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Emergency Department Toolkit

This post has been archived and contains information that may be out of date.

Special resource toolkit developed by CHA’s EMS/Trauma Committee and the Center for Behavioral Health.  Designed to help staff provide support to patients in the ED with psychosis and/or substance abuse disorders, this toolkit provides access to articles, policies, management techniques, assessment tools and more. Click the topic tabs below to access resources and information.

CMS Proposes Regulation to Alleviate State Burden

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The Centers for Medicare & Medicaid Services (CMS) recently issued a proposed rule that would provide states with greater flexibility in how they meet access to care requirements within the Medicaid program.

The proposed rule addresses concerns associated with the 2015 final rule — which CHA commented on — that requires states proposing to reduce or restructure Medicaid fee-for-service payment rates to collect data through an Access Monitoring Review Plan and solicit input on the potential impact on beneficiaries’ access to care. 

CMS proposes to exempt states with an overall Medicaid managed care penetration rate of 85 percent or greater from most fee-for-service access monitoring requirements; California’s current Medi-Cal managed care penetration rate is 80 percent.

CMS Provides Updates for Post-Acute Care Quality Reporting

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The Centers for Medicare & Medicaid Services (CMS) regularly provides important updates about post-acute care quality reporting programs, including training opportunities, public reporting details and reminders of data submission and review deadlines. Following are the recent updates for inpatient rehabilitation facilities, long-term care hospitals and hospice providers:

Inpatient Rehabilitation Facilities
Provider Preview Reports
Provider preview reports are now available for inpatient rehabilitation facilities (IRFs). IRFs have until April 5, 2018, to review their performance on quality measures based on data from quarter 3 of 2016 to quarter 2 of 2017, prior to their posting to the IRF Compare website in June 2018. Access instructions for the provider reports are available online. Corrections to the underlying data will not be permitted during this time. However, providers can request review by CMS during the preview period if they believe their data are inaccurate. 

CHA Responds to Request for Information on Revised Clinical Laboratory Regulations

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CHA has submitted the attached  comment letter in response to the Centers for Medicare & Medicaid Services (CMS) request for information on revisions to the Clinical Laboratory Improvement Amendments of 1988 regulations. CMS — in consultation with the Centers for Disease Control and Prevention, state surveyors and other stakeholders – has identified a number of areas within the regulations that could be updated to better reflect current knowledge, changes in academic context and advancements in laboratory testing.

In the letter, CHA urges CMS to adopt regulations that provide the most flexibility for laboratory directors to make personnel decisions that address their workforce needs, based on an individual’s experience and educational background. CHA also supports giving CMS a greater level of discretion for Category 1 proficiency testing referral violations, particularly when sanctions are applied for laboratories following their standard operating procedures. In addition, CHA supports the recommendations of the Clinical Laboratory Improvement Amendments Advisory Committee Virtual Crossmatch Workgroup to update histocompatibility regulations, reflecting advancements in the field. Comments on the request for information are due March 12.

CHA DataSuite Releases Medicare Cost Report Model Update

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CHA DataSuite has issued the fourth quarter 2017 update of the Medicare cost report model, which provides hospitals with commonly sought after data elements from the Centers for Medicare & Medicaid Services (CMS) Healthcare Cost Report Information System database. The model highlights hospital utilization data, inpatient and outpatient data, overall hospital statistics and uncompensated care data.

Worksheets include:

S-3 Part I – utilization data
S-10 – uncompensated care data
G-3 – overall revenue and expense data
E Part A – hospital inpatient data
E Part B – hospital outpatient data
E-3 Part V – critical access hospital inpatient services data
E-4 – hospital direct graduate medical education and end stage renal disease outpatient direct medical education data

CMS Provides Updates for Post-Acute Care Quality Reporting

This post has been archived and contains information that may be out of date.

The Centers for Medicare & Medicaid Services (CMS) regularly provides important updates about post-acute care quality reporting programs, including training opportunities, public reporting, and reminders of data submission and review deadlines.  

Inpatient Rehabilitation Facilities 

Data Submission Deadline Approaching
Assessment data for the Inpatient Rehabilitation Facility Patient Assessment Instrument (IRF PAI) and data submitted to CMS via the Center for Disease Control and Prevention National Healthcare Safety Network for July-September (Q3) of calendar year 2017 are due no later than 11:59 (PT) on Feb. 15.  

Long-Term Acute Care Hospitals 

Data Submission Deadline Approaching
Assessment data for the Long-Term Care Hospital Continuity Assessment Record and Evaluation (LTCH CARE) and data submitted to CMS via the Center for Disease Control and Prevention National Healthcare Safety Network for July-September (Q3) of calendar year 2017 are due no later than 11:59 (PT) on Feb. 15.  

Training
Materials from the December 2017 Long-Term Care Hospital Quality Reporting Program provider training are now available under “Related Links” on CMS’ dedicated long-term care hospital web page.  

CMS Seeks Comments on Clinical Laboratory Personnel Requirements

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The Centers for Medicare & Medicaid Services (CMS) has issued the attached request for information on updating personnel requirements, testing standards and industry fee structures under the clinical laboratory improvement amendments. Among the personnel requirements listed, CMS seeks comment on whether it should codify in regulations the current guidance that a bachelor’s degree in nursing is considered equivalent to a bachelor’s degree in biological sciences for the purposes of educational requirements for moderate and high-complexity testing personnel under the clinical laboratory improvement amendments.

CMS notes that these regulations have not been meaningfully updated since 1992. The topics listed in the request for information are areas that the Centers for Disease Control and Prevention, state agency surveyors and other stakeholders have identified as needing to be updated to better reflect current knowledge and advancements in laboratory testing. CMS intends to consider public responses to the request for information when it drafts proposals to update the existing regulations. Comments are due March 12.

CHA Releases Draft Model of 2017-19 Hospital Fee Program

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As reported in CHA News last week, the Department of Health Care Services (DHCS) recently sent hospitals invoices covering the first six fee-for-service cycles of the 2017-19 Hospital Fee Program. The attached draft model incorporates those invoiced amounts, as well as the supplemental fee-for-service payment amounts approved last month by the Centers for Medicare & Medicaid (CMS) services. Notably, the “Gain.Contribute” tab in the model includes a summary, by state fiscal year, of the estimated fee and payment amounts for the 30-month program period. CHA is in the process of creating hospital-specific fee and payment schedules, which will be distributed within the next week.