJ.nccl edit

Edit Network Information

Page 17: EQRS 2.0 Training - MyCROWNWeb...OCT D!o(i,-sis {l U0'3iib4208} OvPrview Form 2728 Oat.a is ~1nporarH:1 unavait.:blc. Please~/ ag.:in later. Past due 0 0 Notifit'alion" & A

0 Contact ln(ormation

e cenification

0 HOUl'S and :.hifts

1-~cilil'( stunrn~ny

Contact information

Physical address of facility

Pitt:<.h11r.gh, f'l!'!nn:'i)'lv;iniil

1 ~17J

County:

AllP.gh.,.ny

Address effective start date:

0 1/11 1/1n 1a

Mailing address of facility

Pitt:<.h11r5h, f'l!'!nn:'i)'lv;inin

1 ~17J

County:

AllP.gh.,.ny

Address effective start date:

01/11 1tnna

Facility phonP. and fax

Phone numbtr: (aoo) ·;.s~ u12

Fax number: (aoo) ·;.s~ UJ 3

~ t dit $ Hi!tt<>r/

~ Edit t>Hi!ttor;

iEJit

Contact Information

Page 18: EQRS 2.0 Training - MyCROWNWeb...OCT D!o(i,-sis {l U0'3iib4208} OvPrview Form 2728 Oat.a is ~1nporarH:1 unavait.:blc. Please~/ ag.:in later. Past due 0 0 Notifit'alion" & A

OCT Dialysis

" N~twork lntormation

(') Contact Information

(!") Scr:iccs lnforn1ation

(') Ownership

" n~c:k11r t11d1ity

I ac:il ily s1n r11rmry

Contact information

Physical ad<lr*'ss of fac:ilily

Pitt~h11q~h. Pf!nn~/li.::::ni;,

1~111

County:

1~llcghc·ny

Address eff&ettve start date:

Ol j Ol/201-S

Mailing addJ:ess of facility

Pittsburgh, P~nnsylv.:nia

15122

County:

All"J;h•ny

Address effec.tive start date:

01/ 0lf.!!Jl.:f

f.adlil y phon*' and r ax

Phone number:

l1?.1\4~F..-7fi00

' Cdit ~1 listory

' Edit '!DHistoiy

Contact Information – Click Edit

Page 19: EQRS 2.0 Training - MyCROWNWeb...OCT D!o(i,-sis {l U0'3iib4208} OvPrview Form 2728 Oat.a is ~1nporarH:1 unavait.:blc. Please~/ ag.:in later. Past due 0 0 Notifit'alion" & A

OCT otalysls

0 N~llJvurk l11fo1111<1lion

0 Contact Information

0 Ce1lifi <.;<1lion

0 S!=!rt1ir;:.~ lntorm~tion

0 Own~1:;h iµ

0 I lnu~ a net ~hittc;;

0 8a,kup facitity

Contact information

Physical address of facility

Wht1l lV~ or €llil t11E: vou 111~ki 11g.·!

@ Movinc to"' nFVi.' 1<trhir~~

'" r...1· . .... •,._., 111t rn th1~ adur~~~ r;:<:orrl

Street .lddrC'!is line 1

Street .lddrC'!is line '.l (optio11al)

City State

Select option v

7ip coc1~ 7ip ext. (option.I)

Cou11lv

J'..ddrcs.s ~ffcctivc ~ta1t date

t"°nth

Cancel

x Cu11~~1 t:dil "::> Hisloty

Moving to a new address

Page 20: EQRS 2.0 Training - MyCROWNWeb...OCT D!o(i,-sis {l U0'3iib4208} OvPrview Form 2728 Oat.a is ~1nporarH:1 unavait.:blc. Please~/ ag.:in later. Past due 0 0 Notifit'alion" & A

Contact information 0 Mct .. 1ork lnfonviation

Physic,11 ;iililr~ss of foc.ility • Cancel edit '2)History

0 contact Information \'~ht1l lv~ or t:llil i.11~ you lilf.lking'!

