Post-Acute Care

Overview

Home Health

Home health care is a formal, regulated program of care delivered by a variety of health care professionals in the patient’s home for the treatment of a medical condition, illness or disability. Home health is provided through certified home health agencies (HHAs).

As components of the post-acute continuum of care, HHAs provide essential health care services. This specialized support allows patients to remain at home when they would otherwise have to be admitted to a costly institutional setting, such as a skilled-nursing facility or hospital.

CHA provides state and federal representation and advocacy in the legislative and regulatory arenas to improve access to quality, cost-effective home health care services.

CHA News Article

Five-Star Ratings Announced for Home Health
CMS will host provider webinar

The Centers for Medicare & Medicaid Services (CMS) has finalized the methodology for a star ratings program to be added to the Home Health Compare (HHC) website. HHC star ratings will be published beginning in July, and preview reports will be available to providers in late March or early April. CMS will hold a webinar March 26 at 10 a.m. (PT) to review the report format as well as the process for requesting review of star ratings. To register for the webinar, visit www.livemeeting.com/lrs/8000055450/Registration.aspx?pageName=h1m25cfj95z4zdq0. Additional information on HHC star ratings is available on the HHC website. A document addressing frequently asked questions is attached. 

CHA News Article

CMS to Host Open Door Forum on Star Ratings for Home Health Agencies
Call scheduled for Feb. 5 at 10:30 a.m. (PT)

The Centers for Medicare & Medicaid Services (CMS) will host an open door forum on the planned addition of star ratings to the Home Health Compare website. On the call, set for Feb. 5 from 10:30 a.m. – noon (PT), CMS will present its revised methodology for the star ratings and describe its plans for implementation of the rating system. CMS held a previous open door forum on the subject in December, and the materials from that presentation are available on the CMS website. To participate in the Feb. 5 call, dial (800) 837-1935 and enter conference ID 73412220. More information is available at the Home Health Quality Initiative website.

CHA News Article

DHCS Provides Details on Hospice Face-to-Face Requirement

The Department of Health Care Services (DHCS) has provided updated information about new requirements for a face-to-face encounter as part of determining eligibility for hospice services. Effective Feb. 1, a hospice physician or nurse practitioner is required to have a face-to-face encounter with every hospice patient to determine the continued eligibility of that patient. The face-to-face encounter must occur not more than 30 calendar days prior to the start of the third benefit period and every subsequent period. The written attestation by the practitioner performing the encounter must be a separate and distinct section or addendum to the recertification form, and must include specified elements. Additional information is available on the DHCS provider update web page.

Overview

Hospice

Hospice provides comprehensive and interdisciplinary health care to terminally ill patients, as well as bereavement and support services to the patients’ loved ones. Patients receiving hospice care forgo curative treatments. Hospice care is provided through certified hospice programs, and may be delivered in any patient care setting, but is most often provided in the patient’s home.

CHA provides state and federal representation and advocacy in the legislative and regulatory arenas to improve access to quality, cost-effective hospice health care services.
 

CHA News Article

IOM to Host National Conference on End-of-Life Policy

The Institute of Medicine (IOM) will convene health leaders, policymakers and other stakeholders at a conference to discuss recommendations from its report Dying in America: Improving Quality and Honoring Individual Preferences Near the End of Life. The conference, to be held March 20 in Washington, D.C., will include panel discussions on implementation opportunities and challenges for health care providers, payment policies and other national policy issues. Participants may attend the free event in person or by live webcast. Organizations that have undertaken action related to the report’s recommendations are encouraged to submit statements prior to the conference. For more information and to register, visit the IOM conference web page.

CHA News Article

DHCS Provides Details on Hospice Face-to-Face Requirement

The Department of Health Care Services (DHCS) has provided updated information about new requirements for a face-to-face encounter as part of determining eligibility for hospice services. Effective Feb. 1, a hospice physician or nurse practitioner is required to have a face-to-face encounter with every hospice patient to determine the continued eligibility of that patient. The face-to-face encounter must occur not more than 30 calendar days prior to the start of the third benefit period and every subsequent period. The written attestation by the practitioner performing the encounter must be a separate and distinct section or addendum to the recertification form, and must include specified elements. Additional information is available on the DHCS provider update web page.

CHA News Article

CHA Center for Post-Acute Care Announces 2015 Officers

The CHA Center for Post-Acute Care has announced its leadership team for 2015. Mivic Hirose, administrative director, Laguna Honda Hospital and Rehabilitation Center, will assume the position of chair. Pamela Chevreaux, vice president for ambulatory services, Long Beach Memorial Hospital, has been appointed to serve as chair-elect. Hirose and Chevreaux will represent the Center on the CHA Board of Trustees.

