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

CMS Announces 2 Quality Improvement Initiatives

The Centers for Medicare & Medicaid Services (CMS) has announced two initiatives addressing quality improvement in post-acute care settings. Beginning in 2015, CMS will implement improvements to the nursing home five-star rating system, including the development of a process to collect and audit payroll data to monitor staffing, changes in scoring methodology and the addition of new quality measures addressing the use of anti-psychotic medications and re-hospitalization rates. CMS also announced it is proposing new conditions of participation (COPs) for home health agencies in an effort to update and modernize the COPs, with a focus on patient-centered, coordinated care. The proposed regulation was published in the Oct. 9 Federal Register

CHA News Article

Post-Acute Care Bill Signed Into Law

On Oct. 6, President Obama signed into law the Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014. The bipartisan bill was designed to increase quality, transparency and accountability in post-acute care for Medicare beneficiaries. The Act would require post-acute care providers — including long-term acute care hospitals, inpatient rehabilitation facilities, skilled-nursing facilities and home health agencies — to collect and report standardized assessment data as a first step in developing recommendations for alternative post-acute care payment models. Additionally, the legislation includes new survey and medical review requirements for hospices. These provisions will be implemented between 2016 and 2022. A copy of the bill is available at www.congress.gov/113/bills/s2553/BILLS-113s2553is.pdf. CHA has also created the attached summary of the bill.  

CHA News Article

Ordering and Referring Denial Edits Will Apply to Certifying HHA Physicians
Implementation to begin July 7

Beginning July 7, the Centers for Medicare & Medicaid Services will apply phase 2 ordering and referring denial edits to certifying physicians of Part A home health agencies (HHAs).

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

Post-Acute Care Bill Signed Into Law

On Oct. 6, President Obama signed into law the Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014. The bipartisan bill was designed to increase quality, transparency and accountability in post-acute care for Medicare beneficiaries. The Act would require post-acute care providers — including long-term acute care hospitals, inpatient rehabilitation facilities, skilled-nursing facilities and home health agencies — to collect and report standardized assessment data as a first step in developing recommendations for alternative post-acute care payment models. Additionally, the legislation includes new survey and medical review requirements for hospices. These provisions will be implemented between 2016 and 2022. A copy of the bill is available at www.congress.gov/113/bills/s2553/BILLS-113s2553is.pdf. CHA has also created the attached summary of the bill.  

CHA News Article

CMS Issues Final Rule for FFY 2015 Medicare Hospice Wage Index and Payment Rates

On Aug. 1, the Centers for Medicare & Medicaid Services (CMS) issued a final rule to update the Medicare hospice payment rates and wage index for federal fiscal year (FFY) 2015.

CHA News Article

Registration for Hospice Item Set User IDs Now Available

Online registration for the Hospice Item Set (HIS) Quality Improvement and Evaluation System (QIES) Assessment Submission and Processing system is now available.

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

Open Door Forum Scheduled for IRF Quality Reporting Program

The Centers for Medicare & Medicaid Services (CMS) will host a conference call on the inpatient rehabilitation facility (IRF) quality reporting program (QRP) on Oct. 29 from 10 a.m. – 11:30 a.m. (PT). Information on data collection and reporting requirements for the NHSN Facility-wide Inpatient Hospital-onset Methicillin-resistant Staphylococcus aureus Bacteremia Outcome measure (NQF #1716) and Facility-wide Inpatient Hospital-onset Clostridium difficile Infection Outcome measure (NQF #1717) will be provided, which IRFs are required to report to CMS beginning Jan. 1, 2015. A question-and-answer session will follow the presentation.

CHA News Article

New IRF PAI Training Manual Available From CMS

The Centers for Medicare & Medicaid Services (CMS) has released the new Inpatient Rehabilitation Facility Patient Assessment Instrument (IRF PAI) training manual. The revised manual, attached, offers instructions for completing IRF PAIs submitted on or after Oct. 1, and includes information about reporting quality measures and pressure ulcers. CMS plans to issue additional manual revisions in the future to address changes that will be required beginning Oct. 1, 2016. More information about the IRF PAI is available on the CMS website.

CHA News Article

NHSN Issues Guidance on Reporting Requirements for IRFs and LTCHs
Information specific to MRSA and CDI reporting

The National Health Safety Network (NHSN) has issued information on new reporting requirements for inpatient rehabilitation facilities (IRFs) and long-term acute care hospitals (LTCHs). Beginning Jan. 1, 2015, all IRFs and LTCHs — both free-standing and units within affiliated acute care facilities — will begin reporting facility-wide inpatient  Methicillin-resistant Staphylococcus aureus (MRSA) blood specimen and Clostridium difficile infection (CDI) laboratory-identified event data to NHSN. Operational guidance documents detailing the reporting requirements will be posted in the coming months at www.cdc.gov/nhsn/cms/index.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 Guidance Focuses on New LTCH Moratorium

The Centers for Medicare & Medicaid Services (CMS) has issued guidance on its moratorium on new and satellite long-term care hospitals (LTCH). The moratorium prohibits an increase in the number of an LTCH’s certified beds, effective April 1, 2014, through Sept. 30, 2017. According to the attached memo, CMS regional offices will be charged with determining if a hospital seeking to convert to LTCH status or to open an LTCH satellite will qualify for an exemption.

