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

Upcoming Call to Address IMPACT Act for Patients and Families
CMS to host call May 12 from 11 a.m. – noon (PT)

The Centers for Medicare & Medicaid Services (CMS) will host a special open door forum to allow patients, families, caregivers, patient advocacy groups, disabled groups and other interested parties to ask questions on the Improving Medicare Post-Acute Care Transformation (IMPACT) Act. The call will also provide a forum for questions on standardizing the assessment of patients across post-acute care settings, including skilled-nursing facilities, home health agencies, inpatient rehabilitation facility hospitals and long-term care acute hospitals. CMS will provide background on the IMPACT Act, the IMPACT Act website and other consumer information important for assessing patients in the post-acute care setting. To join the foum, participants should call (800) 837-1935 and enter conference ID #77707137.

Presentation slides will  be posted to the IMPACT Act Downloads & Videos web page. CMS invites questions from patients, families and consumer advocates in advance of or during the forum. Questions may be submitted to PACQualityInitiative@cms.hhs.gov.

CHA News Article

CDPH Reviews Criminal Background Requirements for Home Health Agencies
Issues AFL for HHAs participating in Medi-Cal

The California Department of Public Health (CDPH) has issued the attached All Facilities Letter (AFL), which reviews fingerprint submission and criminal background check requirements for home health agencies licensed by CDPH and participating in the Medi-Cal program. A criminal record clearance, including fingerprinting, is required for individual owners, administrators and administrator designees. If the owner of a home health agency is a corporation, partnership or association, the clearance and fingerprinting are required for any person having a 10 percent or greater interest in that corporation, partnership or association. CDPH notes that the AFL is a final request to individuals who have not yet submitted fingerprints as required.

CHA News Article

CMS to Host Call on IMPACT Act Data Elements
Call to be held April 14, 11 a.m.-noon (PT)

The Centers for Medicare & Medicaid Services (CMS) will conduct a call on the data element library that is being developed to meet the Improving Medicare Post-Acute Care Transformation (IMPACT) Act’s requirements that post-acute care providers report standardized and interoperable patient assessment data. The requirements apply to inpatient rehabilitation facilities, long-term care hospitals, skilled-nursing facilities and home health agencies and are intended to allow for the exchange and use of data to facilitate coordinated care and improved outcomes.

The call will be held April 14 from 11 a.m. to noon (PT), and will include a question-and-answer session as well as an opportunity to provide feedback. To register, visit MLN Connects Event Registration. Space may be limited; early registration is advised.  

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 Issues Proposed Updates to the Wage Index and Payment Rates for Hospice

The Centers for Medicare & Medicaid Services (CMS) issued the attached proposed rule that would update fiscal year (FY) 2017 Medicare payment rates and the wage index for hospices. CMS proposes a 2 percent ($330 million) increase in its payments for FY 2017, based on an estimated 2.8 percent inpatient hospital market basket update, reduced by a 0.5 percentage point productivity adjustment and a 0.3 percentage point adjustment set by the Affordable Care Act. CMS also implements changes required by the Improving Medicare Post-Acute Care Transformation (IMPACT) Act. The hospice cap amount for the 2017 cap year will be $28,377.17.  

CHA News Article

PEPPER Provider Webinars Scheduled

Several provider-specific webinars on the Program for Evaluating Payment Patterns Electronic Report have been scheduled. The webinars will provide updates on changes in the fourth quarter fiscal year 2015 reports, which are scheduled for release in mid-April. The webinar schedule is outlined below.

CHA News Article

End of Life Option Act Becomes Effective June 9
Comprehensive resources available

The End of Life Option Act permits an adult with a terminal disease and the mental capacity to make health care decisions to request and be prescribed an aid-in-dying drug if specified conditions are met. This week, the Legislature adjourned the Special Session on Public Health and Developmental Services, giving the End of Life Option Act an effective date of June 9.

Last month, CHA issued guidelines for hospitals about the Act, including a comprehensive document describing the requirements and options under the law, and  a recording, available for purchase, of a webinar that provides an overview.

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 Increases Access to Training on IRF Quality Reporting Program
Will focus on IRF-PAI version 1.4 and other reporting requirements

The Centers for Medicare & Medicaid Services (CMS) has announced that provider training for the inpatient rehabilitation facility (IRF) quality reporting program, to be held May 18-19, will be available via live web streaming. Additionally, recordings of the training sessions will be posted to the CMS YouTube site several weeks after the event. Copies of presentation materials and the agenda for the two-day training have been posted to the CMS website. The link to the files is located at the bottom of the page under “Downloads.”

