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 Comments on IMPACT Act Beta Test Results

CHA has submitted comments to the Centers for Medicare & Medicaid Services (CMS) on its release of preliminary findings from the national beta test of standardized patient assessment data elements (SPADEs).

CHA News Article

Palliative Care Pilot Program Participants Required to Use New Web-Based Reporting Tool

In All Facilities Letter 18-57, the California Department of Public Health announces a new web-based data collection tool intended to assist providers that participate in the Palliative Care Pilot Program with annual reporting. Program participants must submit certain information using this tool by Jan. 1 of each program year. 2018 reports were due Jan. 1, 2019, but the online reporting portal will remain open through March 1.

CHA News Article

DME Competitive Bidding Suspended for Two Years

The Centers for Medicare & Medicaid Services (CMS) has issued a fact sheet announcing that it expects a temporary gap for the Medicare Durable Medical Equipment, Prosthetics, Orthotics, and Supplies Competitive Bidding Program to last until Dec. 31, 2020. 

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

Palliative Care Pilot Program Participants Required to Use New Web-Based Reporting Tool

In All Facilities Letter 18-57, the California Department of Public Health announces a new web-based data collection tool intended to assist providers that participate in the Palliative Care Pilot Program with annual reporting. Program participants must submit certain information using this tool by Jan. 1 of each program year. 2018 reports were due Jan. 1, 2019, but the online reporting portal will remain open through March 1.

CHA News Article

CMS Provides Updates 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.  

Inpatient Rehabilitation Facilities 
Provider Preview Reports
Updated inpatient rehabilitation facility (IRF) provider preview reports are now available. Providers have until Oct. 8 to review their 2017 quality measure performance data prior to their posting to the IRF Compare website in December. Corrections to the underlying data will not be permitted during this time. However, providers can request CMS review if they believe the data scores displayed are inaccurate. 

Four new quality measures will be reported on IRF Compare: 

  • Assessment-based measures:
    • Application of Percent of Long-Term Care Hospital Patients With an Admission and Discharge Functional Assessment and a Care Plan That Addresses Function (NQF #2631)
    • Application of Percent of Residents Experiencing One or More Falls with Major Injury (NQF #0674)
  • Claims-based measures: 
    • Medicare Spending Per Beneficiary
    • Discharge to Community
CHA News Article

CMS Issues FFY 2019 Hospice Wage Index Final Rule

The Centers for Medicare & Medicaid Services (CMS) has issued its final rule updating the hospice wage index for federal fiscal year (FFY) 2019. CMS finalized a 1.8 percent hospice payment update based on a 2.9 percent inpatient hospital market basket update, reduced by a 0.8 percent productivity adjustment and a 0.3 percentage point adjustment mandated by the Affordable Care Act. The agency estimates the payment update will result in a $340 million increase in hospice payments compared to FFY 2018.

CMS also finalized several changes to the Hospice Quality Reporting Program and, as required by the Bipartisan Budget Act of 2018, expanded the definition of a “hospice attending physician” to include physician assistants in addition to physicians and nurse practitioners. Additional information is available in a CMS fact sheet.

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

Requirements Change for Medicare Outpatient Therapy Services Billing

Requirements for billing outpatient physical therapy (PT), occupational therapy (OT) and speech language pathology (SLP) services have changed as of Jan. 1.   

CHA News Article

CHA Comments on IMPACT Act Beta Test Results

CHA has submitted comments to the Centers for Medicare & Medicaid Services (CMS) on its release of preliminary findings from the national beta test of standardized patient assessment data elements (SPADEs).

CHA News Article

DME Competitive Bidding Suspended for Two Years

The Centers for Medicare & Medicaid Services (CMS) has issued a fact sheet announcing that it expects a temporary gap for the Medicare Durable Medical Equipment, Prosthetics, Orthotics, and Supplies Competitive Bidding Program to last until Dec. 31, 2020. 

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

CHA Comments on IMPACT Act Beta Test Results

CHA has submitted comments to the Centers for Medicare & Medicaid Services (CMS) on its release of preliminary findings from the national beta test of standardized patient assessment data elements (SPADEs).

CHA News Article

CMS Extends Timeline for Publishing Discharge Planning Requirements

The Centers for Medicare & Medicaid Services (CMS) has extended until Nov. 9, 2019, its timeline for revising discharge planning requirements for hospitals, critical access hospitals and home health agencies. 

On Nov. 3, 2015, CMS proposed updates to discharge planning requirements that included provisions required by the Improving Medicare Post-Acute Care Transitions (IMPACT) Act of 2014. At that time, CHA submitted a comment letter on members’ behalf. Based on the numerous comments and information it received, CMS has determined that significant policy issues must be resolved and it needs additional time to coordinate with other government agencies. More information is available in the attached notice. 

CHA News Article

CMS Provides Updates for IRF, LTCH 2019 Policy Changes

The Centers for Medicare & Medicaid Services (CMS) has issued the attached MLN Matters article about federal fiscal year 2019 policy changes to the inpatient rehabilitation facility (IRF) and long-term care hospital (LTCH) prospective payment systems. Included are MS-DRG grouper changes, wage index changes, and updates to quality reporting and value-based purchasing programs. 

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

Requirements Change for Medicare Outpatient Therapy Services Billing

Requirements for billing outpatient physical therapy (PT), occupational therapy (OT) and speech language pathology (SLP) services have changed as of Jan. 1.   

CHA News Article

CHA Comments on IMPACT Act Beta Test Results

CHA has submitted comments to the Centers for Medicare & Medicaid Services (CMS) on its release of preliminary findings from the national beta test of standardized patient assessment data elements (SPADEs).

CHA News Article

Health Care Facilities Reminded of New Requirement to Provide Plant-Based Meals

The California Department of Public Health reminds health care providers that, effective Jan. 1, they must make plant-based meal options — without meat, poultry, fish, dairy or eggs — available to patients, in accordance with their physician’s orders. For more information about the law, see page 15 of CHA’s 2018 Report on Legislation.

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 Provides Updates 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.  

Inpatient Rehabilitation Facilities 
Provider Preview Reports
Updated inpatient rehabilitation facility (IRF) provider preview reports are now available. Providers have until Oct. 8 to review their 2017 quality measure performance data prior to their posting to the IRF Compare website in December. Corrections to the underlying data will not be permitted during this time. However, providers can request CMS review if they believe the data scores displayed are inaccurate. 

Four new quality measures will be reported on IRF Compare: 

  • Assessment-based measures:
    • Application of Percent of Long-Term Care Hospital Patients With an Admission and Discharge Functional Assessment and a Care Plan That Addresses Function (NQF #2631)
    • Application of Percent of Residents Experiencing One or More Falls with Major Injury (NQF #0674)
  • Claims-based measures: 
    • Medicare Spending Per Beneficiary
    • Discharge to Community
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.

Commands