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 CY 2021 Home Health PPS Final Rule
For CFOs, home health leaders, directors of reimbursement

The Centers for Medicare & Medicaid Services (CMS) has issued the final rule for the home health prospective payment system (PPS) for calendar year (CY) 2021. 

Private Post

CDPH Issues Guidance for Skilled-Nursing Facilities, Home Health Agencies
September 22, 2020

CDPH has issued several AFLs for post-acute care providers, including:

  • AFL 20-72, which waives certain requirements for home health agencies during the COVID-19 public health emergency. This includes provisions related to licensing, staffing and services, and supervision.
  • AFL 20-73, which provides guidance to skilled-nursing facilities to support residents’ ability to express their treatment wishes through proactive advance care planning. The AFL includes recommendations for all residents, including those who have tested positive for COVID-19.
  • AFL 20-74, which provides recommendations for use of personal protective equipment, cohorting, and staffing for skilled-nursing facility residents. The AFL includes a chart with guidance for each category of COVID-19 status, including COVID-19-positive residents, symptomatic residents awaiting test results, exposed and non-exposed residents, and new admissions.
CHA News Article

Post-Acute Care Quality Reporting Program Tip Sheets Available
For post-acute care leaders, quality leaders, and compliance staff

The Centers for Medicare & Medicaid Services (CMS) has issued several post-acute care quality reporting program COVID-19 tip sheets to help providers understand CMS’ public reporting strategy for the program during the public health emergency. 

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

Feb. 10 Is Deadline for Creating Care Partnerships Conference Registration and Hotel Discounts
For CNOs, COOs, CFOs, strategic planning officers, post-acute and skilled-nursing staff, case managers

Register by Feb. 10 for CHA’s upcoming Creating Care Partnerships Conference, March 2-3 in Pasadena, to save $100 on registration and take advantage of group room rates at the host hotel, The Westin Pasadena. 

CHA News Article

Upcoming Conference Examines Patient Perspective in Post-Acute Care Recovery
For CNOs, COOs, CFOs, strategic planning officers, post-acute and skilled-nursing staff, case managers

CHA’s Creating Care Partnerships: Beyond the Continuum conference, March 2-3 in Pasadena, features a post-acute care patient advocate who gained insight into her patients’ experience when she became one herself.

CHA News Article

Video ‘Learning Brief’ Explains Hospital Discharge Planning Final Rule
For COOs, case managers, post-acute care staff, compliance leaders

CHA members can now learn about the Centers for Medicare & Medicaid Services’ (CMS) discharge planning final rule in a free on-demand webinar. The 30-minute webinar offers a high-level overview of the rule and solicits requests for more information and clarification to inform CHA’s ongoing advocacy with CMS.

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 Issues CY 2021 DMEPOS Proposed Rule and Competitive Bidding Program Information
For CEOs, CFOs, finance & reimbursement staff, post-acute care staff, and case managers

The Centers for Medicare & Medicaid Services (CMS) has issued its proposed rule updating payment methodologies for the Medicare durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) fee schedule for calendar year (CY) 2021. In addition, CMS announced changes to the DMEPOS competitive bidding program (CBP) for 2021, which will be limited to off-the-shelf knee and back braces.  

Private Post

CDPH Releases COVID-19 Hospital, SNF Outbreak Reporting Thresholds
September 29, 2020

CDPH has issued All Facilities Letter 20-75, which sets thresholds for COVID-19 outbreaks in hospitals. Hospitals are required to report outbreaks and unusual infectious disease occurrences to their local health department and CDPH Licensing and Certification District Office. Under these definitions, acute care hospitals are to report an outbreak when they have:

  • In all counties: Two or more cases of confirmed COVID-19 in a patient seven or more days after admission for a non-COVID condition with epi-linkage. Epi-linkage among patients is defined as overlap on the same unit or ward for any duration or having the potential to have been cared for by common health care personnel within a 14-day time period of each other.
  • In purple or red tier counties: Two or more cases of confirmed COVID-19 in health care personnel with epi-linkage who do not share a household and are not close contacts outside of the workplace. Epi-linkage among health care personnel is defined as having the potential to have been within six feet for 15 minutes or longer while working in the facility during the 14 days prior to the onset of symptoms or a positive test. For example, the health care personnel worked on the same unit during the same shift.
  • In orange or yellow tier counties: Three or more cases of confirmed COVID-19 in health care personnel with epi-linkage who do not share a household and are not close contacts outside of the workplace. The same definition of epi-linkage in the bullet above applies.