The CHA Center for Post-Acute Care was established in 2011 to serve the needs of CHA members at all levels of the post-acute care continuum, including inpatient rehabilitation facilities, long-term acute care hospitals, skilled-nursing facilities and home health agencies.

Overview

Inpatient Rehabilitation & Therapy Services

Medical rehabilitation focuses on improving or restoring functional independence for individuals with disabilities resulting from injury, illness or a medical condition.

Medical rehabilitation is provided at all levels of the health care continuum, including general acute-care hospitals, inpatient rehabilitation facilities (IRFs), skilled-nursing facilities, long-term-care hospitals, outpatient programs and home health agencies.

CHA News Article

CMS Provides Guidance for IRF-PAI Completion

The Centers for Medicare & Medicaid Services (CMS) has provided additional information and resources to educate providers on how to complete new items on the inpatient rehabilitation facility patient assessment instrument. The new items, which will become effective Oct. 1, include data collection on the amount and mode of therapy services and information about patients with an arthritis diagnosis. CMS held a provider call about the new items Jan. 15, and materials from that call along with a follow-up clarification document are attached. An audio recording of the call is also available on the National Provider Call website.

CHA News Article

CMS Announces DMEPOS Competitive Bidding Timeline

The Centers for Medicare & Medicaid Services (CMS) has announced the bidding timeline for round 2 recompete of the Medicare Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) competitive bidding program. The deadline for suppliers to submit bids is March 25. CMS will announce contract suppliers in 2016.

Numerous CHA member hospitals have reported difficulty obtaining DME for Medicare patients since the implementation of the competitive bidding program in 2013. CHA has been in ongoing communication with representatives of Palmetto GBA, the California competitive bidding implementation contractor, as well as with staff of CMS Region IX and the Medicare Payment Advisory Commission. CHA encourages members to continue to report problems and concerns to Palmetto and to CHA. For additional information, contact CHA.

CHA News Article

Updated IRF-PAI Information Available

The Centers for Medicare & Medicaid Services (CMS) has added information to Section 2 of the inpatient rehabilitation facility patient assessment instrument (IRF-PAI) training manual, as provided for in the fiscal year (FY) 2015 IRF prospective payment system final rule. The new IRF-PAI items – effective Oct. 1, 2015 – include Arthritis Attestation (item 24A) and Therapy Information Section (items O0401 and O0402). CMS has also made changes to the manual’s Helpful Resources document. The updated IRF-PAI training manual is available on the CMS website.

CMS will hold a national provider call on this information Jan. 15 from 10:30 a.m. – noon (PT). For additional information and to register, visit www.cms.gov/Outreach-and-Education/Outreach/NPC/National-Provider-Calls-and-Events.html.

Overview

Long-Term-Care Hospitals

Long-term-care hospitals (LTCHs) provide hospital-level care for medically complex, long-stay patients. LTCHs meet the same requirements as general acute-care hospitals, but have significantly longer average lengths of stay of 25 days or greater. LTCHs may be freestanding facilities or be co-located within hospitals, and treat a wide variety of conditions, including respiratory failure with ventilator dependency, infections, complex wounds and trauma.

CHA provides state and federal representation and advocacy in the legislative and regulatory arenas to improve access to quality, cost-effective long-term health care services.

CHA News Article

CMS to Release Corrected LTCH Quality Reports

The Centers for Medicare & Medicaid Services (CMS) has released the long-term care hospital (LTCH) preliminary review reports, which display quality measure data calculations for LTCH quality reporting program data collected and submitted to CMS between Jan. 1 and Sept. 30, 2014. CMS discovered an error in the data displayed for the hospital associated infection measure calculations, and has removed those reports from the LTCH provider CASPER folders. They will be corrected and replaced as soon as possible. 

CHA News Article

CHA Center for Post-Acute Care Announces 2015 Officers

The CHA Center for Post-Acute Care has announced its leadership team for 2015. Mivic Hirose, administrative director, Laguna Honda Hospital and Rehabilitation Center, will assume the position of chair. Pamela Chevreaux, vice president for ambulatory services, Long Beach Memorial Hospital, has been appointed to serve as chair-elect. Hirose and Chevreaux will represent the Center on the CHA Board of Trustees.

The CHA Center for Post-Acute Care was established in 2011 to serve the needs of CHA members at all levels of the post-acute care continuum, including inpatient rehabilitation facilities, long-term acute care hospitals, skilled-nursing facilities and home health agencies.

CHA News Article

New AFL Focuses on Patients’ Nutritional Needs

The attached All Facilities Letter (AFL) from the California Department of Public Health reminds providers that patients’ nutritional needs should be met through menu development according to physicians’ diet orders and in coordination with each facility’s diet manual. The AFL explains how facility diet manuals should be used and developed, and addresses the issue of recommended dietary allowances in patients’ diets. The AFL, which supersedes AFL 13-11, also clarifies the intent of disaster menu planning.