0 Certification .-, <.._.1 Movi11g lo a 1u:w i.ld<.lre!)l)

ti) rrt it ro thi~addr~to.c,r~rorrt

Sl1~l adt.he:;:; li11E: 1

12345 Main Street

0 Hours and ~him

0 fl.1'r.kup h::rility

I udlily su11uru11y Pittsburgh Pennsylvania y

7ip coc1~ 7ip ~xt. (option111)

l!i I))

r.011nty

01 01 201 8

Edit to this address record

Page 21: EQRS 2.0 Training - MyCROWNWeb...OCT D!o(i,-sis {l U0'3iib4208} OvPrview Form 2728 Oat.a is ~1nporarH:1 unavait.:blc. Please~/ ag.:in later. Past due 0 0 Notifit'alion" & A

Physical address updated successfully Click History

Page 22: EQRS 2.0 Training - MyCROWNWeb...OCT D!o(i,-sis {l U0'3iib4208} OvPrview Form 2728 Oat.a is ~1nporarH:1 unavait.:blc. Please~/ ag.:in later. Past due 0 0 Notifit'alion" & A

OCT Dia lys is ( ~d tu c.:011locl i11forr11atiu 11

(") Network lnforrnation Address History & Contact Information

Physical J\<ldress & <.:e1liliit:aliUJ1

Start date: •)7/01i?01 A. c:ut1wif Startdat~: 10/01/19AR & Scrlficcs lnforn1ation

& O\Vnf-~hip '!>43:21 M.;in Street llJ.i:> Main Strc"Ct

& Hours and .shifts Pill::iUurgil, PA, 15122 - 11ilLslJu1i;h, I 'A, 15122

fdit rdit O?:rkup t11dlity

I iJl:ilil'/ liUHllOUfY Mailing Address + MtJ 111ailing t1tkh~s

Stortdote: 07/01/2018 C.:uuenl Start dote: 01/02/2018

'!>43:21 \1,;in Street llJ4:> Main Strc"Ct

Pill::iUurgil, PA, 15122 - 11ilLslJu1i;h, I 'A, 15122

tdil t dil

Address History

Page 23: EQRS 2.0 Training - MyCROWNWeb...OCT D!o(i,-sis {l U0'3iib4208} OvPrview Form 2728 Oat.a is ~1nporarH:1 unavait.:blc. Please~/ ag.:in later. Past due 0 0 Notifit'alion" & A

Search Facilities· Facility Lookup

Search byt.:.cility ID. facility n.lnlc, tacilitf 08.'\, tac iii~.' CCN, l~;dl ity NPI, phone numbcf, ta.x nu1nbcr

Or.T

f:i<i5i'.lOO:>fi:1, I 1-NRlt.() OOCTf)R~ l lOfi?ITAI TRAtlf;PI ANT. 1 lfN~l<:O OOCTORf; l lOSPITAI TRANSPI ANT. n'a, ·11il170:>~'1 . n.'i;, n:a. n.'11,

n.'a. n1~ Tr?.n~pl~ ,1· Op~n

?rnnnoo~l\1 , KlflNfY' <:J>.RI <TNTI R!; OF co st OCTON OlllO Ktnr~rv <:ARI C-Nr RS OF <:O!;l IOCTON, Ol 10, ~6?7111\, ·10;;~~7~~?.1 , nl• , ll!'a, n1a n:a, nia, Di::ilysis, Open

tl00000101, OCT Dialysis, o c T Oia~/Sis, OC.2503, 100300·120(;, (123}'156 7ll;o, <'12.)}156 7091, Fittsburg1, PA, 15122, Diatysis, Opell

.3. ~ . • , L.

·100030101, OCT Oial~sis, OC. r Oial~~is. 002:03, 1003JC··12DC, rl a, n.'a, n:a, n.1«, ni'a. Dial~~is. Op'in

1 UOIYJOU'.213, L •.:_OSLLl uoetors 1 lespit.a 01 l.ak;.¥1¢00, L <.:LO$LL1 UOt lX)rS 11ospna1 er Lak~\\IO:CI, tV-21, n:a, n:a, n.1i , n:a. 111a, n'a. UJalj"SIS, CIOSe<t

0.

v

After Contact Information Added

Page 24: EQRS 2.0 Training - MyCROWNWeb...OCT D!o(i,-sis {l U0'3iib4208} OvPrview Form 2728 Oat.a is ~1nporarH:1 unavait.:blc. Please~/ ag.:in later. Past due 0 0 Notifit'alion" & A

oaoi .. •t'"'- Certification <:> H~t'l!orklnfonn<itioi1

FACll r-· 1HF(;RMAT CM If C:il!l(e{ edit

~ co11uct lnform<ition

~ Certific;ation ,..,1

/',(.hi.111;"<•0 1Ov111c1!i!1i111CI l('/i'(+ hll:..<x:• 11111·dm ll 1 ~:'!>'1 (.(.N hi.•: l 1i~r11a!:::it'.r1t!1 l1lm: l 11 ;1<hl'l llt).• ' i ll

