Post-Acute Radar

Welcome to SDAHO’s Post-Acute Radar, designed to keep our post-acute providers updated on major changes in regulatory, quality and payment initiatives that may be heading your way.

Each page below contains a brief synopsis of an initiative, icons to show whether the initiative falls into regulatory, quality or payment categories, links to additional resources and a timeline of expected implementation dates and deadlines.

Genworth Financial releases annual Cost of Care Survey

Genworth Financial, an insurance and financial planning company, recently released its annual 2017 Cost of Care Survey, which uses survey results to inform long term...
CMS logo

CMS proposes 2018 and 2019 payment changes for home health

The CMS proposed rule updates the home health prospective payment system (HH PPS) payment rates, including the national, standardized 60-day episode payment rates, the national...
On our radar

Medicare and Medicaid Requirements of Participation for Long-Term Care Facilities

This proposed federal rule revises the requirements that care centers must meet to participate in the Medicare and Medicaid programs. It will update or reorganize nearly all existing regulatory requirements and create new requirements.
On our radar

Revised Nursing Facility Survey Process

CMS intends to revise the nursing facility survey process, with the goal of moving to a uniform national system that blends traditional survey processes with the Quality Indicator Survey (QIS) process. CMS has indicated the revised process will continue to be computer-based and will use QIS critical element pathways.
On our radar

Emergency Preparedness Requirements

Issued in late 2013, this proposed federal rule establishes emergency preparedness requirements for Medicare and Medicaid providers. The goal is for providers to prepare to meet the needs of patients, residents, clients, and participants during disasters and emergency situations.
On our radar

Skilled Nursing Facility Quality Reporting Program

The IMPACT Act mandates a quality reporting program for skilled nursing facilities. For federal fiscal year 2018 (FY18), SNFs that do not report required quality data to CMS will have their market basket updates reduced by two percent.
On our radar

Nondiscrimination Rule

The U.S. Department of Health and Human Services, Office of Civil Rights, has finalized a regulation that implements nondiscrimination provisions enacted as part of the Affordable Care Act of 2010. Those provisions state that an individual shall not be discriminated against on the basis of race, color, national origin, sex, age or disability.
On our radar

2012 Edition of NFPA 101 Life Safety Code

CMS has adopted the National Fire Protection Association’s (NFPA) 2012 edition of the Life Safety Code (LSC) as well as provisions of the NFPA’s 2012 edition of the Health Care Facilities Code. The 2012 LSC includes important changes from the 2000 edition of the LSC.
On our radar

Payroll Based Journal Reporting

Effective July 1, 2016, care centers must electronically submit to CMS complete and accurate direct care staffing information, including information for agency and contract staff, based on payroll and other auditable data according to specifications established by CMS. This new system is called Payroll-Based Journal (PBJ).
On our radar

Revision of Federal Overtime Rules

The U.S. Department of Labor (DOL) has issued a final rule that affects overtime pay for executive, administrative, professional, outside sales and computer employees (the "white collar" exemption). It's currently on hold due to a preliminary injunction.
On our radar

OSHA Tracking of Workplace Injuries/Illnesses

Finalized May 12, 2016, this OSHA rule calls for electronic submission of injury and illness reports, and states that reports will be posted in a publicly accessible website. It also includes provisions requiring employer policies to support prompt and accurate reporting.
On our radar

Nursing Home Compare: Six New Quality Measures Publicly Reported

In April 2016, the Centers for Medicare & Medicaid Services (CMS) began posting data for six new quality measures on Nursing Home Compare. There are four new short stay measures and two new long-stay measures.
On our radar

Five Star Quality Rating System: Five New Measures Added to Quality Domain

In April 2016, CMS added six new quality measures (QMs) to Nursing Home Compare (see above). On July 27, 2016, CMS added the first five of those QMs to the Five Star Nursing Home Quality Rating System.
On our radar

Hospital Discharge Planning Requirements

CMS has issued a proposed rule that would require hospitals to assist patients in selecting a post-acute care provider by using and sharing SNF quality measures data.
On our radar

Medicare Overpayments Rule

CMS has implemented a rule governing the ACA requirement to identify and return Medicare overpayments to CMS within 60 days. Under the rule, providers, including Skilled Nursing Facilities, are required to use “reasonable diligence” to identify overpayments and to see that they are returned within the time frame to avoid penalties.
On our radar

Medicare SNF Value Based Purchasing (VBP)

This program will begin with the rate year starting on Oct. 1, 2018. In the first year, the only quality measure used will be 30-day all cause readmission rates (both the overall rate and improvement by each facility). The first measurement period will be calendar year 2017.
On our radar

HCBS Settings Rule

In January 2014, CMS issued a rule listing criteria that must be met by Home and Community-Based Services (HCBS) settings in which Medicaid/Medical Assistance (MA) waiver services are provided. The purpose enhance quality, add consumer protections and ensure services are being provided in the most integrated settings.
On our radar

IMPACT Act Home Health Quality Reporting Requirements

The IMPACT Act mandates a quality reporting program for Medicare Home Health Agencies utilizing OASIS data. Quality measure domains are Skin Integrity, Medication Reconciliation, Resource Use, Functional Status/Cognitive Function, Incidence of Major Falls and Patient Health Information and Preference.
On our radar

Hazardous Pharmaceutical Waste Disposal

The EPA has proposed a rule that would increase regulations regarding disposal of pharmaceuticals classified as hazardous waste. Facilities would be prohibited from disposing of hazardous waste pharmaceuticals by flushing them down the toilet or into a drain.
On our radar

Medicare and Medicaid Conditions of Participation for Home Health Agencies

This proposed federal rule revises the conditions of participation that home health agencies must meet to participate in Medicare and Medicaid. It updates many existing regulatory requirements and creates new requirements.