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 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.

CHA News Article

CMS Releases Home Health Patient Experience of Care Star Ratings

The Centers for Medicare & Medicaid Services (CMS) has released the first patient experience of care star ratings on Home Health Compare. Known as Home Health Care Consumer Assessment of Healthcare Providers and Systems (HHCAHPS) Survey star ratings, these measures evaluate patients’ experiences with home health agencies.

In addition to an overall summary star rating, HHCAHPS Survey star ratings are listed for each of the following areas: care of patients, communication between providers and patients, specific care issues and overall rating of care provided by the home health agency.

CHA News Article

CMS Issues Final Rule on Medi-Cal Home Health Face to Face

The Centers for Medicare & Medicaid Services (CMS) has issued the attached final rule on Medicaid home health services. The final rule adds to the Medicaid home health service definition by requiring that physicians — or for certain medical equipment, physicians or certain authorized non-physician practitioners — document face-to-face encounters within reasonable timeframes. The requirement includes face-to-face encounters through the use of telehealth with a Medicaid-eligible beneficiary. The rule also aligns the timeframes with similar regulatory requirements for Medicare home health services, and will take effect July 1.  

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

End of Life Option Act Referendum Fails to Qualify for Ballot

On Oct. 5, 2015, Gov. Brown signed AB X2-15, the End of Life Option Act, which 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. Opponents of AB X2-15 had filed a referendum with the California Secretary of State to repeal the End of Life Option Act. However, they failed to submit enough valid signatures to put the referendum on the ballot.

Because the bill was enacted during a special session of the California Legislature and not during the regular 2015 legislative session, the usual rules regarding its effective date do not apply. Instead, it will become effective 90 days after the special session ends. Legislative leaders have not yet decided exactly when that will occur, but it will be sometime between now and November 2016. CHA will notify members when the special session ends and, subsequently, the effective date of the End of Life Option Act.

CHA News Article

Governor Signs Aid-in-Dying Bill
Effective date unknown; CHA preparing webinar for hospital compliance

Gov. Brown has signed AB X2-15, the End of Life Option Act, which allows a “qualified” adult to request and be prescribed an aid-in-dying drug if specified conditions are met. In the Act, a qualified adult is one who has the mental capacity to make medical decisions and who has been confirmed by two physicians to have an incurable and irreversible disease that will, within reasonable medical judgment, cause the individual’s death within six months. Because AB X2-15 was enacted during a special session of the legislature, and not during the regular 2015 legislative session, the usual rules regarding its effective date do not apply. Instead, it will become effective 90 days after the special session ends. The legislative leaders have not yet decided exactly when the special session will end, but it will be sometime between January 2016 and November 2016.

CHA News Article

CMS Issues FFY 2016 Hospice Final Rule

The Centers for Medicare & Medicaid Services (CMS) has issued the attached final rule updating the federal fiscal year (FFY) 2016 payment rates and wage index for hospices serving Medicare beneficiaries. The overall impact of the rule will be an estimated $160 million (1.1 percent) increase in payments to hospices. In addition, the rule adopts CMS’ proposal to differentiate payments for routine home care based on a beneficiary’s length of stay and implements a service intensity add-on payment that would help to promote and compensate for the provisions of skilled visits at end of life. Both policies will become effective Jan. 1, 2016.

The final rule also changes the aggregate cap calculation as mandated by the Improving Medicare Post-Acute Care Transformation Act of 2014 (IMPACT Act); aligns the cap accounting year for both the inpatient cap and the hospice aggregate cap beginning with FFY 2017; changes the hospice quality reporting program; and clarifies that hospices must report on the hospice claim all diagnoses identified in the initial and comprehensive assessments, whether related or unrelated to the terminal prognosis of the individual. CHA is currently analyzing the final rule and will release a detailed summary in the coming weeks. Payment and policy changes will be effective Oct. 1 unless otherwise noted.

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 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.