• •• .; f <it.:ili ()· l~·p:

@ ,".11~'(J il lv tl'1i:; l.Jdlil:r 1<:lv1d

Me.DICAR.I: ceraneo

1,;rili;yHl'I I llr.ilir)' t·,p f

lC•)3~.E-<'2CS rnaepenaem Re-nel Clel)'!.'S Fecmtle9;

I.~>" !1

10 01 1988 MM DO YYYY

'"""""'"'"'' '!-¥ .,,., ... 10 01 1988 MM DO YYYV

1 ,;ri1i<'~· CCN

Cancel •'•

Certification

Page 25: EQRS 2.0 Training - MyCROWNWeb...OCT D!o(i,-sis {l U0'3iib4208} OvPrview Form 2728 Oat.a is ~1nporarH:1 unavait.:blc. Please~/ ag.:in later. Past due 0 0 Notifit'alion" & A

O Nttwo1klntofma1ion

O Conl&Ct lnfonnttion

0 Cfftifieation

0 ~lnfonnation

0 Owne1ship

O Houn and shifts

lYPES OF SERVICES

Ptritonul dialysis (2 stltcttd)

C!'J CCPO

C!'J CAPO

IPO

Home trelftlng and support

Mod.-111.its CMi«t• i.-orit1

l!J CCl'O

l!J CAPO

~ ,PO

Homodialysls (3 stlocttd)

ln •ccnlt-r

Ctftititd lo off tr

Erfecti\'t stMt ct.11t - ... 10 01

C«tified 10 ofter

crftcu .... start w i t - ... 10 01

Ctrtified to otfc1

l ffKtlwstMtO.tt -10

... 0

-

-1984

-

Services Information (Top)

Page 26: EQRS 2.0 Training - MyCROWNWeb...OCT D!o(i,-sis {l U0'3iib4208} OvPrview Form 2728 Oat.a is ~1nporarH:1 unavait.:blc. Please~/ ag.:in later. Past due 0 0 Notifit'alion" & A

HEmodialys s {3 $elected)

ln ·tente1

Hom• tninlntaind w.pport

~ freq!Wlt hemodialysis

Sdectillg in.oenttr ooc:umal meitll$ Ui~tyou t0Yestilt$

BftfU )C>.m

Oialyzer reu$e (1 sele<ted)

Ol1ly1"rr"u.s" Htvle"

Ceftifled to offtr

10 0 1

Cectif"-ecl to offt1

Effec:ive start date -Ul

Cef1ified to offtr

£ffec:iw sbrt date -10

.., 01

Ctctif'"-ecl to offtr

Effec:ive mrt date -10

191»

. ., 01

,_

,.. 1988

,_ 1988

Services Information (Middle)

Page 27: EQRS 2.0 Training - MyCROWNWeb...OCT D!o(i,-sis {l U0'3iib4208} OvPrview Form 2728 Oat.a is ~1nporarH:1 unavait.:blc. Please~/ ag.:in later. Past due 0 0 Notifit'alion" & A

AOOl'IOMI. S£1MUS OPnONA.Ll

~ -Podlotrlc

9'ifts start nftt1 s p.m.

[_ Patients receMngdialysis within L TC f;Kilities

"' • lhis facility offers no add,uonal s.ervius

ST A TIONS INFOPMA TION

Numbtr of isolation ~tiotls

)

r ot&I number of sullons

15

MME

~- ..... , .... ~ tsol10on sla:tions

Certified number of sr.ations

,.

