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 Hold Training on Home Health Quality Reporting Program

The Centers for Medicare & Medicaid Services (CMS) has announced it will host a two-day, in-person training event on the home health quality reporting program on May 3-4 in Baltimore, MD. For more information and to register, visit the CMS website

CHA News Article

CMS Provides Post-Acute Care Quality Reporting Resources

The Centers for Medicare & Medicaid Services (CMS) has posted the attached quick reference guides for quality reporting programs for several post-acute care providers, including home health agencies, hospice providers, inpatient rehabilitation facilities and long-term care hospitals. The guides include frequently asked questions, information on quality reporting help desks, and links to additional resources.  

CHA News Article

CMS Issues New CoPs for Home Health Agencies

The Centers for Medicare & Medicaid Services (CMS) has finalized the attached revised conditions of participation (CoPs) outlining the minimum health and safety standards that a home health agency must meet to be certified for participation in the Medicare and Medicaid programs.    

CMS states that the new CoPs are part of its overall effort to improve quality of care while also streamlining requirements for providers. The finalized changes include provisions on patient assessment, patient/caregiver communications, quality assessment and performance improvement, and care coordination. CHA will provide a summary of the final rule in the near future.  

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 Provides Post-Acute Care Quality Reporting Resources

The Centers for Medicare & Medicaid Services (CMS) has posted the attached quick reference guides for quality reporting programs for several post-acute care providers, including home health agencies, hospice providers, inpatient rehabilitation facilities and long-term care hospitals. The guides include frequently asked questions, information on quality reporting help desks, and links to additional resources.  

CHA News Article

MedPAC Releases Draft Recommendations for 2018 Payment Updates

The Medicare Payment Advisory Commission (MedPAC) has released draft recommendations on Medicare fee-for-service payment and policy changes as well as Medicare Advantage, as required by law. These recommendations, directed at Congress and the Department of Health and Human Services Secretary, are for calendar and federal fiscal year (FFY) 2018. 

The presentations made by MedPAC staff at the December meeting, along with the meeting transcript, are available on the MedPAC website. During its January meeting, the commission voted unanimously to accept each of the draft recommendations to present to Congress in their March report. 

MedPAC’s specific draft recommendations include:

  • Hospital inpatient and outpatient payments: MedPAC noted that cost growth remains low but that further reductions in uncompensated care payments — combined with estimated future cost growth — have contributed to continued negative Medicare margins. In 2015, overall Medicare margins were negative 7 percent. MedPAC projects that margin to decrease further, to negative 10 percent, in 2017. Despite these negative projections, MedPAC noted that access to care and capital remain sufficient and that quality of care is improving, with steady decreases in readmission and mortality rates in hospitals. MedPAC recommends that Congress retain the inpatient and outpatient update amounts specified in current law. MedPAC estimated that update will be approximately 1.85 percent for FFY 2018; however, this estimate does not include any adjustments related to the coding offset or the restoration of payments from the two-midnight policy. The commission also reiterated its strong support for site-neutral payment policies for hospitals. 
CHA News Article

CMS Issues Report on Hospice HIS Submissions

The Centers for Medicare & Medicaid Services (CMS) has released the Hospice Timeliness Compliance Threshold report. The report displays provider-level data on the hospice item set (HIS), including provider identification information, number of HIS records submitted and number of HIS records submitted on time, as well as percentage of HIS records submitted on time. Additional information is available on the CMS website

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 Delays Implementation of Cardiac EPMs, Expanded CJR Model
Implementation dates delayed until Oct. 1

The Centers for Medicare & Medicaid Services (CMS) has issued the attached interim final rule with comment period delaying, by three months, implementation of its new mandatory episode-based payment model (EPM) for cardiac care and expansion of the current Comprehensive Care for Joint Replacement (CJR) model to include surgical treatments for hip and femur fractures beyond hip replacement. The interim final rule, which was issued to give the Trump Administration additional time to review the original final rule consistent with the administration’s regulatory freeze, delays the implementation date of these models from July 1 to Oct. 1. It also further delays certain provisions for a second time, from March 21 to May 20. In addition, CMS seeks comments on the appropriateness of the delay, and whether implementation of the new models should be delayed further until Jan. 1, 2018.

CHA anticipates that CMS will make fairly significant modifications to these programs through separate rulemaking in the very near future, and will respond during this 30-day comment period. As providers await more details from CMS, CHA is interested in learning from members about the programs’ opportunities and challenges and changes that are needed. Contact Alyssa Keefe, CHA vice president, federal regulatory affairs, at akeefe@calhospital.org or (202) 488-4688 with feedback.    

CHA News Article

IRF, LTCH Quality Public Reporting Preview Reports Available
Providers should review, correct errors by March 30

The Centers for Medicare & Medicaid Services (CMS) has announced that Inpatient Rehabilitation Facility (IRF) and Long-Term Care Hospital (LTCH) Quality Reporting program provider preview reports are now available. The reports include data on each quality measure prior to public display on the IRF Compare and LTCH Compare websites. Providers have until March 30 to review the current reports and request a CMS review if they believe their data is inaccurate. 

For more information and instructions on how to access the reports, visit the IRF Quality Public Reporting and LTCH Quality Public Reporting web pages.

