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’s Center for Post-Acute Care represents the interests of CHA member post-acute care providers,  including inpatient rehabilitation hospitals and units,  long-term acute care hospitals, distinct-part skilled-nursing facilities and home health agencies.  As a part of CHA, the Center for Post-Acute Care serves as the primary public policy arm of the hospital association for post-acute care issues. The center also advocates for hospital-based post-acute care services  in the federal and state legislative and regulatory arenas.

CHA News Article

CHA Issues Summary of Home Health Prospective Payment System Final Rule
For home health agency staff, directors of reimbursement

CHA has issued a summary, prepared by Health Policy Alternatives, of the final rule for the home health agency prospective payment system for calendar year (CY) 2020. The final rule’s provisions are effective Jan. 1, 2020.

CHA News Article

CMS Issues CY 2020 Home Health PPS Final Rule
For home health staff, finance & reimbursement staff

The Centers for Medicare & Medicaid Services (CMS) has issued the final rule for the prospective payment system (PPS) for home health agencies (HHAs) for calendar year (CY) 2020. The provisions in the rule will be effective Jan. 1, 2020. 

CHA News Article

CMS Issues Final Rule on Hospital, Home Health Discharge Planning
For hospital case managers, post-acute care providers, compliance personnel

The Centers for Medicare & Medicaid Services (CMS) has issued a final rule revising requirements for discharge planning for hospitals, critical access hospitals, and home health agencies. The provisions in the final rule will take effect in approximately 60 days, and CMS will provide additional interpretative guidance 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 Issues Final Rule for FFY 2020 Hospice Payment

The Centers for Medicare & Medicaid Services (CMS) has issued its final rule updating hospice payment rates for federal fiscal year (FFY) 2020. CMS finalizes a net payment increase of 2.6%, or $520 million, as compared to FFY 2019. The rule also rebases the rates hospices are paid for certain types of care. In addition, the rule modifies the beneficiary hospice election statement to reduce the time spent trying to obtain information needed for treatment decisions and accurate claims submissions.

CHA News Article

CDPH Outlines Alternative Pathway for Obtaining a Hospice License
For Licensing and Certification Staff, Home Health and Hospice Leaders

In All Facilities Letter 19-23, issued last week, the California Department of Public Health (CDPH) outlines an alternative pathway to hospice licensing recently made available through the enactment of Senate Bill 1495 (Chapter 424, Statutes of 2018). Under the bill, CDPH must issue a hospice license to any applicant that meets certain standards, including approval by a Centers for Medicare & Medicaid Services-certified national accreditation organization.

CHA News Article

CMS Issues FFY 2020 Inpatient Rehabilitation Facility PPS Proposed Rule
For CEOs, CFOs, Directors of Rehabilitation Services

The Centers for Medicare & Medicaid Services (CMS) has issued the proposed rule for the inpatient rehabilitation facility prospective payment system (IRF PPS) for federal fiscal year (FFY) 2020. If finalized, the provisions would be effective Oct. 1, 2020.

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.Services may range from coordinated interdisciplinary programs to individual therapy disciplines.

CHA News Article

CHA Issues Summaries of CY 2020 Physician Fee Schedule and Quality Payment Program Final Rule
For CFOs, CMOs, finance & reimbursement staff, quality staff

CHA has issued the two summaries, prepared by Health Policy Alternatives, detailing provisions of the calendar year 2020 physician fee schedule and quality payment program final rule. The policies described in the summaries are generally effective Jan. 1.

CHA News Article

CMS Issues CY 2020 Physician Fee Schedule Final Rule
For CFOs, CMOs, finance & reimbursement staff, quality staff

The Centers for Medicare & Medicaid Services (CMS) has issued its final rule updating the Medicare physician fee schedule (PFS), quality payment program, and other Medicare Part B payment policies for calendar year (CY) 2020. The final rule is effective Jan. 1.

CHA News Article

CHA Comments to MedPAC on Access to Durable Medical Equipment
For case managers

CHA has submitted comments to the Medicare Payment Advisory Commission (MedPAC) in response to the commission’s September discussion on the effects of the Durable Medical Equipment, Prosthetics, Orthotics, & Supplies (DMEPOS) Competitive Bidding Program, urging significant changes to modernize current DME payment and regulatory policy so that it aligns with the goals of value-based payment and reduced regulatory burden.

