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

First Round of Home Health Compare Quality of Patient Care Star Ratings Released

As required by the Affordable Care Act and to provide consumers with a summary of quality measures in an accessible format, the Centers for Medicare & Medicaid Services (CMS) has published a quality of patient care star rating for home health agencies (HHAs) on the Home Health Compare website. Star ratings are designed to help consumers more quickly identify differences in quality and make use of information when selecting a health care provider, as well as assist agencies in identifying areas for improvement. Each HHA will receive a single star rating encompassing that agency’s relative performance on nine of the 29 quality measures already posted on Home Health Compare. The measures are calculated using information from patient assessments performed by the HHA and from Medicare claims submitted by the HHA, and will be updated quarterly. In addition, CMS plans to introduce additional star ratings based on a patient experience of care survey in January 2016. For more information on home health star ratings, visit the CMS website

CHA News Article

Save the Date for CHA’s Post-Acute Care Conference

CHA’s next Post-Acute Care Conference will be held Feb. 10-12, 2016, in Redondo Beach. Save the date and plan to attend this annual event tailored to providers from across the care continuum, including medical rehabilitation, distinct-part skilled nursing and home health. Sessions will focus on innovations in care and ways to improve integration of patient services. Detailed agenda information will be available in August.

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. 

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

CMS Announces Awardees for Medicare Care Choices Model

The Centers for Medicare & Medicaid Services (CMS) has invited more than 140 Medicare-certified hospices to participate in the Medicare Care Choices Model, which is designed to evaluate whether eligible Medicare beneficiaries would elect to receive supportive care services typically provided by hospices if they also continue to receive curative services. Under the model, participating hospices will receive a monthly per-beneficiary fee to provide services that are currently available through the hospice benefit, including nursing, social work, bereavement, nutritional support and others.

To read a fact sheet about the model, including a list of participants, visit www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2015-Fact-sheets-items/2015-07-20.html.

CHA News Article

Save the Date for CHA’s Post-Acute Care Conference

CHA’s next Post-Acute Care Conference will be held Feb. 10-12, 2016, in Redondo Beach. Save the date and plan to attend this annual event tailored to providers from across the care continuum, including medical rehabilitation, distinct-part skilled nursing and home health. Sessions will focus on innovations in care and ways to improve integration of patient services. Detailed agenda information will be available in August.

CHA News Article

CHA Issues Summary of Hospice Proposed Rule

CHA has issued a summary, prepared by Health Policy Alternatives, Inc., of the Center for Medicare & Medicaid Services (CMS) federal fiscal year (FFY) 2016 hospice proposed rule. The proposed rule, available in the May 5 Federal Register, describes updates to the Medicare hospice payment rates and wage index. CMS estimates the proposed rule’s overall impact will be an increase of $200 million (1.3 percent) in Medicare payments to hospices during FFY 2016. The proposed rule intends to differentiate payments for routine home care based on a beneficiary’s length of stay and to implement a service intensity add-on payment for services provided in the final seven days of a beneficiary’s life, if certain criteria are met. The rule also proposes changes to the hospice quality reporting program and includes clarification on diagnosis reporting on the hospice claim. Comments on the proposed rule are due by June 29.

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

Save the Date for CHA’s Post-Acute Care Conference

CHA’s next Post-Acute Care Conference will be held Feb. 10-12, 2016, in Redondo Beach. Save the date and plan to attend this annual event tailored to providers from across the care continuum, including medical rehabilitation, distinct-part skilled nursing and home health. Sessions will focus on innovations in care and ways to improve integration of patient services. Detailed agenda information will be available in August.

CHA News Article

CMS Provides ICD-10-CM Information for Inpatient Rehabilitation Facilities

The Centers for Medicare & Medicaid Services has posted to its website several ICD-10-CM code files to support inpatient rehabilitation facilities (IRFs) in their preparation for the new coding system. The files contain the diagnoses and impairment group codes that will be used for determining presumptive compliance with the IRF 60-percent rule, as well as codes for tier comorbidities. 

CHA News Article

Updated IRF, LTCH PEPPER Reports Available

The Program for Evaluating Payment Patterns Electronic Report (PEPPER), with statistics through September 2014, is now available for long-term acute care hospitals (LTCHs) and inpatient rehabilitation facilities (IRFs). A hospital’s authorized representative  may download the PEPPER report through the PEPPER Resources Portal. Instructions for accessing the report are included in the Secure PEPPER Access Guide.

