CHA News

CMS Issues Final Rule on FFY 2022 Long-Term Care Hospital Prospective Payment System

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

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The Centers for Medicare & Medicaid Services (CMS) issued the federal fiscal year (FFY) 2022 long-term care hospital (LTCH) prospective payment system (PPS) final rule.  

CMS expects LTCH PPS payments to increase by approximately 1.1%, or $42 million, for FFY 2022. LTCH PPS payments for FFY 2022 for discharges paid the standard LTCH payment rate are expected to increase by 0.9%. LTCH PPS payments for FFY 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 FFY 2022.

In addition to the annual payment updates, CMS also finalizes several changes to the LTCH quality reporting program (QRP) and provides feedback on two requests for information (RFI) highlighted below:  

  • COVID-19 Vaccination Coverage among Healthcare Personnel (HCP) Measure: CMS finalizes the adoption of a new measure that requires LTCHs to report COVID-19 HCP vaccinations in their facilities beginning with the FFY 2023 LTCH QRP.   
  • Transfer of Health (TOH) Information to the Patient-Post Acute Care (PAC) Quality Measure: CMS finalizes revisions to 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 FFY 2023.    
  • 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: CMS finalizes its proposal to publicly report on these measures beginning with the March 2022 Care Compare refresh or as soon as technically feasible.     
  • Public Reporting of Quality Measures Impacted by COVID-19 Public Health Emergency Exemptions: CMS finalizes its proposal to publicly report quality measures with fewer than the standard numbers of quarters due to COVID-19 public health emergency exemptions. 
  • RFI on Closing the Health Equity Gap: The proposed rule solicited feedback on ways to improve health equity for all patients. The comments CMS received will be taken into consideration as the agency works to develop policies to improve health equity. CMS plans to provide additional stratified quality measure information to providers related to race and ethnicity.
  • RFI on Digital Quality Measurement in PAC Quality Reporting Programs: CMS will consider the feedback received on the agency’s plans to define and develop digital quality measures (dQMs) for the IRF QRP, including the use of Fast Healthcare Interoperability Resources to support digital quality measures, as the agency develops future policies and continues to work with other agencies and stakeholders to coordinate and to inform the transformation to dQMs leveraging health IT standards.

Additional information is available in a CMS fact sheet.