The state’s Blueprint for a Safer Economy updates the color tiers and is searchable by county.

Long-term acute care hospitals and long-term care facilities are to report an outbreak to their local health department and CDPH District Office any time one or more residents has a confirmed COVID-19 diagnosis 14 days or more after admission for a non-COVID condition, without an exposure during the previous 14 days to another setting where an outbreak was known or suspected to occur.

Additional thresholds for a facility should investigate and report to the local health department are provided for acute care hospitals, long-term acute care hospitals, and long-term care facilities.

Next CDPH Call for Health Care Facilities: Oct. 6, 8-9 a.m. (PT)
Dial: (844) 721-7239
Passcode: 7993227

CHA News Article

CMS Publishes Clarifications on Inpatient Rehabilitation Facility, Long-Term Care Hospital Data Sets
For inpatient rehabilitation facility leaders, long-term care hospital leaders, quality and compliance officers

The Centers for Medicare & Medicaid Services (CMS) has published quarterly guidance and clarifications for the inpatient rehabilitation facility patient assessment instrument (IRF-PAI) and the long-term care hospital continuity assessment record and evaluation (LTCH CARE) data sets.  

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.

Private Post

CDPH Releases COVID-19 Hospital, SNF Outbreak Reporting Thresholds
September 29, 2020

CDPH has issued All Facilities Letter 20-75, which sets thresholds for COVID-19 outbreaks in hospitals. Hospitals are required to report outbreaks and unusual infectious disease occurrences to their local health department and CDPH Licensing and Certification District Office. Under these definitions, acute care hospitals are to report an outbreak when they have:

  • In all counties: Two or more cases of confirmed COVID-19 in a patient seven or more days after admission for a non-COVID condition with epi-linkage. Epi-linkage among patients is defined as overlap on the same unit or ward for any duration or having the potential to have been cared for by common health care personnel within a 14-day time period of each other.
  • In purple or red tier counties: Two or more cases of confirmed COVID-19 in health care personnel with epi-linkage who do not share a household and are not close contacts outside of the workplace. Epi-linkage among health care personnel is defined as having the potential to have been within six feet for 15 minutes or longer while working in the facility during the 14 days prior to the onset of symptoms or a positive test. For example, the health care personnel worked on the same unit during the same shift.
  • In orange or yellow tier counties: Three or more cases of confirmed COVID-19 in health care personnel with epi-linkage who do not share a household and are not close contacts outside of the workplace. The same definition of epi-linkage in the bullet above applies.

The state’s Blueprint for a Safer Economy updates the color tiers and is searchable by county.

Long-term acute care hospitals and long-term care facilities are to report an outbreak to their local health department and CDPH District Office any time one or more residents has a confirmed COVID-19 diagnosis 14 days or more after admission for a non-COVID condition, without an exposure during the previous 14 days to another setting where an outbreak was known or suspected to occur.

Additional thresholds for a facility should investigate and report to the local health department are provided for acute care hospitals, long-term acute care hospitals, and long-term care facilities.

Next CDPH Call for Health Care Facilities: Oct. 6, 8-9 a.m. (PT)
Dial: (844) 721-7239
Passcode: 7993227

CHA News Article

CMS Publishes Clarifications on Inpatient Rehabilitation Facility, Long-Term Care Hospital Data Sets
For inpatient rehabilitation facility leaders, long-term care hospital leaders, quality and compliance officers

The Centers for Medicare & Medicaid Services (CMS) has published quarterly guidance and clarifications for the inpatient rehabilitation facility patient assessment instrument (IRF-PAI) and the long-term care hospital continuity assessment record and evaluation (LTCH CARE) data sets.  

