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Policy Snapshot

November 8, 2024

The Centers for Medicare & Medicaid Services (CMS) has issued its final rule for the Calendar Year (CY) 2025 Home Health Prospective Payment System (HH PPS), which includes updates to Medicare payment policies and rates for Home Health Agencies (HHAs). Among the key changes, CMS is finalizing a new data reporting standard for long-term care (LTC) facilities aimed at improving monitoring of acute respiratory illnesses.

Beginning January 1, 2025, LTC facilities will be required to electronically report data on COVID-19, influenza, and respiratory syncytial virus (RSV) in a standardized format, replacing the current COVID-19 reporting requirements that are set to expire in December 2024. This new reporting mandate is designed to broaden the scope of data collected on respiratory illnesses and support better infection control practices within LTC facilities.

The required data elements will include:

  • Facility census
  • Resident vaccination status for COVID-19, influenza, and RSV
  • Confirmed resident cases of COVID-19, influenza, and RSV (broken down by vaccination status)
  • Hospitalized residents with confirmed cases of these illnesses (also by vaccination status)

CMS believes that sustained collection of this data outside of emergency situations will help LTC facilities gain valuable insights into their infection control needs and improve their response to respiratory illness outbreaks.

Additionally, CMS notes that in the event of a national public health emergency (PHE) related to an acute respiratory illness, LTC facilities may be required to report additional data, including daily frequency reports and information on confirmed infections, staffing shortages, supply inventories, and medical countermeasures.