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

CMS Releases Home Health PPS Proposed Rule

The Centers for Medicare & Medicaid Services (CMS) has issued the attached proposed rule outlining proposed calendar year 2019 Medicare payment updates and proposed quality reporting changes for home health agencies. CHA is currently reviewing the proposed rule and will provide additional information later this week in CHA News. A CMS fact sheet and press release are attached.  

CHA News Article

CMS Launches Data Element Library
Will hold informational session July 11

The Centers for Medicare & Medicaid Services (CMS) has established its first Data Element Library, a free, centralized resource that allows the public to view specific types of patient assessment data that post-acute care facilities are required to collect and report. The library also includes health information technology standards that support the collection of health information. The resource is intended to support the exchange of electronic health information between health care providers and to advance data standardization and interoperability, a goal of the Improving Medicare Post Acute Care Transformation Act. On July 11 from 10-11 a.m. (PT), CMS will host a webinar to provide further details about the library; registration is available online. Additional information and a fact sheet are available on the CMS website.   

CHA News Article

Updates Available for Post-Acute Care Quality Reporting   

The Centers for Medicare & Medicaid Services (CMS) regularly provides important updates for post-acute care quality reporting programs, including training opportunities, public reporting details and reminders of data submission and review deadlines. The latest updates for inpatient rehabilitation facilities, skilled-nursing facilities, long-term care hospitals, home health and hospice providers are below.

Inpatient Rehabilitation Facilities 
Provider Preview Reports
Inpatient rehabilitation facility (IRF) provider preview reports have been updated and are now available. Providers have until June 30 to review their performance data on quality measures based on data from the fourth quarter of 2016 to the third quarter of 2017, prior to their posting to the IRF Compare website in September. Corrections to the underlying data will not be permitted during this time. However, providers can request a CMS review if they believe their data scores are inaccurate. 

This update of the provider reports includes two additional assessment-based measures and four new claims-based measures, as well as removal of the All-Cause Unplanned Readmission Measure for 30 Days Post-Discharge from Inpatient Rehabilitation Facility measure.  

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

Post-Acute Care Facilities Notified of Non-Compliance With Quality Reporting

The Centers for Medicare & Medicaid Services (CMS) has identified inpatient rehabilitation facilities, long-term care hospitals, skilled-nursing facilities and hospices that are not in compliance with quality reporting program requirements for calendar year 2017, and sent those facilities notices of non-compliance on July 9. The non-compliance determination will affect the annual increase factor for fiscal year 2019 reimbursement rates.

The notifications were both mailed to the facilities and placed in their Certification and Survey Provider Enhanced Reports folders in the Quality Improvement and Evaluation System. Facilities that receive a letter of non-compliance may submit a request for reconsideration to CMS via email no later than 11:59 p.m. (PT) on Aug. 7. Instructions for requesting a reconsideration are included in the notification letter.  

CHA News Article

Physician-Assisted Death Law Ruled Unconstitutional

A Riverside County Superior Court ruled in May that California’s End of Life Option Act violated the state constitution because it was passed during a special legislative session called to work on other issues. The act, which went into effect in 2016, allows terminally ill individuals to obtain a prescription for a drug to end their life if they meet specified requirements.

The judge’s ruling was limited to this procedural issue; he did not rule on the legality of physician-assisted death. The California attorney general appealed the ruling and requested the appellate court to allow the act to be effective while the appeal is pending. The appellate court responded by ordering the parties to submit briefs on the legal issues involved. In addition, the attorney general filed a motion to vacate the trial court judgment, and a hearing on that motion will be held June 29.

In the meantime, the superior court’s ruling declaring the act void and enjoining the state from recognizing it remains in effect throughout the state. CHA will update its members on the status of the case after the hearing later this month.

CHA News Article

Updates Available for Post-Acute Care Quality Reporting   

The Centers for Medicare & Medicaid Services (CMS) regularly provides important updates for post-acute care quality reporting programs, including training opportunities, public reporting details and reminders of data submission and review deadlines. The latest updates for inpatient rehabilitation facilities, skilled-nursing facilities, long-term care hospitals, home health and hospice providers are below.

Inpatient Rehabilitation Facilities 
Provider Preview Reports
Inpatient rehabilitation facility (IRF) provider preview reports have been updated and are now available. Providers have until June 30 to review their performance data on quality measures based on data from the fourth quarter of 2016 to the third quarter of 2017, prior to their posting to the IRF Compare website in September. Corrections to the underlying data will not be permitted during this time. However, providers can request a CMS review if they believe their data scores are inaccurate. 