CHA News Article

Post-Acute Care Quality Reporting Program Tip Sheets Available
For post-acute care leaders, quality leaders, and compliance staff

The Centers for Medicare & Medicaid Services (CMS) has issued several post-acute care quality reporting program COVID-19 tip sheets to help providers understand CMS’ public reporting strategy for the program during the public health emergency. 

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.

Private Post

CDPH Issues AFL on Infection Control for SNFs During Holiday Celebrations

The California Department of Public Health (CDPH)  has issued all facilities letter (AFL) 20-86, which provides recommendations for COVID-19 infection control during holiday celebrations for skilled nursing facilities (SNFs).  The letter includes guidance for communal activities, private gatherings,  as well as resident placement upon return to the facility. 

CHA News Article

CDPH Issues AFL on Infection Prevention Requirements for Skilled-Nursing Facilities
For skilled-nursing facility leaders, compliance officers, infection preventionists

The California Department of Public Health (CDPH) has issued All Facilities Letter (AFL) 20-85, which informs skilled-nursing facilities (SNFs) of the requirement that they have a full-time dedicated infection preventionist, a plan for infection prevention control, and annual training for all health care personnel, as provided in Assembly Bill (AB) 2644.   

CHA News Article

CDPH Issues AFL on Interdisciplinary Team Treatment Decisions in SNFs
For skilled-nursing facility leaders, case managers, compliance officers

The California Department of Public Health (CDPH) has issued All Facilities Letter (AFL) 20-83, regarding the interdisciplinary team (IDT) medical decision-making process for skilled-nursing facility residents who are unable to provide informed consent and do not have a representative to make decisions on their behalf.  

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

Updated Minimum Data Set for SNFs, Hospitals With Swing Beds Effective Oct. 1
For skilled-nursing facility leaders, compliance, and reimbursement professionals   

The California Department of Public Health has issued All Facilities Letter (AFL) 20-76, which informs skilled-nursing facilities and hospitals with swing beds to use the revised Minimum Data Set (MDS), effective Oct. 1.  

Private Post

CDPH Issues Guidance for Skilled-Nursing Facilities, Home Health Agencies
September 22, 2020

CDPH has issued several AFLs for post-acute care providers, including:

  • AFL 20-72, which waives certain requirements for home health agencies during the COVID-19 public health emergency. This includes provisions related to licensing, staffing and services, and supervision.
  • AFL 20-73, which provides guidance to skilled-nursing facilities to support residents’ ability to express their treatment wishes through proactive advance care planning. The AFL includes recommendations for all residents, including those who have tested positive for COVID-19.
  • AFL 20-74, which provides recommendations for use of personal protective equipment, cohorting, and staffing for skilled-nursing facility residents. The AFL includes a chart with guidance for each category of COVID-19 status, including COVID-19-positive residents, symptomatic residents awaiting test results, exposed and non-exposed residents, and new admissions.
Private Post

CMS Updates Skilled-Nursing Facility Visitation Guidance
September 22, 2020

The Centers for Medicare & Medicaid Services (CMS) has issued updated guidance for visitation in skilled-nursing facilities during the pandemic. The revised guidance notes that previous restrictions, which focused on protecting residents from COVID-19 by limiting visitation, have taken a physical and emotional toll on residents. It provides reasonable ways that facilities can safely accommodate in-person visitation to address the psychosocial needs of their residents.

While CMS notes that skilled-nursing facilities may continue to restrict visitation (except virtual visits) based on the county’s positivity rate, the facility’s COVID-19 status, or other factors, they may not restrict visitation without a reasonable clinical or safety cause. The new guidance, which is effective immediately, also provides that communal activities and dining can occur with alterations to adhere to guidelines to prevent transmission. Additionally, CMS notes that facilities may apply to use civil money penalties funds to purchase tents for outdoor visitation or dividers to create physical barriers and reduce risk of transmission during in-person visits.

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