About Continuum of Care
Post-acute care — often provided at inpatient rehabilitation facilities, long-term care hospitals, skilled-nursing facilities, and at patients’ homes — is vital to the health care delivery system. These providers deliver essential medical and rehabilitative services following hospital care. Hospital case managers help support, and connect patients, families, and caregivers through communication and coordination with post-acute care providers and home and community-based services. This includes the development of a discharge or transition plan that addresses the patient’s goals, needs and treatment preferences, and prepares patients and caregivers for post-discharge care.
CHA Issues Summaries of IPPS, LTCH PPS Proposed Rule
What’s happening: Summaries of the federal fiscal year 2026 inpatient prospective payment system (IPPS) and long-term care hospital (LTCH) PPS proposed rule are now available, and on May 21, CHA will host a complimentary, members-only webinar on the IPPS provisions.
DHCS Updates Community Services and Supports Guide
What’s happening: The Department of Health Care Services’ (DHCS’) revised Community Supports Policy Guide reflects extensive feedback from managed care plans, providers, and other stakeholders.
Members-Only Summaries Detail Post-Acute Care, Psychiatric Facility Payment Provisions for FFY 2026
What’s happening: Summaries of the inpatient rehabilitation facility (IRF) prospective payment system (PPS), skilled-nursing facility (SNF) PPS, hospice wage index, and inpatient psychiatric facility (IPF) PPS proposed rules are now available.
District Court Rejects Federal SNF Staffing Requirements
What’s happening: On April 7, the U.S. District Court for the Northern District of Texas vacated key portions of the minimum staffing requirements for skilled-nursing facilities (SNFs) mandated by the Centers for Medicare & Medicaid Services (CMS).
What else to know: The court ruled that CMS’ standardized numerical minimums were inconsistent with existing federal law passed by Congress in 1987.
CMS Issues Post-Acute Care Payment Proposed Rules
What’s happening: On April 11, the Centers for Medicare & Medicaid Services (CMS) issued its proposed payment policies for inpatient rehabilitation facilities (IRFs), skilled-nursing facilities (SNFs), and long-term care hospitals (LTCHs) for federal fiscal year (FFY) 2026.
What else to know: Comments on the proposed rules are due to CMS by June 10.
DHCS Community Support Updates Take Effect July 1
What’s happening: The Department of Health Care Services (DHCS) has updated service definitions for four of the 14 community supports that Medi-Cal managed care plans (MCPs) may offer as part of the state’s Medi-Cal reform effort, California Advancing and Innovating Medi-Cal (CalAIM). The four updated service definitions go into effect July 1.
CMS Finalizes Medicare Advantage, Part D Rule for 2026
What’s happening: In its finalized changes to the Medicare Advantage (MA) and Part D prescription drug programs for contract year 2026, the Centers for Medicare & Medicaid Services (CMS) struck most of the Biden-era proposals and declined to finalize additional insurer accountability provisions.
What else to know: The rule, which did not address several other proposals (detailed below), is effective Jan. 1, 2026.
CHA Memo Helps Hospital EDs with Psychiatric Emergencies Under AB 1316
What’s happening: As of Jan. 1, hospital emergency departments (EDs) have a clear pathway for Medi-Cal reimbursement for behavioral health visits under CHA-sponsored Assembly Bill (AB) 1316 (2024). In a memo to members, CHA provides guidance to hospitals on the new requirements and their obligations for stabilizing or transferring individuals in EDs experiencing a mental health crisis.
Post-Acute Care Transfer Policy Analysis for FFYs 2020-25 Shows Estimated Impact on Medicare Inpatient FFS Payments and More
What’s happening: CHA DataSuite has issued a hospital-specific analysis of the inpatient post-acute care transfer (PACT) adjustment policy that shows the estimated impact on Medicare inpatient fee-for-service (FFS) payments.
What else to know: The analysis also shows corresponding Medicare severity diagnosis-related group (MS-DRG) volumes from the inpatient prospective payment system (IPPS) during federal fiscal years (FFYs) 2020-25.
CDPH Seeks Input on Reporting Unusual Occurrences
What’s happening: The California Department of Public Health (CDPH) Center for Health Care Quality (CHCQ) is seeking public comment from long-term care facilities, including skilled-nursing facilities, on regulations for reporting unusual occurrences. For more information, refer to All Facilities Letter 25-11.
What else to know: CHCQ seeks input on several topics, including definitions, reporting processes, and requirements for documentation. Comments are due by April 7 and can be submitted to the CHCQ Regulation Development Section at CHCQRegulations@cdph.ca.gov