Services Information (Bottom)

Page 28: EQRS 2.0 Training - MyCROWNWeb...OCT D!o(i,-sis {l U0'3iib4208} OvPrview Form 2728 Oat.a is ~1nporarH:1 unavait.:blc. Please~/ ag.:in later. Past due 0 0 Notifit'alion" & A

O'TPbtl/'S-ts

& NHIW(ll k lr1fo1111;.1 lion

& Contac.t lnfomui.tion

& Cc·rtit(cai:ion

& servic.QS lnfomlati<ln

& Ownership

& Hours and c.hitts

O Oackup t3citi tv

~i1c il il y surnn•i'I•}'

Ownership

Profit status information

Profit status:

Non.profi t

Profit status effecli"e start date:

10/01/19/dS

Primary ownership

Primary owner:

vi;.i:~rans.D.c'ministration

Primt11ry owner eff~ctive s1:'11rt da«i:

10/01/19/dS

S<~l'o n<l ary ownership

Secondary owner: Vct<:r ans. .".Cm inistr a ti on

M11naging o rgani211tion:

Independent

Authorized batch submitter

Authorized batch submitting organization:

n/a

tlcxt >

Org3nlzatlon faclltty code:

n; a

~l l islo1y

~l l islo1y

"Edk

Ownership

Page 29: EQRS 2.0 Training - MyCROWNWeb...OCT D!o(i,-sis {l U0'3iib4208} OvPrview Form 2728 Oat.a is ~1nporarH:1 unavait.:blc. Please~/ ag.:in later. Past due 0 0 Notifit'alion" & A

,.,... ......... Hours and shifts uptlaled suc<..~ssfuUy "~~·('Ol~ >"'r """"' "''<""~,...

Hours and shifts A i;.. ,;, ...,.,>tl><t ...... l• ;l t...w.-1...., ~ ,1o,1itin.•.

llooo <>f optt<1don 9<•••.t " <1ou1 ..i•

:.1i.w' O,t~Tll!'.C «os~rmt "'"' .......... , .,.~- ·- '"" " ""' . ; . ,, y ,., . 11 ... : ,,, . f"t.I Y

Appl~

r ... ..i~· - ·- '"'" \lpA.~ ... !K• y N• • " . ... . f .. I V

w.J11n:;loy <)~ ~ ... ,.,, ~ ""' . ' . ) ) y ,., . 1 1 ... : "' . .,, .. , v

Th~y ·-- ~ ·- .,,,, -0pe,, ... ' . J ) v N• • ,, . ., . f:M v

rr4.,. '"" .. ;ltO(<I ·- ,..,,,_., ....

\lpll!'l v :.;, ..,. N• • 11 ... : ... . (. .. I Y

., ... ,.,, ""' . !> v ) )v NA v 1 1 ... : en ... .,,.,, ....

Hours and Shifts

Page 30: EQRS 2.0 Training - MyCROWNWeb...OCT D!o(i,-sis {l U0'3iib4208} OvPrview Form 2728 Oat.a is ~1nporarH:1 unavait.:blc. Please~/ ag.:in later. Past due 0 0 Notifit'alion" & A

0 N~twnrk lntorml'trion

t> Co11lat:l 111ro11ni1lion

0 Hours nnd .shifts

0 Backupfaclllty

Backup Facility Information

Backup facility

nacknp fad Iii i~s

oo::::is:s-::~r.1 1 ::. YALLl:.Y l)L!J.Y!:il!=­

(t \l.t:i

( Prt=-viou~. N~rt )

+ Add bad<up .., Cd it

-----·--03:2-°SS') J235.0.:4J) )5 C-5375 SU" (ITYV..'t~T ,..z

2 Fac.ility CCN #1 2 Facility NrI #l m Fadlily OBA Name #1 LI S:.e::le::ct::...:O::n:.:e~-------------------------l-lv;..JI

2 Facility CCN #2 2 Facility NP! #2 m Far.ilitv ORA N•m" #? I Select One lv l

Backup Facility

Page 31: EQRS 2.0 Training - MyCROWNWeb...OCT D!o(i,-sis {l U0'3iib4208} OvPrview Form 2728 Oat.a is ~1nporarH:1 unavait.:blc. Please~/ ag.:in later. Past due 0 0 Notifit'alion" & A

& fl.l~twork Information

(!) Ccntact lnforn1ntion

& I lours and shitts

B•ckup fa"ility

t-;:;<:iliry ~11mm111y

Backup facility

Hackup facilities

tfyou have backup fcdtity inforn1ction p~ease co111plete thi3 section. If not, you n1ay ~kip.

