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 Issues Bulletin on Enforcement of Medicaid Home Health Final Regulation

The Centers for Medicare & Medicaid Services (CMS) has released the attached informational bulletin describing its plans for enforcement of the Medicaid Home Health final rule. The rule expands coverage for medical supplies, equipment and appliances under the Medicaid (Medi-Cal) home health benefit. The rule was effective on July 1, 2016, but CMS delayed the compliance date for up to two years — based on state legislative cycles — recognizing that states are experiencing operational and budgetary issues as they implement the rule.

The bulletin states CMS’ intent to work with states on a case-by-case basis to provide flexibility for certain provisions of the rule. It also clarifies which provisions of the rule are not subject to enforcement flexibility. CMS asks states to contact it by May 31, 2018, to request flexibility.

CHA News Article

CMS Issues Information for Claims Processing Under Bipartisan Budget Act
Addresses rural home health and outpatient therapy services

The Centers for Medicare & Medicaid Services has issued the attached MLN Matters article providing Medicare administrative contractors with instructions and timelines related to claims processing for certain provisions of the Bipartisan Budget Act of 2018, known as Medicare extenders. Due to the retroactive effective dates of these provisions, Medicare administrative contractors will reprocess impacted claims. 

Among other changes, the act reinstates the 3 percent home health rural add-on payment and permanently repeals the outpatient (Part B) therapy caps, effective Jan. 1, 2018. However, the requirement to submit the “KX” modifier for services in excess of the prior cap amounts has been retained. 

CHA News Article

CMS Provides Updates for Post-Acute Care Quality Reporting

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

Inpatient Rehabilitation Facilities
Provider Preview Reports
Provider preview reports are now available for inpatient rehabilitation facilities (IRFs). IRFs have until April 5, 2018, to review their performance on quality measures based on data from quarter 3 of 2016 to quarter 2 of 2017, prior to their posting to the IRF Compare website in June 2018. Access instructions for the provider reports are available online. Corrections to the underlying data will not be permitted during this time. However, providers can request review by CMS during the preview period if they believe their data are inaccurate. 

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 Updates for Post-Acute Care Quality Reporting

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

Inpatient Rehabilitation Facilities
Provider Preview Reports
Provider preview reports are now available for inpatient rehabilitation facilities (IRFs). IRFs have until April 5, 2018, to review their performance on quality measures based on data from quarter 3 of 2016 to quarter 2 of 2017, prior to their posting to the IRF Compare website in June 2018. Access instructions for the provider reports are available online. Corrections to the underlying data will not be permitted during this time. However, providers can request review by CMS during the preview period if they believe their data are inaccurate. 

Education event For Members

Productive Partners: Hospitals and the Continuum of Care Webinar Series
Using post-acute services to achieve clinical and financial success

Webinar 2: May 3, 2018
Webinar 3: May 29, 2018
10:00 – 11:30 a.m., Pacific Time

Increasingly, providers are looking for continuing care solutions beyond acute care hospital walls. These “post-acute” services support a patient’s continued recovery from illness and play a crucial role in patient care and recovery.  Additionally, as the health care delivery system continues to shift toward population health management, acute care providers will benefit from a better understanding of post-acute care’s role in the health care delivery system. 

CHA News Article

CMS Provides Updates for Post-Acute Care Quality Reporting

The Centers for Medicare & Medicaid Services (CMS) regularly provides important updates about post-acute care quality reporting programs, including training opportunities, public reporting, and reminders of data submission and review deadlines.  

Inpatient Rehabilitation Facilities 

Data Submission Deadline Approaching
Assessment data for the Inpatient Rehabilitation Facility Patient Assessment Instrument (IRF PAI) and data submitted to CMS via the Center for Disease Control and Prevention National Healthcare Safety Network for July-September (Q3) of calendar year 2017 are due no later than 11:59 (PT) on Feb. 15.  

Long-Term Acute Care Hospitals 

Data Submission Deadline Approaching
Assessment data for the Long-Term Care Hospital Continuity Assessment Record and Evaluation (LTCH CARE) and data submitted to CMS via the Center for Disease Control and Prevention National Healthcare Safety Network for July-September (Q3) of calendar year 2017 are due no later than 11:59 (PT) on Feb. 15.  

Training
Materials from the December 2017 Long-Term Care Hospital Quality Reporting Program provider training are now available under “Related Links” on CMS’ dedicated long-term care hospital web page.  

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

CMS to Host Quality Reporting Training
Specific to long-term care hospitals, inpatient rehabilitation facilities

Registration is now open for in-person training for the Long-Term Care Hospital (LTCH) and Inpatient Rehabilitation Facility (IRF) Quality Reporting programs. The two-day “train the trainer” programs will be held in Baltimore, MD, and are open to all LTCH and IRF providers, associations and organizations. LTCH training will take place May 8- 9, and the IRF training will be held May 9- 10.  For additional information and to register, visit the LTCH quality reporting training or the IRF quality reporting training web pages. 