CHA News Article

NHSN Issues Guidance on Reporting Requirements for IRFs and LTCHs
Information specific to MRSA and CDI reporting

The National Health Safety Network (NHSN) has issued information on new reporting requirements for inpatient rehabilitation facilities (IRFs) and long-term acute care hospitals (LTCHs). Beginning Jan. 1, 2015, all IRFs and LTCHs — both free-standing and units within affiliated acute care facilities — will begin reporting facility-wide inpatient  Methicillin-resistant Staphylococcus aureus (MRSA) blood specimen and Clostridium difficile infection (CDI) laboratory-identified event data to NHSN. Operational guidance documents detailing the reporting requirements will be posted in the coming months at www.cdc.gov/nhsn/cms/index.html.

CHA News Article

Post-Acute Care Bill Signed Into Law

On Oct. 6, President Obama signed into law the Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014. The bipartisan bill was designed to increase quality, transparency and accountability in post-acute care for Medicare beneficiaries. The Act would require post-acute care providers — including long-term acute care hospitals, inpatient rehabilitation facilities, skilled-nursing facilities and home health agencies — to collect and report standardized assessment data as a first step in developing recommendations for alternative post-acute care payment models. Additionally, the legislation includes new survey and medical review requirements for hospices. These provisions will be implemented between 2016 and 2022. A copy of the bill is available at www.congress.gov/113/bills/s2553/BILLS-113s2553is.pdf. CHA has also created the attached summary of the bill.  

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

CMS Announces 2 Quality Improvement Initiatives

The Centers for Medicare & Medicaid Services (CMS) has announced two initiatives addressing quality improvement in post-acute care settings. Beginning in 2015, CMS will implement improvements to the nursing home five-star rating system, including the development of a process to collect and audit payroll data to monitor staffing, changes in scoring methodology and the addition of new quality measures addressing the use of anti-psychotic medications and re-hospitalization rates. CMS also announced it is proposing new conditions of participation (COPs) for home health agencies in an effort to update and modernize the COPs, with a focus on patient-centered, coordinated care. The proposed regulation was published in the Oct. 9 Federal Register

CHA News Article

Post-Acute Care Bill Signed Into Law

On Oct. 6, President Obama signed into law the Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014. The bipartisan bill was designed to increase quality, transparency and accountability in post-acute care for Medicare beneficiaries. The Act would require post-acute care providers — including long-term acute care hospitals, inpatient rehabilitation facilities, skilled-nursing facilities and home health agencies — to collect and report standardized assessment data as a first step in developing recommendations for alternative post-acute care payment models. Additionally, the legislation includes new survey and medical review requirements for hospices. These provisions will be implemented between 2016 and 2022. A copy of the bill is available at www.congress.gov/113/bills/s2553/BILLS-113s2553is.pdf. CHA has also created the attached summary of the bill.  

CHA News Article

CMS Announces New Goal to Reduce Use of Antipsychotic Medications in Nursing Homes

The National Partnership to Improve Dementia Care, a public-private coalition, has established a new national goal of reducing the use of antipsychotic medications in long-stay nursing home residents by 25 percent by the end of 2015, and by 30 percent by the end of 2016. The coalition includes the Centers for Medicare & Medicaid Services (CMS), consumers, advocacy organizations, providers and professional associations. Between the end of 2011 and the end of 2013, the national prevalence of antipsychotic use in long-stay nursing home residents was reduced by 15.1 percent, decreasing from 23.8 percent to 20.2 percent nationwide. The National Partnership is now working with nursing homes to reduce that rate even further.

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

CMS Announces 2 Quality Improvement Initiatives

The Centers for Medicare & Medicaid Services (CMS) has announced two initiatives addressing quality improvement in post-acute care settings. Beginning in 2015, CMS will implement improvements to the nursing home five-star rating system, including the development of a process to collect and audit payroll data to monitor staffing, changes in scoring methodology and the addition of new quality measures addressing the use of anti-psychotic medications and re-hospitalization rates. CMS also announced it is proposing new conditions of participation (COPs) for home health agencies in an effort to update and modernize the COPs, with a focus on patient-centered, coordinated care. The proposed regulation was published in the Oct. 9 Federal Register

CHA News Article

CDPH Requires New POLST Form After Oct. 1

The California Department of Public Health (CDPH) has issued an All Facility Letter (AFL) to skilled-nursing facilities updating the Physician Orders for Life Sustaining Treatment (POLST) form and providing guidance in coding the revised sections of Minimum Data Set 3.0 “Section S.” The new form will be effective Oct. 1. CDPH will honor previous versions after Oct. 1, but only for preexisting POLSTs. New submissions after Oct. 1 must use the new form. For more information, see the attached AFL.

CHA News Article

CDPH Warns Against Overuse of Antipsychotics in Nursing Facilities

The California Department of Public Health (CDPH) has issued an All Facility Letter (AFL) to skilled-nursing facilities and nursing facilities urging a vigilant effort to curb non-medically necessary prescriptions of antipsychotics and their misuse. CDPH highlights studies that show over-prescribing antipsychotics in nursing homes can place residents at increased risk of death. CDPH also urges facilities to review their practices, ensuring that each antipsychotic prescription is necessary and that all requirements related to their use are met. For more information, see the attached AFL.

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