Skip

Si-!a11 11 by I a r:ilil•; OH.A u,un.-, ('.CN, tJl 11

Q

UCl IU:NAL ocl<VICt~ ()I 1'11 l ~~UWJH. LL(; - UAKL'-Nl! (392610 1500JGG~CO)

-·- ··-·---r· ·r-······--------.... ...,...,...,...,...,...,...,...,...,...,,.. Q

.. l'u:il ili;.;s IH<"ldy 1<1 ;-:1ld as h?"u:k11p (add up l t1 10;.il a lir110')

(!+ ;/ : 1J ( : :~N . .. .... 1 UH~V~li l)lf,I v;.;:iis

rr.1.:;

---·-·-·-

Backup Facility

Page 32: EQRS 2.0 Training - MyCROWNWeb...OCT D!o(i,-sis {l U0'3iib4208} OvPrview Form 2728 Oat.a is ~1nporarH:1 unavait.:blc. Please~/ ag.:in later. Past due 0 0 Notifit'alion" & A

OCTDL•lysb

0 Network Information

0 Contact Information

0 Certificotion

0 SC!fvJCeS lnfo11nation

0 Ownership

0 Hours and shifts

0 Bockup facility

Facility sun1mary

Facility summary QPrint page

Ac:Uons

Atteslolioos l.?

Network infotmat ion

Network:

Network~

Progr~rn typo:

Dialy•IS

F1dllty legol n1m.: OCT Dialysis

Contact informacion

FadUty physlcal addr<ss:

U345 Moin Street Pittsburgl'l. Pennsylvania

l5U2

County:

Allegheny

You haw successfully sobmin~ your facility to CMS.

Network facility cod~:

08002FO

Facility OBA n1m>:

OCT Dialysis

Facility malling address:

12345 Main Street Pittsburgh, Pennsytvanja

15122

County:

Allegheny

~ Viow lo edit

~ Vi•w to edit

Facility Data Complete

Page 33: EQRS 2.0 Training - MyCROWNWeb...OCT D!o(i,-sis {l U0'3iib4208} OvPrview Form 2728 Oat.a is ~1nporarH:1 unavait.:blc. Please~/ ag.:in later. Past due 0 0 Notifit'alion" & A

OCTDL•lysb

0 Network Information

0 Contact Information

0 Certificotion

0 SC!fvJCeS lnfo11nation

0 Ownership

0 Hours and shifts

0 Bockup facility

Facility sun1mary

Facility summary QPrint page

Ac:Uons

Atteslolioos l.?

Network infotmat ion

Network:

Network~

Progr~rn typo:

Dialy•IS

F1dllty legol n1m.: OCT Dialysis

Contact informacion

FadUty physlcal addr<ss:

U345 Moin Street Pittsburgl'l. Pennsylvania

l5U2

County:

Allegheny

You haw successfully sobmin~ your facility to CMS.

Network facility cod~:

08002FO

Facility OBA n1m>:

OCT Dialysis

Facility malling address:

12345 Main Street Pittsburgh, Pennsytvanja

15122

County:

Allegheny

~ Viow lo edit

~ Vi•w to edit

Facility Summary Screen (Actions)

Page 34: EQRS 2.0 Training - MyCROWNWeb...OCT D!o(i,-sis {l U0'3iib4208} OvPrview Form 2728 Oat.a is ~1nporarH:1 unavait.:blc. Please~/ ag.:in later. Past due 0 0 Notifit'alion" & A

• se.:iirch ract11t1es an<I Adel New raclllt-r ha·:e moveo ! •) ~

Cm""1lil <

\'le'A' t-acr!lt'/{!.Ull:JUU1Jl)

Vt'J ·" t1 l;ur11!0<, : <:R()IA'NW• +. s J 5.,•J C)

Facility Attestation

F<1dlily Allcsl.Jlioo lur OCT Didlysis (400000101)

JCll CAI lPS Atte stU'don Last Vt·ia:9d Ir/ on

O•J1i1111 U or ' d il. ib lil ;· 111:1iv:J• ( .i:., C.d~11t.1~ 1 Y~lll 2016 :., ·:l id r v..a l11d l b l1:d1. 10:1'<:!1 U•• h :!!l <:!l i ~itJI..: l'd.•i:.o b tvr l'I ~ !Cll c.:J IP~ R~v1lir•:.i

1 111:.i:mr:~"

Ye!-. I ~t<~st thH m·~· fa dl!t'( Is net ~llolbl~ fer : t! ICll C4.ll?S rteoor!lr.a me2>"\.rc t•!C~us~ It !rtn!d fewer thaB )0 ~llolbl~ padtv.s vvEr Ito: c:1u: i;:~ ol llM' c•ul iH~ d i'.tihilil >' l'l~li++tl.

