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 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.  

CHA News Article

Revised Home Health Benefit Booklet Now Available

The Centers for Medicare & Medicaid Services (CMS) has issued a revised booklet about home health services and benefits. The booklet includes information on qualifying for home health benefits, including the required face-to-face encounter and patient criteria for eligibility; consolidated billing, including a list of services included in the home health prospective payment system; therapy services, including standards and requirements that must be met; and more. 

CHA News Article

CMS Issues Video Overview of the IMPACT Act
Explains requirement for standardized patient assessment data

The Centers for Medicare & Medicaid Services (CMS) has developed a video that describes the Improving Post-Acute Care Transformation (IMPACT) Act of 2014. In the video, Dr. Patrick Conway, CMS’ principle deputy administrator and chief medical officer, provides an overview of the Act, which requires that patient assessment data used in post-acute care settings (skilled-nursing facilities, home health agencies, inpatient rehabilitation facilities and long-term care hospitals) be standardized to improve quality of care.

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 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.

CHA News Article

Registration Now Open for CMS Inpatient Rehabilitation Facility Training
Training to address quality reporting program and patient assessment instrument

Registration has opened for the Centers for Medicare & Medicaid Services’ (CMS) two-day “train-the-trainer” event on updates and changes to the inpatient rehabilitation facility (IRF) patient assessment instrument, including new reporting requirements for the IRF quality reporting program, that will go into effect Oct. 1. The in-person training will be held in Dallas on May 18 from 8 a.m. – 5 p.m. (CT) and May 19 from 8 a.m. – 3:30 p.m. (CT) at the Dallas/Addison Marriot Quorum by the Galleria hotel. CMS notes that registration is limited to 250 people on a first-come, first-served basis, and that a special conference rate is available at the hotel for those who register by May 10. Additional information is available on the CMS website.

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.

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 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. 

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.

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

DHCS Announces Fresno Pilot for Community Care Transitions Program

The Department of Health Care Services (DHCS) is initiating a pilot project to measure the effectiveness of newly created marketing materials, attached, for the Community Care Transitions (CCT) program. CCT, California’s Money Follow the Person demonstration, is funded through a federal grant awarded to rebalance the state’s Medicaid spending on long-term care for residents who wish to live and receive care in the community. Under CCT, eligible residents who have lived in an institution or facility for 90 consecutive days and want to transition back to the community are provided with transition coordination, support and follow-up from contracted service providers. Facilities unable to meet residents’ needs for long-term home and community-based services are required to refer identified residents to state-designated local contact agencies (LCAs).

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.  

CHA News Article

New Effort Launched to Reduce Nursing Facility Re-Hospitalizations

The Centers for Medicare & Medicaid Services has announced that it will test whether a new payment model for nursing facilities and practitioners will reduce avoidable hospitalizations, lower combined Medicare and Medicaid spending, and improve the quality of care received by nursing facility residents. The effort represents the second phase of an initiative that seeks to reduce avoidable hospitalizations among beneficiaries eligible for Medicare and/or Medicaid by providing new payments to practitioners for engaging in multidisciplinary care planning activities.

In addition, participating skilled-nursing facilities will receive payment to provide additional treatment for common medical conditions that often lead to avoidable hospitalizations. This new four-year payment phase of the initiative, slated to begin in fall 2016, will be implemented through cooperative agreements with six enhanced care and coordination providers located in Alabama, Nevada, Colorado,  Indiana, Missouri, New York and Pennsylvania.  

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 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.  

CHA News Article

CDPH Issues Updated SNF Relicensing Workbook
New version implemented March 1

The California Department of Public Health has issued the attached updated state relicensing survey workbook for skilled-nursing facilities. Licensing and Certification district offices began using the new workbook March 1. 

CHA News Article

CDPH Issues Information on Discharge and Readmission Requirements

The California Department of Public Health (CDPH) has issued the attached All Facilities Letter, which reviews requirements skilled-nursing facilities (SNFs) and intermediate care facilities (ICFs) must meet when transferring, discharging and readmitting patients. The letter notes that SNFs and ICFs may transfer and discharge residents only under specified circumstances and must notify all residents of the bed hold policy. Upon request, all SNFs and ICFs must hold the bed of any resident transferred to a general acute care hospital for at least seven days, and allow for readmission to the facility upon the first available bed if the bed hold period has lapsed.  

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