CHA News Article

CMS Issues Information for Claims Processing Under Bipartisan Budget Act
Addresses rural home health and outpatient therapy services

The Centers for Medicare & Medicaid Services has issued the attached MLN Matters article providing Medicare administrative contractors with instructions and timelines related to claims processing for certain provisions of the Bipartisan Budget Act of 2018, known as Medicare extenders. Due to the retroactive effective dates of these provisions, Medicare administrative contractors will reprocess impacted claims. 

Among other changes, the act reinstates the 3 percent home health rural add-on payment and permanently repeals the outpatient (Part B) therapy caps, effective Jan. 1, 2018. However, the requirement to submit the “KX” modifier for services in excess of the prior cap amounts has been retained. 

CHA News Article

CMS Provides Updates for Post-Acute Care Quality Reporting

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

Inpatient Rehabilitation Facilities
Provider Preview Reports
Provider preview reports are now available for inpatient rehabilitation facilities (IRFs). IRFs have until April 5, 2018, to review their performance on quality measures based on data from quarter 3 of 2016 to quarter 2 of 2017, prior to their posting to the IRF Compare website in June 2018. Access instructions for the provider reports are available online. Corrections to the underlying data will not be permitted during this time. However, providers can request review by CMS during the preview period if they believe their data are inaccurate. 

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 to Host Quality Reporting Training
Specific to long-term care hospitals, inpatient rehabilitation facilities

Registration is now open for in-person training for the Long-Term Care Hospital (LTCH) and Inpatient Rehabilitation Facility (IRF) Quality Reporting programs. The two-day “train the trainer” programs will be held in Baltimore, MD, and are open to all LTCH and IRF providers, associations and organizations. LTCH training will take place May 8- 9, and the IRF training will be held May 9- 10.  For additional information and to register, visit the LTCH quality reporting training or the IRF quality reporting training web pages. 

CHA News Article

CMS Provides Updates for Post-Acute Care Quality Reporting

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

Inpatient Rehabilitation Facilities
Provider Preview Reports
Provider preview reports are now available for inpatient rehabilitation facilities (IRFs). IRFs have until April 5, 2018, to review their performance on quality measures based on data from quarter 3 of 2016 to quarter 2 of 2017, prior to their posting to the IRF Compare website in June 2018. Access instructions for the provider reports are available online. Corrections to the underlying data will not be permitted during this time. However, providers can request review by CMS during the preview period if they believe their data are inaccurate. 

Education event For Members

Productive Partners: Hospitals and the Continuum of Care Webinar Series
Using post-acute services to achieve clinical and financial success

Webinar 2: May 3, 2018
Webinar 3: May 29, 2018
10:00 – 11:30 a.m., Pacific Time

Increasingly, providers are looking for continuing care solutions beyond acute care hospital walls. These “post-acute” services support a patient’s continued recovery from illness and play a crucial role in patient care and recovery.  Additionally, as the health care delivery system continues to shift toward population health management, acute care providers will benefit from a better understanding of post-acute care’s role in the health care delivery system. 

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

All Facilities Letter Addresses Skilled-Nursing Facility Online Applications

The California Department of Public Health has released the attached All Facilities Letter 18-18 outlining the new online licensing and certification application process for certain facilities, including skilled-nursing facilities. The new online process should be used only for initial licensing approval; reports of changes and change of ownership applications must still be submitted by hard copy. More details, including instructions for registering and submitting an application, are available in the attached letter.

CHA News Article

CMS Provides Information on Changes to Staffing Measure Reporting

The Centers for Medicare & Medicaid Services (CMS) has issued the attached letter to state survey agencies on the transition to the payroll-based journal staffing measure for data publicly reported on Nursing Home Compare and for the Five-Star Quality Rating System.   

Beginning this month, CMS will use payroll-based journal data to determine each facility’s staffing measure on the Nursing Home Compare tool on the Medicare.gov website, as well as to calculate the staffing rating used in the Nursing Home Five-Star Quality Rating System. Beginning June 1, CMS will no longer collect facility staffing data through the CMS-671 form.

Additionally, CMS provides facilities with resources for technical assistance and guidance for improving the accuracy of their reporting, including a list of frequently observed errors. Skilled-nursing facilities that fail to submit any data by the required deadline, or whose audit identifies significant inaccuracies between the hours reported and the hours verified, will be assigned a one-star rating in the staffing domain.  

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.

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.

Education event For Members

Productive Partners: Hospitals and the Continuum of Care Webinar Series
Using post-acute services to achieve clinical and financial success

Webinar 2: May 3, 2018
Webinar 3: May 29, 2018
10:00 – 11:30 a.m., Pacific Time

Increasingly, providers are looking for continuing care solutions beyond acute care hospital walls. These “post-acute” services support a patient’s continued recovery from illness and play a crucial role in patient care and recovery.  Additionally, as the health care delivery system continues to shift toward population health management, acute care providers will benefit from a better understanding of post-acute care’s role in the health care delivery system. 

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.

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