Overview

Skilled Nursing Facilities / Distinct Part Nursing Facilities

Skilled-nursing facilities (SNFs) have the staff and equipment to provide skilled nursing, medical management and therapy services to individuals, on a 24-hour basis, who do not require high-intensity services provided in the hospital setting.

CHA News Article

CDPH Issues SNF Change of Ownership Notification Requirements

The California Department of Public Health (CDPH) has issued the attached All Facilities Letter, which provides notification to skilled-nursing facilities (SNFs) about state and federal requirements for reporting a change of ownership. State law requires SNFs to submit a new licensing application for any change of ownership, subject to the full application review and approval process. Additionally, federal law requires certified SNFs to notify CDPH within 35 days after any change of ownership of the disclosing entity, a fiscal agent or the managed care entity. 

CHA News Article

CMS Announces Changes to SNF Five-Star Rating Program

The Centers for Medicare & Medicaid Services (CMS) recently announced changes to the five-star quality rating system for skilled-nursing facilities (SNFs) on the Nursing Home Compare website. The changes are aimed at providing more precise and meaningful quality information.

Effective Feb. 20, the SNF star rating will:

  • Include use of antipsychotics in its calculation;
  • Have improved calculations for staffing levels; and
  • Reflect higher standards for nursing homes to achieve high ratings on the quality measure dimension.

CMS estimates that, because the standards for performance on quality measures are increasing, approximately two-thirds of SNFs will see a decline in their quality measures rating and about one-third will experience a decline in their overall five-star rating. Additional information is available on the CMS website.

CHA News Article

DHCS Issues Managed Medi-Cal SNF Information for CCI Counties

The Department of Health Care Services has released the attached all plan letter (APL). The letter clarifies the responsibilities of Medi-Cal managed care health plans to provide coverage of nursing facility services under the Coordinated Care Initiative for beneficiaries who are not enrolled in Cal MediConnect. The APL includes information on payment rates and policies, timelines and continuity of care. 

Overview

Subacute Care

Subacute-care units provide a specialized level of care to medically fragile patients. Subacute patients are individuals who do not need acute care, but who are too ill to be cared for by most skilled-nursing facilities. Frequently, these individuals are ventilator-dependent or require frequent respiratory treatments. While subacute beds are licensed as skilled-nursing beds, they are reimbursed differently and are subject to additional staffing and patient criteria requirements.

CHA provides state and federal representation and advocacy in the legislative and regulatory arenas to improve access to quality, cost-effective subacute-care services.

CHA News Article

CHA Center for Post-Acute Care Announces 2015 Officers

The CHA Center for Post-Acute Care has announced its leadership team for 2015. Mivic Hirose, administrative director, Laguna Honda Hospital and Rehabilitation Center, will assume the position of chair. Pamela Chevreaux, vice president for ambulatory services, Long Beach Memorial Hospital, has been appointed to serve as chair-elect. Hirose and Chevreaux will represent the Center on the CHA Board of Trustees.

The CHA Center for Post-Acute Care was established in 2011 to serve the needs of CHA members at all levels of the post-acute care continuum, including inpatient rehabilitation facilities, long-term acute care hospitals, skilled-nursing facilities and home health agencies.

CHA News Article

California MDS Newsletter Available

The California Department of Public Health (CDPH) has issued the attached All Facilities Letter (AFL) to inform skilled-nursing facilities that the October edition of the Minimum Data Set (MDS) newsletter, California MDS Nuggets, is now available. The AFL also notes that the October issue includes information on MDS 3.0 Sections “S” and “Q,” a link to the new Physician Order for Life-Sustaining Treatment form, the new change of therapy other Medicare required assessment, and other topics. A copy of the newsletter is attached. 

CHA News Article

CDPH Issues AFL on New Law for Optional Services in Federally Certified and Skilled-Nursing Facilities

The California Department of Public Health (CDPH) has issued an All Facilities Letter superseding its AFL 13-19. Beginning Jan. 1, 2015, occupational therapy, physical therapy, speech pathology and audiology services will no longer be considered special services — also known as optional services — when provided to inpatients of federally certified nursing facilities or skilled-nursing facilities. However, the services will still be considered optional as they pertain to non-residents on an outpatient basis. It is important to note that physical therapy, occupational therapy, speech pathology and audiology, social work and special treatment program services in licensed-only skilled-nursing facilities will continue to be considered optional services by the CDPH Licensing and Certification Program. For more information, see the attached AFL.

Commands