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

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. 

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.

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

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.

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

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.

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. 

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

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

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

Budget Gives CDPH New Investigation Timelines
Also adds L&C positions to address survey activities

The 2015-16 state budget provides the California Department of Public Health’s (CDPH) Licensing and Certification (L&C) Division with 237 additional positions to assist with its workload, including addressing “past failures to complete its survey workload and close/complete complaint investigations.” In addition, the budget increases hospital fees and adjusts the timelines for CDPH to complete investigations of skilled-nursing facilities (SNFs).

Many provider fees were increased in the budget to correspond to the associated survey activity within each type of provider (hospital, clinic, etc.). Hospitals and SNFs will likely experience increased survey and investigation activities as L&C will have additional staff to complete this work. In addition, providers fees may increase in coming years as the L&C workload continues to increase.

CHA News Article

CDPH to Conduct MDS/Staffing Surveys

The California Department of Public Health Division of Licensing and Certification will conduct unannounced Minimum Data Set/staffing-focused surveys at 27 skilled-nursing facilities between June and the end of September. As directed by the Centers for Medicare & Medicaid Services and described in the attached survey and certification memo, the focused surveys will not be part of the annual recertification survey and will be conducted throughout the state. 

CHA News Article

Governor Signs State Budget

Gov. Brown has signed the 2015-16 state budget,which eliminates the partial restoration of the Medi-Cal AB 97 payment cuts to hospital-based, distinct-part nursing facilities, as well as restorations for doctors and other providers, but includes funding to extend Medi-Cal coverage to undocumented children beginning in May 2016.

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

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.

CHA News Article

CMS Expands SNF PPS Payment Reform Research Project

The Centers for Medicare & Medicaid Services (CMS) is expanding the scope of its skilled-nursing facility (SNF) payment reform project to examine potential improvements and refinements to the overall SNF prospective payment system (PPS). In the first two phases of the project, the contractor focused on SNF PPS therapy payment by reviewing current policy and research and identifying potential therapy models suitable for further analysis. CMS is considering stakeholder comments and concerns as it continues to investigate alternative therapy payment approaches.

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