This release includes revisions to the methods determining the numerator and denominator for the “STACH Admissions following IRF/LTCH Discharge.” As a result, some providers will notice changes in target area percent and percentile values from the prior release.

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.

Education event

Decision Making for Unrepresented Patients Webinar
Court decision expands patient protections, prompts change in policies and procedures

October 13, 2015
10:00 a.m.  — 12:00 p.m., PT

Recently, the Alameda County Superior Court found unconstitutional a California law that permits skilled-nursing facilities (SNFs) to use interdisciplinary teams to make medical decisions for patients who lack capacity and have no one to make decisions for them. While the law applies to SNFs, many hospital interdisciplinary teams have also been operating under a CHA/CMA/ACH model policy, which is based the SNF law. Participate in this webinar to learn about this important case decision and how SNFs and hospitals should revise policies and procedures to comply.

CHA News Article

CDPH Issues Guidance on Health Care Facility License Renewal Fees

The California Department of Public Health has issued the attached All Facilities Letter (AFL) informing health care facilities of the 2015-16 license renewal fees approved by the Governor and effective July 1. The AFL contains instructions for completing a license renewal and a link to the current fee schedule.

The Center for Health Care Quality will send renewal notices/applications to each facility’s licensee 45-120 days prior to its license expiration date. Late payment penalties will be applied to delinquent renewal fees. 

CHA News Article

CDPH Issues Hot Weather Advisory for Hospitals

The California Department of Public Health (CDPH) has released the attached All Facilities Letter (AFL) as a hot weather advisory to remind health care facilities that elderly patients and individuals with high health risk are more vulnerable in extreme heat and at risk of dehydration. The advisory outlines precautionary measures and informs health care facilities that they must have a contingency plan for facilitating patient safety during fluctuating high temperatures and any loss of air conditioning. CDPH also notes that health care facilities must report emergency/disaster-related occurrences, including extreme heat conditions, that could harm a patient’s health and safety, necessary evaluation, transfer or discharge. 

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.

Education event

Decision Making for Unrepresented Patients Webinar
Court decision expands patient protections, prompts change in policies and procedures

October 13, 2015
10:00 a.m.  — 12:00 p.m., PT

Recently, the Alameda County Superior Court found unconstitutional a California law that permits skilled-nursing facilities (SNFs) to use interdisciplinary teams to make medical decisions for patients who lack capacity and have no one to make decisions for them. While the law applies to SNFs, many hospital interdisciplinary teams have also been operating under a CHA/CMA/ACH model policy, which is based the SNF law. Participate in this webinar to learn about this important case decision and how SNFs and hospitals should revise policies and procedures to comply.

CHA News Article

CMS Proposes Updates to SNF Regulations

The Centers for Medicare & Medicaid Services (CMS) has released the attached proposed rule, revising and updating the conditions of participation for skilled-nursing facilities (SNFs). The proposals include a requirement to develop and implement effective discharge planning processes, as well as establish a quality assurance and performance improvement program, and new requirements for behavioral health services and staff training.

CHA will provide a summary of the proposed rule to members. Comments are due to CMS by Sept. 14 at 2 p.m. (PT).   

CHA News Article

CDPH Issues Guidance on Health Care Facility License Renewal Fees

The California Department of Public Health has issued the attached All Facilities Letter (AFL) informing health care facilities of the 2015-16 license renewal fees approved by the Governor and effective July 1. The AFL contains instructions for completing a license renewal and a link to the current fee schedule.

The Center for Health Care Quality will send renewal notices/applications to each facility’s licensee 45-120 days prior to its license expiration date. Late payment penalties will be applied to delinquent renewal fees. 

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

CDPH Issues Guidance on Health Care Facility License Renewal Fees

The California Department of Public Health has issued the attached All Facilities Letter (AFL) informing health care facilities of the 2015-16 license renewal fees approved by the Governor and effective July 1. The AFL contains instructions for completing a license renewal and a link to the current fee schedule.

The Center for Health Care Quality will send renewal notices/applications to each facility’s licensee 45-120 days prior to its license expiration date. Late payment penalties will be applied to delinquent renewal fees. 

CHA News Article

Save the Date for CHA’s Post-Acute Care Conference

CHA’s next Post-Acute Care Conference will be held Feb. 10-12, 2016, in Redondo Beach. Save the date and plan to attend this annual event tailored to providers from across the care continuum, including medical rehabilitation, distinct-part skilled nursing and home health. Sessions will focus on innovations in care and ways to improve integration of patient services. Detailed agenda information will be available in August.

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.

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