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’s Center for Post-Acute Care represents the interests of CHA member post-acute care providers,  including inpatient rehabilitation hospitals and units,  long-term acute care hospitals, distinct-part skilled-nursing facilities and home health agencies.  As a part of CHA, the Center for Post-Acute Care serves as the primary public policy arm of the hospital association for post-acute care issues. The center also advocates for hospital-based post-acute care services  in the federal and state legislative and regulatory arenas.

CHA News Article

CMS Issues Final Rule on Hospital, Home Health Discharge Planning
For hospital case managers, post-acute care providers, compliance personnel

The Centers for Medicare & Medicaid Services (CMS) has issued a final rule revising requirements for discharge planning for hospitals, critical access hospitals, and home health agencies. The provisions in the final rule will take effect in approximately 60 days, and CMS will provide additional interpretative guidance in the near future.       

CHA News Article

CMS Issues FFY 2020 Long Term Care Hospital PPS Final Rule

The Centers for Medicare & Medicaid Services (CMS) has issued the final rule for the long-term care hospital (LTCH) prospective payment system (PPS) for federal fiscal year (FFY) 2020. The provisions of the final rule will be effective Oct. 1, 2020.  

Below are highlights of the final rule.  

Payment Impact
As provided in the FFY 2016 final rule, LTCHs are reimbursed under a dual-rate system; patients who meet specified criteria are reimbursed by the LTCH PPS standard federal payment amount and remaining patients are reimbursed at the lower site-neutral payment rate. Implementation of the dual-rate payment system included a transition period during which facilities received a blended rate.  For cost reporting periods beginning in FFY 2020, the transition period will end and LTCHs will be paid exclusively on the site-neutral payment rate for patients who do not meet LTCH PPS criteria.   

Overall, CMS projects that LTCH PPS payments will increase by approximately 1%, or $43 million. For cases reimbursed at the site-neutral rate, CMS projects a decrease of approximately 5.9%.  

Quality Reporting/SPADEs
CMS finalizes several proposals relating to the LTCH Quality Reporting Program (QRP), including the addition of several standardized patient assessment data elements (SPADEs), several of which address social determinants of health. CMS also finalizes two new measures addressing transfer of health information and changes the existing “Discharge to Community” measure to exclude baseline nursing home residents. 

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 Announces Updates to Nursing Home Compare, Adds Abuse Icon to SNF listings  
For case managers, quality & patient staff, skilled-nursing facility staff

The Centers for Medicare & Medicaid Services (CMS) has issued updates to the Nursing Home Compare website. Among the most significant changes is the addition of a new “abuse icon,” which will be used to highlight facilities with instances of non-compliance related to abuse, based on specified criteria. 

CHA News Article

CMS Issues Final Rule on Hospital, Home Health Discharge Planning
For hospital case managers, post-acute care providers, compliance personnel

The Centers for Medicare & Medicaid Services (CMS) has issued a final rule revising requirements for discharge planning for hospitals, critical access hospitals, and home health agencies. The provisions in the final rule will take effect in approximately 60 days, and CMS will provide additional interpretative guidance in the near future.       

CHA News Article

DHCS Announces Coverage Changes for Medi-Cal Managed Care Plans, Coordinated Care Initiative
For CEOs, CFOs, Government Relations Executives

The Department of Health Care Services (DHCS) has announced it will make long-term care and transplant coverage the responsibility of all Medi-Cal managed care plan model types — including Two Plan, Geographic Managed Care, Imperial, Regional, and San Benito — effective Jan. 1, 2021. These benefits are currently carved in to County Organized Health Systems, and no changes will be made for them. 

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 FFY 2020 Skilled-Nursing Facility PPS Final Rule

The Centers for Medicare & Medicaid Services (CMS) has issued the federal fiscal year (FFY) 2020 final rule for the skilled-nursing facility prospective payment system (SNF PPS). The provisions in the proposed rules will be effective Oct. 1, 2020.

Highlights of the final rule include:  

Commands