No •I :~: in lhi:. 1w•1~. Uw 1:.i:w1i1111 IM41!'11l:o ;1r(! • :Kd 1Mk~! h rn11 lh c: 1:iuihl1: 11>1lk nl ' ++11111: 1; f'lo ll ic11I•; 1ml u -:::i .. ·i111J iri 11:11'1•1 h C'111:111.11, .. ;i:;

:!: l'atier1U len tt ilr Jtl years vn the l ;ist da'I cftt.e 2-ilm~!in~ •vind"'"' fur the SEmi<ir.nu~ S\.r:c·; :1: l'atier.u recai\oi l)O- hemodi;ilysis frvm tt.ci~ :urNnt facilit'!' for less dun ~ n.,ntlu ~: Patler.u rec!l-,1rK· hospk~ c2~ s: Patler.u cutrendv· resldlnc:i In an lmrtwtlvn, suet. es a res!dcntlal r urslnc:i ho-n€ c.r o-thtr lc.n.Q·tcrrn ca:e fad ll:·,-. ()r ;i 1all t• prtsc.n

y 1 Rrt1r11h'J'1 P.<irl h•llQ

... , .... "" hd .... lf "' y

Attestations

Page 35: EQRS 2.0 Training - MyCROWNWeb...OCT D!o(i,-sis {l U0'3iib4208} OvPrview Form 2728 Oat.a is ~1nporarH:1 unavait.:blc. Please~/ ag.:in later. Past due 0 0 Notifit'alion" & A

· To ftnd a s.; ve:l "actlltv, q~ tc ~dick •)O the racll't ies menu Item, an·j then sear-::h to llnd ·,-our s~·;ed fa::llltv.

PE-nonne 1 (

to•.,...&oo1t l'rell'ro?nett

v ....... 1-.7!.iMyµo<J&00101)

'.'1·i-.ru11 Hun I " ( l<UHrH\rb s 1 'i .. 1.n

IPrererences ror OCT Dialysis (400000J01J

v Method {PD): ~-P.:11ly W1:'!) '•I

P0t1lent \'telobt unit of It..:; M"'-"' 'l"r~:

I 11h IM1>1b()rl fnr ·'""" lln CK.F· l\-.1nnin:

GrR Culc.u kll iuu

A<lull r .... 1c:1• .tli•• • to:Ulo'J..l lUM~ sondarC~~d M1•1hu1I:

K.t/v Mt'thrut {HU): 1.. l~M

Pat1«1t lleloht Ur.It of NeasuN!: in

ReslduOJI Rell<ll runctlon 11.ssessed Y..::; in c;...h:11f111i~ rt.t/Y (l 'U):

1

Default Preferences

Page 36: EQRS 2.0 Training - MyCROWNWeb...OCT D!o(i,-sis {l U0'3iib4208} OvPrview Form 2728 Oat.a is ~1nporarH:1 unavait.:blc. Please~/ ag.:in later. Past due 0 0 Notifit'alion" & A

• T•:· ti rid 3 sa•;e j fa:lll!f, go to~ cU:k on the F:icl!IU:s m:flu It>:··, and t hen S.~rch to find ·:'our -;~·;e (:I fa:lltt':··

\'IYi>IQn l>;uMeH: ~r.O'/.'IHHI~ S.J.S·•,1.~

Pc:n.unnc:I Sc~n.h Rt:suhs - 19 RcLvrds round

Oorcin"'"" llPl'N ~,,, ......... ')oh((WU Fadllry N l'llllO : ••• 01'!<ri1rrtll'lh ,___ (",\~FY. H'tl ... ::-.~:;(; F .. · 1111\· {l,-;r

fl~h,~.(IT~r.l$t n1~h110!c:

("("'/JDt !>Tl''IN F¥111ty !l\-.T

~ .-.r.m1~ :m111V1r n1~1.,110!c:

rov. P.\'ll'iFl:T n;;;,.:io F .. ·111ty {l,-;r U~l\·~ ~(l$t nl~l.,11'!<:

J.:OMJS\:. I, 1-¥-il iN '>t e~t :J+::I .. , i.:.-,..-~.:-nt:i·i·1r 11i:il•,'!:i<:

Kl!H~. l :"IH!t l '; hv.il il\• :1.;:1 l()S~l>H fl~ho~~T~r.i:-t 11i:ih'!:i<:

P.O."'-l lt;"I, Ff;l' ... .'M F,v.Jlll\• !l+::T f'X"llW.:.. ll~ho--.. .. ~r.1:-r n l:il•,'!:I<:

R0.:;1:+:>, F .. · 1111\· ;)'u;ri:: · {l,-;r

""""" l'.~Ul>I\'! l>JlJ\ Uiiih~i:;

"" t-:0'.:-J lt:.>, 1-;)-;ililY :.ir: 1 OOl l"JA 1-'XIA~~_.::11lJ.i'J~ UiJl·,~i:;

1-:0-.:-1 :.t:.>, t-~:il iN '-lc·:l iu l :J•::I OOIW.:.. Ui~cto:- ui:h-::i~

Sl-\ t:M.111, ol.'1101 1-.v.il il\• :1.;:1

t!lJ;t U~h·Q~i.bl Oicl·,~i:·

;•;1 ; ;,1

;•;1 ; ;,1

F11rlltv

• ••

Personnel

Page 37: EQRS 2.0 Training - MyCROWNWeb...OCT D!o(i,-sis {l U0'3iib4208} OvPrview Form 2728 Oat.a is ~1nporarH:1 unavait.:blc. Please~/ ag.:in later. Past due 0 0 Notifit'alion" & A

'.'E~brr Numt~ · :R:\'.'NV.'~l> S.J.S-vl 5

Sys lcrn Nevi~

[!!clcomc to l:tWWNWcb!

~~le•' is a I ;tino .>f the <.:KOWl'J'•Vat fa.arure-s in this r~lea: a.. I lw ~r»ducticn cnvironman: oontains ourt•J~ cm ::~oiEd from SJM~. tM t::itl.!i Patlatit F.aolstr)' moilrulr.ed t~ the e.sR.D tter":ork~.

. u~..:1 :; ..... I !>Ii ;:!I:: w :i'-' J lcl • ;.io.hl. ~ .... , :: . ... :il. w:11 11i~ •nJ a;1i11I. i01::itily IO."C.1.>l oi:; •

. u~..:1 :; ..... I !>Ii ;:!I:: w :i'-' J ld ' ;.io.111. ..:1;1l, :;\,lb tfJil. ;,u :J :.ui11l f..i .. mlv &;t.'ll:;Q!IH(.!I r :.:o.vrd~ .

· us .. rs wl ~ ab'! to a;jmlt tc.-and dlschuoe pat!er.ts f:cm a faclllt».

· us .. rs wl ~ ab'! to a;jd. edit. ar.::1 i'L!bmlt pa!lff'I: o-EabTert r!<ur~ .

• us .. rs wl ~ ab'! to SE >i rct •. edit ;ind iubml: a pa!lmt r~oord .

• us .. rs wl ~ ab'! to E1ter lifonne'!lxi anodated • ... ·ith t1E ~7.i:O form f " cr.ltlal, $u~tl1Err1er.nl. and 1c-er.tltl .. rrent patlE·\U {lncl1Jdln.J Ir1tlal C•!el~ls, J1lt!al T:an:.,lam, !>llPP!Em .. r.tal n-al11r.:i. ~urolerr enul Transp!er.t. and r..e-entltlem!llt forms) .

• us .. rs wl ~ ab'! to E1ter a 274; fc.rm for a r,oident.

• us .. rs wl ~ ab'! to ~rlnt blank £72(; a1d 2746 ~orm: ak 1-:i \\111' « E·pcoo!ated 2723 ar.::1 27-13 form a for patlff'! !SJl'n

• Users wl bt eb:a to ve1if; patiEots ar :I patier.t <hU L&Sino ttia 1-'l .1".I femirE. CJ • Users wl bt eb:a to se11rct, add. 9Cit, end subn it d nkal lab tEU m v!ts end ·;;$:11 oi r ac.«ss infom1a ; >11 f~ ~lltiEntS-.

• Users wl bt eb:a to a;jd, adit . ar.d w!xnit fa c. litt :>rEferencas fur clinkal da!c;,

• users wl l>t eb:a to <rE :11 ta :lr :I prirA: a ~;i tiEnt ros:Er for;; faciliw.