This update of the provider reports includes two additional assessment-based measures and four new claims-based measures, as well as removal of the All-Cause Unplanned Readmission Measure for 30 Days Post-Discharge from Inpatient Rehabilitation Facility measure.  

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

Post-Acute Care Facilities Notified of Non-Compliance With Quality Reporting

The Centers for Medicare & Medicaid Services (CMS) has identified inpatient rehabilitation facilities, long-term care hospitals, skilled-nursing facilities and hospices that are not in compliance with quality reporting program requirements for calendar year 2017, and sent those facilities notices of non-compliance on July 9. The non-compliance determination will affect the annual increase factor for fiscal year 2019 reimbursement rates.

The notifications were both mailed to the facilities and placed in their Certification and Survey Provider Enhanced Reports folders in the Quality Improvement and Evaluation System. Facilities that receive a letter of non-compliance may submit a request for reconsideration to CMS via email no later than 11:59 p.m. (PT) on Aug. 7. Instructions for requesting a reconsideration are included in the notification letter.  

CHA News Article

CMS Launches Data Element Library
Will hold informational session July 11

The Centers for Medicare & Medicaid Services (CMS) has established its first Data Element Library, a free, centralized resource that allows the public to view specific types of patient assessment data that post-acute care facilities are required to collect and report. The library also includes health information technology standards that support the collection of health information. The resource is intended to support the exchange of electronic health information between health care providers and to advance data standardization and interoperability, a goal of the Improving Medicare Post Acute Care Transformation Act. On July 11 from 10-11 a.m. (PT), CMS will host a webinar to provide further details about the library; registration is available online. Additional information and a fact sheet are available on the CMS website.   

CHA News Article

CHA Comments on Inpatient Rehabilitation Facility PPS Proposed Rule

CHA has submitted the attached comment letter to the Centers for Medicare & Medicaid Services (CMS) on its proposed rule for the federal fiscal year 2019 inpatient rehabilitation facility (IRF) prospective payment system (PPS).

In the letter, CHA supports CMS’ proposals to make limited changes to rehabilitation physician supervision requirements and to expand exemptions to separateness and control requirements for long-term care hospitals co-located with another inpatient prospective payment system-excluded hospital, including IRFs.

While CHA supports the efforts to improve payment accuracy, CHA believes the proposed changes to the case-mix classification system have not been sufficiently vetted. CHA urges CMS not to finalize the proposed changes until data elements have been adequately tested.

CHA encourages members to submit their own letters to CMS. Comments are due by 2 p.m. (PT) tomorrow, June 26, and may be submitted electronically.

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

Post-Acute Care Facilities Notified of Non-Compliance With Quality Reporting

The Centers for Medicare & Medicaid Services (CMS) has identified inpatient rehabilitation facilities, long-term care hospitals, skilled-nursing facilities and hospices that are not in compliance with quality reporting program requirements for calendar year 2017, and sent those facilities notices of non-compliance on July 9. The non-compliance determination will affect the annual increase factor for fiscal year 2019 reimbursement rates.

The notifications were both mailed to the facilities and placed in their Certification and Survey Provider Enhanced Reports folders in the Quality Improvement and Evaluation System. Facilities that receive a letter of non-compliance may submit a request for reconsideration to CMS via email no later than 11:59 p.m. (PT) on Aug. 7. Instructions for requesting a reconsideration are included in the notification letter.  

CHA News Article

CMS Launches Data Element Library
Will hold informational session July 11

The Centers for Medicare & Medicaid Services (CMS) has established its first Data Element Library, a free, centralized resource that allows the public to view specific types of patient assessment data that post-acute care facilities are required to collect and report. The library also includes health information technology standards that support the collection of health information. The resource is intended to support the exchange of electronic health information between health care providers and to advance data standardization and interoperability, a goal of the Improving Medicare Post Acute Care Transformation Act. On July 11 from 10-11 a.m. (PT), CMS will host a webinar to provide further details about the library; registration is available online. Additional information and a fact sheet are available on the CMS website.   

CHA News Article

Updates Available for Post-Acute Care Quality Reporting   

The Centers for Medicare & Medicaid Services (CMS) regularly provides important updates for post-acute care quality reporting programs, including training opportunities, public reporting details and reminders of data submission and review deadlines. The latest updates for inpatient rehabilitation facilities, skilled-nursing facilities, long-term care hospitals, home health and hospice providers are below.