CHA News Article

CMS Provides Post-Acute Care Quality Reporting Resources

The Centers for Medicare & Medicaid Services (CMS) has posted the attached quick reference guides for quality reporting programs for several post-acute care providers, including home health agencies, hospice providers, inpatient rehabilitation facilities and long-term care hospitals. The guides include frequently asked questions, information on quality reporting help desks, and links to additional resources.  

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

IRF, LTCH Quality Public Reporting Preview Reports Available
Providers should review, correct errors by March 30

The Centers for Medicare & Medicaid Services (CMS) has announced that Inpatient Rehabilitation Facility (IRF) and Long-Term Care Hospital (LTCH) Quality Reporting program provider preview reports are now available. The reports include data on each quality measure prior to public display on the IRF Compare and LTCH Compare websites. Providers have until March 30 to review the current reports and request a CMS review if they believe their data is inaccurate. 

For more information and instructions on how to access the reports, visit the IRF Quality Public Reporting and LTCH Quality Public Reporting web pages.

CHA News Article

CMS Provides Post-Acute Care Quality Reporting Resources

The Centers for Medicare & Medicaid Services (CMS) has posted the attached quick reference guides for quality reporting programs for several post-acute care providers, including home health agencies, hospice providers, inpatient rehabilitation facilities and long-term care hospitals. The guides include frequently asked questions, information on quality reporting help desks, and links to additional resources.  

CHA News Article

CMS Seeks Post-Acute Care Providers for Pilot on IMPACT TOH Measure
Interest forms due Jan. 17

The Centers for Medicare & Medicaid Services (CMS) is seeking inpatient rehabilitation facilities, long-term care hospitals, skilled-nursing facilities and home health agencies to participate in a pilot study on Transfer of Health (TOH) Information and Care Preferences quality measures. The TOH measures are being developed to meet requirements under the Improving Medicare Post-Acute Care Transformation Act of 2014 (IMPACT Act). Agencies and facilities that have been Medicare-certified for at least one year are eligible to participate in the pilot study.

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

CDPH Issues Guidance on Automated Drug Delivery Systems
Impacts nursing, skilled-nursing and intermediate care facilities

The California Department of Public Health (CDPH) has notified providers that, as of Jan. 1, new state legislation has reinstated facilities’ ability to use automated drug delivery systems that allow personnel to access multiple drugs and are not patient-specific in their design. However, these systems must have electronic and mechanical safeguards in place to ensure that the drugs delivered to the patient are specific to that patient. As detailed in the attached All Facilities Letter, facilities must obtain authorization from the Licensing and Certification Program prior to using this type of system. 

CHA News Article

Avoidable Hospitalizations for Long-Term Care Residents Sharply Reduced

The Centers for Medicare & Medicaid Services (CMS) reports that collaboration between various government agencies, patient organizations and others has dramatically reduced avoidable hospitalizations for long-term care patients, particularly for dually eligible beneficiaries, over the last several years. 

According to CMS’ recent analysis, the hospitalization rate for six potentially avoidable conditions decreased by 31 percent for dually eligible beneficiaries living in long-term care facilities. This reduced rate means that dually eligible long-term care residents avoided 133,000 hospitalizations over the five year period.

CHA News Article

CDPH Reports High Flu Activity in California
Reiterates guidance for long-term care facilities

The California Department of Public Health (CDPH) has issued the attached All Facilities Letter reminding providers that influenza activity in California remains high and is rapidly increasing. CDPH has received numerous reports of influenza outbreaks in health care facilities, particularly long-term care facilities and skilled-nursing facilities. The attached letter reiterates important infection control measures providers should be aware of and encourages facilities to follow infection control guidance from the Centers for Disease Control and Prevention if they experience an outbreak. If an outbreak occurs, facilities should avoid new admissions or transfers to units with symptomatic residents. Facilities should also note the broad impact these outbreaks, and their effect on patient admissions, can have across the continuum of care.

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 Automated Drug Delivery Systems
Impacts nursing, skilled-nursing and intermediate care facilities

The California Department of Public Health (CDPH) has notified providers that, as of Jan. 1, new state legislation has reinstated facilities’ ability to use automated drug delivery systems that allow personnel to access multiple drugs and are not patient-specific in their design. However, these systems must have electronic and mechanical safeguards in place to ensure that the drugs delivered to the patient are specific to that patient. As detailed in the attached All Facilities Letter, facilities must obtain authorization from the Licensing and Certification Program prior to using this type of system. 

CHA News Article

CDPH Reports High Flu Activity in California
Reiterates guidance for long-term care facilities

The California Department of Public Health (CDPH) has issued the attached All Facilities Letter reminding providers that influenza activity in California remains high and is rapidly increasing. CDPH has received numerous reports of influenza outbreaks in health care facilities, particularly long-term care facilities and skilled-nursing facilities. The attached letter reiterates important infection control measures providers should be aware of and encourages facilities to follow infection control guidance from the Centers for Disease Control and Prevention if they experience an outbreak. If an outbreak occurs, facilities should avoid new admissions or transfers to units with symptomatic residents. Facilities should also note the broad impact these outbreaks, and their effect on patient admissions, can have across the continuum of care.

CHA News Article

CMS Posts Recording Materials About SNF Reforms

The Centers for Medicare & Medicaid Services has posted an audio recording and transcript from the Oct. 27 national provider call on its final rule addressing reformed requirements for skilled-nursing facilities. Topics covered include changes in the final rule, the implementation and survey process, and provider training and resources.

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