Rural Health Information Hub Latest News

CMS Issues Final Rule on Discharge Planning Requirements for Hospitals, CAHs, and HHAs

On September 26, the Centers for Medicare and Medicaid Services (CMS) issued a final rule updating regulations for hospitals, Critical Access Hospitals (CAHs), and home health agencies (HHAs) on the transition from acute care into post-acute care (PAC), a process called “discharge planning.” For CAHs, the final rule adds a new, separate condition of participation (CoP) specific to discharge planning. The new regulatory language outlines the standards for the discharge planning process, beginning with identifying those patients (at an early stage of hospitalization) likely to suffer adverse health consequences upon discharge in the absence of adequate discharge planning. Detail on the specific requirements is provided in the Federal Register. These regulations will go into effect on November 29, 2019.

CMS Issues Omnibus Burden Reduction Final Rule

On September 26, the Centers for Medicare and Medicaid Services (CMS) issued a final rule to remove or update Medicare regulations the agency has identified as unnecessary, obsolete, or excessively burdensome on hospitals and other healthcare providers. This includes regulatory updates for Critical Access Hospitals (CAHs), rural health clinics (RHCs) federally qualified health centers (FQHCs), and hospital and CAH swing-bed providers. Among other updates for CAHs, the final rule replaces the current requirement on systems for infection control with a new infection prevention and control and antibiotic stewardship Condition of Participation (CoP). CMS is also requiring that CAHs develop, implement, and maintain Quality Assessment and Performance Improvement Programs (QAPI) programs, that will replace the existing annual evaluation and quality assurance review requirement. In implementing the QAPI requirements, CMS encourages CAHs to utilize the technical assistance and services available through the State Flex Programs, including the Medicare Beneficiary Quality Improvement Project (MBQIP). For RHCs and FQHCs, the final rule reduces the frequency of review of the patient care policies and facility evaluation from annually to every two years. The final rule also makes changes to other requirements such as those pertaining to emergency preparedness. To see all the facility types and regulations affected, you may access the final rule in the Federal Register. These regulations will go into effect on November 29, 2019, except for the CAH QAPI and antibiotic stewardship requirements (March 30, 2021 and March 30, 2020, respectively).

RHIhub Toolkit for Rural Suicide Prevention

The Rural Health Information Hub (RHIhub) recently announced a new toolkit that compiles resources and model programs to aid organizations in implementing suicide prevention programs in rural communities.  According to data collected by the Centers for Disease Control and Prevention (CDC), suicide rates are higher in rural areas of the country.  Earlier this year, the CDC released a map of suicide mortality, showing a concentration in states that are mostly rural.

New Brief: CAH Participation in Flex Financial and Operational Improvement Activities

The national Medicare Rural Hospital Flexibility Program (Flex) Monitoring Team has released a new policy brief on Critical Access Hospital (CAH) participation in Flex financial and operational improvement activities. The brief aims to identify the patterns of CAH participation in Flex-funded activities from 2015 to 2018 and to investigate whether CAHs at greater risk of financial distress were more likely to participate in financial and operational improvement activities.  The brief may accessed via the link below or on the Flex Monitoring Team website.

Pennsylvania Governor Wolf’s Administration Announces Expansion of Long-Term Care Program Helping Seniors Live in their Homes and Communities

October 1, 2019

Harrisburg, PA – The Wolf Administration today announced a 14-county expansion of the Living Independence for the Elderly (LIFE) program, a long-term care program that helps seniors live in their home and coordinates their health and personal needs. Through this expansion, LIFE programs, under the jurisdiction of the Department of Human Services (DHS), will be established in Bradford, Cameron, Carbon, Centre, Clearfield, Elk, Fulton, Jefferson, Monroe, Potter, Sullivan, Susquehanna, Tioga, and Wayne Counties.

“All Pennsylvanians deserve to age in place in their community with family and peers as they are able. LIFE programs around Pennsylvania help make this possible,” said DHS Secretary Teresa Miller. “We are pleased to be able to bring the LIFE program to more Pennsylvanians around the commonwealth.”

Many older Pennsylvanians wish to continue living in their homes and their communities for as long as economically and medically feasible; and Pennsylvania’s LIFE program enables participants to stay out of nursing homes and remain in their own homes and communities and live happier, more productive, and more fulfilling lives.

“This LIFE expansion will give seniors and their loved ones what we know they want — the opportunity to get the care they need without being separated from the community and family they’ve grown comfortable with,” said Department of Aging Secretary Robert Torres. “Social isolation remains an enormous concern for the aging population, so having this long-term care option made more accessible in 14 counties will benefit many Pennsylvania families.”

The program was first implemented in Pennsylvania in 1998 and is known nationally as the Program of All-Inclusive Care for the Elderly (PACE). People who are 55 or older who meet the level of care for a skilled nursing facility or special rehabilitation facility, are able to be safely served in the community, and live in an area served by a LIFE provider are eligible for LIFE. LIFE participants must also meet financial eligibility requirements or privately pay for services.

The Wolf Administration is committed to serving people in the community, and LIFE is an option that allows older Pennsylvanians to live independently while receiving services and supports that meet their health and personal needs. The LIFE program is one of Pennsylvania’s home and community-based services options, currently serving more than 7,000 people across the state.

The expansion of the program will allow more people in more parts of the state to be served by LIFE. The service areas of Carbon, Monroe, Susquehanna, Wayne and Centre counties have been assigned to LIFE Geisinger. LIFE Geisinger is currently active in nine other counties. The Clearfield, Jefferson, Elk and Cameron service areas have been assigned to LIFE Northwestern Pennsylvania, who is currently active seven other counties. In addition, the Bradford, Potter, Sullivan, Tioga, and Fulton service areas have been assigned to Community LIFE, who is currently active in two other counties.

For more information on the LIFE program, visit

The ‘Best Places to Work’

During the week of September 23, 2019, Modern Healthcare released its 2019 ranked list of the “Best Places to Work in Health Care,” featuring hospitals, suppliers, and other organizations in the industry. For this year’s edition, Modern Healthcare ranked 75 providers and insurers on one list and 75 suppliers on another. (Source: Modern Healthcare, 9/26)