CHA News Article

CMS Provides Updates on IMPACT Act
Comment deadline for post-acute care measure is tomorrow

The Centers for Medicare & Medicaid Services (CMS) will host two upcoming calls on the Improving Post-Acute Care Transformation (IMPACT) Act of 2014 and the standardization of patient assessment data across post-acute care settings, including skilled-nursing facilities, home health agencies, inpatient rehabilitation facilities and long-term care hospitals. Additionally, CMS has announced that the public comment period for “Medicare Spending Per Beneficiary – Post-Acute Care (MSPB-PAC) Resource Use Measures” has been extended to Jan. 29. Information on the measure is available on the public comment website. Comments should be submitted to mspb-pac-measures-support@acumenllc.com by 8:59 p.m. (PT) on Jan. 29.

CHA News Article

Updated IRF-PAI Training Manual Available

The Centers for Medicare & Medicaid Services (CMS) has issued updates to the inpatient rehabilitation facility patient assessment instrument (IRF-PAI) training manual. The updates address reporting for new quality indicators that will be required beginning Oct. 1, as implemented by the Improving Post-Acute Care Transformation (IMPACT) Act of 2014. The updated training manual is available on the CMS IRF-PAI website

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 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.

CHA News Article

CMS to Hold Provider Webinar on Long-Term Care Quality Reporting

The Centers for Medicare & Medicaid Services (CMS) will hold a webinar for long-term care hospitals about Section GG, M and O of the LTCH Continuity Assessment Record and Evaluation data set version 3.0. The webinar is a follow-up to live training on the quality reporting program conducted in November 2015 and will focus on reviewing measures in greater detail and answering provider questions. Materials are available on the CMS website. The conference call will be held Feb. 3 from 10:30 a.m. to 12:30 p.m. (PT). To register, visit https://secure.confertel.net/tsRegister.asp?course=6962801.

CHA News Article

CMS Provides Updates on IMPACT Act
Comment deadline for post-acute care measure is tomorrow

The Centers for Medicare & Medicaid Services (CMS) will host two upcoming calls on the Improving Post-Acute Care Transformation (IMPACT) Act of 2014 and the standardization of patient assessment data across post-acute care settings, including skilled-nursing facilities, home health agencies, inpatient rehabilitation facilities and long-term care hospitals. Additionally, CMS has announced that the public comment period for “Medicare Spending Per Beneficiary – Post-Acute Care (MSPB-PAC) Resource Use Measures” has been extended to Jan. 29. Information on the measure is available on the public comment website. Comments should be submitted to mspb-pac-measures-support@acumenllc.com by 8:59 p.m. (PT) on Jan. 29.

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 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.

CHA News Article

CMS Provides Updates on IMPACT Act
Comment deadline for post-acute care measure is tomorrow

The Centers for Medicare & Medicaid Services (CMS) will host two upcoming calls on the Improving Post-Acute Care Transformation (IMPACT) Act of 2014 and the standardization of patient assessment data across post-acute care settings, including skilled-nursing facilities, home health agencies, inpatient rehabilitation facilities and long-term care hospitals. Additionally, CMS has announced that the public comment period for “Medicare Spending Per Beneficiary – Post-Acute Care (MSPB-PAC) Resource Use Measures” has been extended to Jan. 29. Information on the measure is available on the public comment website. Comments should be submitted to mspb-pac-measures-support@acumenllc.com by 8:59 p.m. (PT) on Jan. 29.

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.  

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 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.  

CHA News Article

New Law Requires Antimicrobial Stewardship in SNFs

The California Department of Public Health has issued the attached All Facilities Letter notifying hospitals of the requirement implemented by SB 361 (Statutes of 2015, Chapter 764) for skilled-nursing facilities to adopt and implement an antimicrobial stewardship policy by Jan. 1, 2017. The policy must be consistent with antimicrobial stewardship guidelines developed by a recognized professional organization, such as the Centers for Disease Control and Prevention or the Centers for Medicare & Medicaid Services.  

CHA News Article

CDPH Announces Implementation Schedule for Electronic Plans of Correction
Phase-in to begin January 2016

The California Department of Public Health (CDPH) has issued the attached All Facilities Letter, which provides information and an implementation schedule for the electronic plans of correction (ePOC). A web-based application, ePOC will streamline the submission, review, correction and approval processes for skilled-nursing facilities (SNFs) by allowing information to be passed between providers and licensing and certification electronically. CDPH is seeking 100 percent participation by SNFs and has developed a county-by-county phase-in schedule, attached, beginning in January 2016. 

Commands