The focus of the upcoming train-the-trainer event is to provide IRFs with assessment-based data collection instructions and updates associated with the changes in the Oct. 1, 2016 release of the IRF Patient Assessment Instrument (IRF-PAI) version 1.4, as well as other requirements of the IRF Quality Reporting program. 

CHA News Article

Upcoming Call to Address IMPACT Act for Patients and Families
CMS to host call May 12 from 11 a.m. – noon (PT)

The Centers for Medicare & Medicaid Services (CMS) will host a special open door forum to allow patients, families, caregivers, patient advocacy groups, disabled groups and other interested parties to ask questions on the Improving Medicare Post-Acute Care Transformation (IMPACT) Act. The call will also provide a forum for questions on standardizing the assessment of patients across post-acute care settings, including skilled-nursing facilities, home health agencies, inpatient rehabilitation facility hospitals and long-term care acute hospitals. CMS will provide background on the IMPACT Act, the IMPACT Act website and other consumer information important for assessing patients in the post-acute care setting. To join the foum, participants should call (800) 837-1935 and enter conference ID #77707137.

Presentation slides will  be posted to the IMPACT Act Downloads & Videos web page. CMS invites questions from patients, families and consumer advocates in advance of or during the forum. Questions may be submitted to PACQualityInitiative@cms.hhs.gov.

CHA News Article

CMS Issues Inpatient Rehabilitation Facility PPS Proposed Rule

The Centers for Medicare & Medicaid Services (CMS) has issued the attached proposed rule for the federal fiscal year (FFY) 2017 inpatient rehabilitation facility prospective payment system (IRF PPS). CMS proposes a rate update of 1.45 percent, reflecting a 2.7 percent specific market basket update increase, reduced by a 0.5 percent productivity adjustment and the mandated 0.75 percent reduction. CMS estimates that aggregate payments to IRFs will increase 1.6 percent, or $125 million, as compared to payments in FFY 2016.

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

Upcoming Call to Address IMPACT Act for Patients and Families
CMS to host call May 12 from 11 a.m. – noon (PT)

The Centers for Medicare & Medicaid Services (CMS) will host a special open door forum to allow patients, families, caregivers, patient advocacy groups, disabled groups and other interested parties to ask questions on the Improving Medicare Post-Acute Care Transformation (IMPACT) Act. The call will also provide a forum for questions on standardizing the assessment of patients across post-acute care settings, including skilled-nursing facilities, home health agencies, inpatient rehabilitation facility hospitals and long-term care acute hospitals. CMS will provide background on the IMPACT Act, the IMPACT Act website and other consumer information important for assessing patients in the post-acute care setting. To join the foum, participants should call (800) 837-1935 and enter conference ID #77707137.

Presentation slides will  be posted to the IMPACT Act Downloads & Videos web page. CMS invites questions from patients, families and consumer advocates in advance of or during the forum. Questions may be submitted to PACQualityInitiative@cms.hhs.gov.

CHA News Article

CMS Issues Interim Final Rule for LTCHs
Comments due June 17

The Centers for Medicare & Medicaid Services (CMS) has issued the attached interim final rule to implement section 231 of the Consolidated Appropriations Act of 2016, which establishes a temporary exception for certain wound care discharges from the site-neutral payment rate for certain long-term acute care hospitals (LTCHs). The interim final rule, which was released in conjunction with the LTCH prospective payment system proposed rule, will be open for public comment through June 17.

In the rule, CMS establishes that a rural LTCH that “participated in Medicare as an LTCH and was co-located with another hospital as of September 30, 1995, that currently meets the requirements of section 412.22(f) of the Social Security Act” qualifies for relief. The relief applies to patients who received treatment in the LTCH for “severe wound” cases and were discharged prior to Jan. 1, 2017.

CHA News Article

Revised LTCH PPS Booklet Available

The Centers for Medicare and Medicaid Services (CMS) has issued the attached materials on the long-term care hospital (LTCH) prospective payment system, including updated information about LTCH certification, patient classification, the new site-neutral payment rate, payment policy adjustments and payment updates, and the LTCH quality reporting program. 