Inpatient Rehabilitation Facilities 
Provider Preview Reports
Inpatient rehabilitation facility (IRF) provider preview reports have been updated and are now available. Providers have until June 30 to review their performance data on quality measures based on data from the fourth quarter of 2016 to the third quarter of 2017, prior to their posting to the IRF Compare website in September. Corrections to the underlying data will not be permitted during this time. However, providers can request a CMS review if they believe their data scores are inaccurate. 

This update of the provider reports includes two additional assessment-based measures and four new claims-based measures, as well as removal of the All-Cause Unplanned Readmission Measure for 30 Days Post-Discharge from Inpatient Rehabilitation Facility measure.  

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

Post-Acute Care Facilities Notified of Non-Compliance With Quality Reporting

The Centers for Medicare & Medicaid Services (CMS) has identified inpatient rehabilitation facilities, long-term care hospitals, skilled-nursing facilities and hospices that are not in compliance with quality reporting program requirements for calendar year 2017, and sent those facilities notices of non-compliance on July 9. The non-compliance determination will affect the annual increase factor for fiscal year 2019 reimbursement rates.

The notifications were both mailed to the facilities and placed in their Certification and Survey Provider Enhanced Reports folders in the Quality Improvement and Evaluation System. Facilities that receive a letter of non-compliance may submit a request for reconsideration to CMS via email no later than 11:59 p.m. (PT) on Aug. 7. Instructions for requesting a reconsideration are included in the notification letter.  

CHA News Article

Skilled-Nursing Facility Policies on Immediate Jeopardy Revised

The Centers for Medicare & Medicaid Services (CMS) has issued the attached memo updating guidance related to the imposition of federal remedies on certified skilled-nursing facilities, including revisions to Chapter 7 of the state operations manual. Substantive revisions to prior guidance include: 

  • When the current survey identifies an immediate jeopardy violation that does not result in serious injury, harm, impairment or death, CMS regional offices may determine the most appropriate remedy.
  • Past noncompliance deficiencies will not be included in the criteria for immediate imposition of remedies.
  • Certain “F” citations will be excluded from immediate imposition of remedies for special focus facilities. 
CHA News Article

CMS Launches Data Element Library
Will hold informational session July 11

The Centers for Medicare & Medicaid Services (CMS) has established its first Data Element Library, a free, centralized resource that allows the public to view specific types of patient assessment data that post-acute care facilities are required to collect and report. The library also includes health information technology standards that support the collection of health information. The resource is intended to support the exchange of electronic health information between health care providers and to advance data standardization and interoperability, a goal of the Improving Medicare Post Acute Care Transformation Act. On July 11 from 10-11 a.m. (PT), CMS will host a webinar to provide further details about the library; registration is available online. Additional information and a fact sheet are available on the CMS website.   

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

Skilled-Nursing Facility Notice of Non-Coverage Revised

The Centers for Medicare & Medicaid Services (CMS) has issued the attached MLN Matters article about the recently revised Skilled-Nursing Facility Notice of Non-coverage form. With this revision, CMS is discontinuing five skilled-nursing facility denial letters, specified in the article, and the Notice of Exclusion from Medicare Benefits. The revised form will be required effective April 30, but facilities are encouraged to begin using it as soon as practicable.

CHA News Article

Guidance Reiterates Flu Prevention, Control in Long-Term Care Facilities
Subscriber alert reports no statewide shortage of antiviral medications

The California Department of Public Health (CDPH) today released the attached All Facilities Letter 18-08 addressing the state’s high rate of influenza activity. The guidance emphasizes infection control measures for long-term care facility residents with suspected or confirmed influenza and includes steps to take for implementation of droplet precautions. The department advises that residents should stay in their own rooms as much as possible, employees and visitors should be screened for illness, ill health care personnel should be furloughed and ill visitors discouraged from entering the facility. The guidance refers providers to the Centers for Disease Control and Prevention guidelines titled “Interim Guidance for Influenza Outbreak Management in Long-Term Care Facilities,” and the CDPH “Recommendations for the Prevention and Control of Influenza – California Long-Term Care Facilities.”

CDPH has also issued a subscriber alert on influenza antiviral recommendations and strategies to obtain influenza antivirals, reporting there does not appear to be a nationwide antiviral shortage. Pharmacies are encouraged to contact their wholesaler’s customer service desk to request drop shipments of antivirals from the manufacturers if the wholesaler is unable to supply needed medications in a timely manner.

CHA News Article

Updated Reimbursement Rates Posted for Skilled-Nursing, Subacute Care Units

The Department of Health Care Services has posted reimbursement rates for distinct-part skilled-nursing facilities and subacute care units  for the 2017-18 rate year. The department projects that the rates, which are effective for services provided beginning Aug. 1, 2017, will be implemented in late December.  

Commands