On October 6, 2014
President Obama signed the "Improving Medicare Post-Acute Care
Transformation Act of 2014". This bill puts in place new and
streamlined quality measures for nursing home, home health agencies, hospices,
and other post-acute providers.
Nursing
Homes will receive Nationwide Focused Survey Inspections, Improved Scoring
Methodology, Timely and Complete Inspection Data, and Additional Quality
Measures. The other item is Electronic Payroll-Based Staffing Reporting
on a quarterly basis. Could this eventually be required of home health or
hospice?
Home
Health Agencies will see new emphasis on explanation of patient rights.
An expanded comprehensive patient assessment requirements that focuses on all
aspects of patient well-being. An integrated communication system, increasingly
enabled by health information technology that ensures the patients' needs are
identified and addressed, care is coordinate among all disciplines, and that
there is active, timely, needs-based communications between the home health
agency and the physician. A data-drive, agency-wide quality assessment
and performance improvement program that continually evaluates and improves
agency care for patients. An expanded care coordination requiring that a
licensed clinician be responsible for all patient care services, such as
coordinating referrals and assuring that plans of care meet each patient's
needs at all times. Didn't the Proposed Home Health COPs we
reported on yesterday address most of these? They did but this act is a
new law that will require new proposed regulations.
Hospices
will see increase in frequency of surveys. By law hospice were intended to be
surveyed every 36 months, but there has not been the funds for these
surveys. Many hospice have between 5 and 7 years between surveys. This
law adds $25 million for hospice surveys for FY 2015 through 2017 and adds $45
million for hospice surveys for FY 2018 through 2025. The law also
addresses hospice patients with length of stays that exceed 180 days.
This will set an automatic medical review on hospices that have more than a
certain percentage of their patient who have length of stays more than 180
days. The law does not specify the percentage. It states the
Secretary, which is the Secretary of Health and Human Services would establish
this percentage. I believe most hospices that have a high percentage of patients
with length of stays beyond 180 days are probably already having their claims
moved to medical review.
We
intend to provide future emails to give you more information on the impact of
this bill. We will also have information for home health agencies at our
3 Day Home Health Seminar to be held in Las Vegas at the Monte Carlo Hotel
& Casino on January 28-30, 2015. We will also
have more information for hospices at our 3 Day Hospice Seminar to be held in
Las Vegas at the Monte Carlo Hotel & Casino on February 2-4, 2015.
Link to Bill
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