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

New Issue of California Minimum Data Set Newsletter Available

The California Minimum Data Set newsletter is now available on the California Department of Public Health’s website. The current issue includes:

  • Revised Resident Assessment Instrument 3.0 User’s Manual, v1.13
  • Change of Therapy Other Medicare Required Assessment
  • Changes to the Practitioner Orders for Life-Sustaining Treatment form, which took effect Jan. 1
  • Department of Health Care Services Pre-Admission Screening and Resident Review online training information
  • An excerpt from the Minimum Data Set and Staffing Focus Survey
  • International Classification of Diseases (ICD-10) links and resource information
CHA News Article

Upcoming Call to Address IMPACT Act for Patients and Families
CMS to host call May 12 from 11 a.m. – noon (PT)

The Centers for Medicare & Medicaid Services (CMS) will host a special open door forum to allow patients, families, caregivers, patient advocacy groups, disabled groups and other interested parties to ask questions on the Improving Medicare Post-Acute Care Transformation (IMPACT) Act. The call will also provide a forum for questions on standardizing the assessment of patients across post-acute care settings, including skilled-nursing facilities, home health agencies, inpatient rehabilitation facility hospitals and long-term care acute hospitals. CMS will provide background on the IMPACT Act, the IMPACT Act website and other consumer information important for assessing patients in the post-acute care setting. To join the foum, participants should call (800) 837-1935 and enter conference ID #77707137.

Presentation slides will  be posted to the IMPACT Act Downloads & Videos web page. CMS invites questions from patients, families and consumer advocates in advance of or during the forum. Questions may be submitted to PACQualityInitiative@cms.hhs.gov.

CHA News Article

CMS Adds Six New Quality Measures to Nursing Home Compare

The Centers for Medicare & Medicaid Services (CMS) has announced the addition of six new quality measures to its Nursing Home Compare website. Three of the new measures — rate of rehospitalization, emergency room use and community discharge among nursing home residents — are based on Medicare-claims data submitted by hospitals, marking the first time CMS has included quality measures not solely based on data that are self-reported by nursing homes. These measures, along with two others on functional improvement and worsening ability to move independently, will be factored into the calculation of the Nursing Home Five-Star Quality Ratings beginning in July 2016. The final measure, which addresses residents receiving antianxiety or hypnotic medications, will not be included in the ratings calculation because CMS has not yet determined appropriate benchmarks for the use of those medications. More information is available on the CMS website

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

New Issue of California Minimum Data Set Newsletter Available

The California Minimum Data Set newsletter is now available on the California Department of Public Health’s website. The current issue includes:

  • Revised Resident Assessment Instrument 3.0 User’s Manual, v1.13
  • Change of Therapy Other Medicare Required Assessment
  • Changes to the Practitioner Orders for Life-Sustaining Treatment form, which took effect Jan. 1
  • Department of Health Care Services Pre-Admission Screening and Resident Review online training information
  • An excerpt from the Minimum Data Set and Staffing Focus Survey
  • International Classification of Diseases (ICD-10) links and resource information
CHA News Article

CMS Adds Six New Quality Measures to Nursing Home Compare

The Centers for Medicare & Medicaid Services (CMS) has announced the addition of six new quality measures to its Nursing Home Compare website. Three of the new measures — rate of rehospitalization, emergency room use and community discharge among nursing home residents — are based on Medicare-claims data submitted by hospitals, marking the first time CMS has included quality measures not solely based on data that are self-reported by nursing homes. These measures, along with two others on functional improvement and worsening ability to move independently, will be factored into the calculation of the Nursing Home Five-Star Quality Ratings beginning in July 2016. The final measure, which addresses residents receiving antianxiety or hypnotic medications, will not be included in the ratings calculation because CMS has not yet determined appropriate benchmarks for the use of those medications. More information is available on the CMS website

CHA News Article

CMS Issues SNF Prospective Payment System Proposed Rule

The Centers for Medicare & Medicaid Services (CMS) has issued the attached proposed rule for the federal fiscal year (FFY) 2017 skilled-nursing facility (SNF) prospective payment system. CMS proposes a rate increase of 1.45 percent, reflecting a 2.6 percent market basket increase, reduced by a required 0.5 percent productivity adjustment, for a final update of 2.1 percent. CMS estimates that aggregate payments to SNFs will increase 2.1 percent, or $800 million, compared to payments in FFY 2016.

To meet the Improving Medicare Post-Acute Care Transformation (IMPACT) Act’s requirements, CMS proposes one new assessment-based measure and three new claims-based measures for inclusion in the SNF quality reporting program. Starting in FFY 2018, SNFs that do not submit required quality data are subject to a 2.0 percent reduction in annual reimbursement updates.

CHA is currently reviewing the proposed rule and will provide members with a more detailed summary in the coming weeks. CHA also will host a members-only call May 26 at 10 a.m. (PT) to discuss these important provisions and solicit member input. Comments on the proposed rule are due June 20. A fact sheet is available on the CMS website.  

Commands