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CMS Issues FFY 2022 Long-Term Care Hospital PPS Proposed Rule

For CFOs, long-term care hospital leaders, compliance officers

The Centers for Medicare & Medicaid Services (CMS) has issued its fiscal year (FY) 2022 updated payment policies and other provisions for the long-term care hospital (LTCH) prospective payment system (PPS). Comments on the proposed rule are due by 2 p.m. (PT) on June 28.   

Overall, CMS expects LTCH PPS payments for 2022 to increase by approximately 1.4% or $52 million. LTCH PPS payments for FY 2022 for discharges paid at the standard LTCH payment rate are expected to increase by 1.2% due primarily to the annual standard federal rate update for FY 2022 of 2.2% and a projected 0.8% decrease in high-cost outlier payments. 

LTCH PPS payments for FY 2022 for discharges paid at the site-neutral payment rate are expected to increase by 3%. CMS estimates that discharges paid at the site-neutral payment rate will represent approximately 25% of all LTCH cases and 10% of all LTCH PPS payments in FY 2022. 

CMS also proposes several changes to the LTCH quality reporting program and solicits input on additional policies via two requests for information (RFI):  

  • COVID-19 Vaccination Coverage among Healthcare Personnel (HCP) Measure: CMS proposes to adopt a new measure that would require LTCHs to report COVID-19 HCP vaccinations in their facilities beginning with the FY 2023 LTCH quality reporting program.  
  • Transfer of Health (TOH) Information to the Patient-Post Acute Care (PAC) Quality Measure: CMS proposes to revise the denominator for the TOH information to the patient-PAC quality measure to include only discharges to a private home/apartment, board and care home, assisted living, group home, or transitional living, beginning with FY 2023.   
  • Public Reporting of Quality Measures Impacted by COVID-19 Public Health Emergency (PHE) Exemptions: To account for COVID-19 PHE exceptions to LTCH quality reporting program (QRP) requirements for Q1 and Q2 2020, CMS proposes to modify the number of quarters used for public reporting for the public display of LTCH QRP data.    
  • Public Reporting of Compliance with Spontaneous Breathing Trial by Day 2 of the LTCH Stay and the Ventilator Liberation Rate for the PAC LTCH QRP Measure: Public reporting on these measures is proposed to begin with the March 2022 Care Compare refresh or as soon as technically feasible.    
  • RFI on Closing the Health Equity Gap: CMS seeks comments on ways to attain health equity for all patients through policy solutions. Specifically, CMS seeks comments on the possibility of expanding measure development and the collection of other standardized patient assessment data elements that address gaps in health equity in the LTCH quality reporting program.   
  • RFI on Digital Quality Measurement in PAC Quality Reporting Programs: CMS seeks feedback on its plans to define and develop digital quality measures for the LTCH QRP, including the use of Fast Healthcare Interoperability Resources to support digital quality measures.   

Additional information is available in a CMS fact sheet.