• users wl l>t eb:a to run :'\udit re~orts for oil! dan adde:I, ui:.:la:ied, or deleted ir. t.1\IJWl'. \';eb,

Internet etpl¢rer 7 users s too:ilC varffr die kllc· ... ·1r11 wain~ befcre using GF.OWHWet-. CIOSE ell !ntemet EXJ;!orer .. 'l'frid:ov;·s a1>:1 cc~n;; ne,,..· lntemet Dpl<or~r br·w.-ser wrr.:lc-11'. Ti .. n g~ ~ TXl!s- -~. !r.tcmH Oi~tloos. select tt ! ti.;jv~r:ed tab, sc•c-11 !~ti .. !>E: urli:y * ;:rbr and tll~J rE

thE "t:n; bla l'U t 11'9 i\fo:LH I11-' s•Jppcrt" oc;ti.,n is NOi s~IE(ted . lf tile ccticn is ielectad, l~,;I )' this :hen~E, ttocn Nt•Jrn t., ttoe ll~Pli::aticn .

1

CROWN Home – EQRS tab

Page 38: EQRS 2.0 Training - MyCROWNWeb...OCT D!o(i,-sis {l U0'3iib4208} OvPrview Form 2728 Oat.a is ~1nporarH:1 unavait.:blc. Please~/ ag.:in later. Past due 0 0 Notifit'alion" & A

search rac:tl1t1es ano ~.:Id New ra:'lllty na·:e move:I t •) CQ&S

1 o fuM.l u :.;.1V1.:J fJuhLy. yv tv ~!~!~~ . 4.'lk'k vu L11·:.: tuu huc:. 111c.·11u 1tt.:·11, a uc.J th..:11 St.:J1 d 1 L'J f1ntJ yt1u1 :;;,i·;c.•;J i;.;uhL)'.

1-'1 rs.nnrn::l ..,

~

~

\.el'Sl~l'I IH.nt;ir. :.KO'/trH'Jilb s J 5.,•1 14

Seard't Per~onni":I

Persot1nel search a ·ite1·ia

% lll.st Name [ I .:i,~ rlrst ~me

'UPJN r 1 ~ ~rsonnel NPI

% J ob t itle

luh 0 1••,1 rip1iu11 ~a:ilit'!' :'ldrr.lnistrafr;a ~Jt:X:rt ra: lllty .Admlntw.e!Gr ra : lllty .Ali:Err adv~ Repres~ntatl'V! ra : lllty Chief ~~cu:t>i! officer ra : lllty C•ata c:iru :t ra : lllty C•!etltlan F;1::ililv Oi•;;1!.lc:1 C::111f;1d -h-••:ili•v 1:rih~rj,,., -

:t F.,dtil y C.C:N 'l Ft1c:ilily Nl'l1 I

F...::ilily ORA loc1 Oii ly"SiS ( '1•J<l00l)l!.;.!) N .. 0111•

%City f

~'tale Alabam.e ~ZIP code I A!.t";k;1 " .6.11w1i 1 ~10 ;~111111; : ' r.u1111lv

I .6.1i1011;1 .6.1lo .1wo.1:. (;.11il::11 ;,, v C:!'Jlr.r:i.tf,-.

I I

I

A

v

- -11!1 :t CROWN Ft11: 1 D I

H I

Facilities tab opens Search Personnel screen

Page 39: EQRS 2.0 Training - MyCROWNWeb...OCT D!o(i,-sis {l U0'3iib4208} OvPrview Form 2728 Oat.a is ~1nporarH:1 unavait.:blc. Please~/ ag.:in later. Past due 0 0 Notifit'alion" & A

Questions

Connecting the Pieces

39

Page 40: EQRS 2.0 Training - MyCROWNWeb...OCT D!o(i,-sis {l U0'3iib4208} OvPrview Form 2728 Oat.a is ~1nporarH:1 unavait.:blc. Please~/ ag.:in later. Past due 0 0 Notifit'alion" & A

For Further Information…

Help Me Form: http://help.MyCROWNWeb.org

QualityNet Help Desk: 1-866-288-8912

Website: http://www.MyCROWNWeb.org

A survey will pop up in your browser when the session ends.

Please follow the link and let us know what you think and what you would like to be covered in future Town Hall events, thank you!