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How Will the IMPACT Act Impact Your Skin Integrity Program?

The Improving Medicare Post-Acute Care Transformation Act, more commonly known as the IMPACT Act, was passed by Congress on September 18, 2014. It requires the reporting of standardized patient-assessment data from post-acute care providers including Long-Term Care Hospitals (LTCH), Skilled Nursing Facilities (SNF), Home Health Agencies (HHA) and Inpatient Rehabilitation Facilities (IRF).

The IMPACT Act identifies five Quality Measure domains, three of which will affect the provider’s payment beginning in 2018 : skin integrity, cognitive function and functional status, and occurrence of major falls. Beginning in October 2016, skilled nursing facilities, inpatient rehabilitation centers, and long-term care hospitals will start submitting this data. Data collection will begin in January 2017 for home health agencies. Starting in October 2018 for IRFs, LTCHs, and SNFS, and in January 2019 for HHAs, the results from this data will be used to determine payment. Beginning in 2019, post-acute providers that fail to collect and report data will have their market basket percentage updates reduced by two percentage points.

Why was the IMPACT Act legislated?

The IMPACT Act was legislated to address:

  • Noted substantial variations in quality and costs among post-acute providers
  • Lack of standardization of quality and cost metrics across the different post-acute providers

The IMPACT Act will:

  • Help ensure the patient is placed in the most appropriate post-acute care setting
  • Improve hospital and post-acute care discharge planning
  • Reform post-acute care payments and reimbursement
  • Promote interoperability across disparate technology platforms

[DOWNLOAD] More you should know about healthcare changes.

What does the IMPACT Act say about skin integrity?

Regardless of setting or provider type, pressure injuries (ulcers) are recognized as a serious medical condition with many pressure ulcers identified as preventable. There is considerable evidence that associates pressure ulcers with pain, decreased quality of life, longer post-acute care stays, increased costs and increased mortality. Developed by the National Quality Forum (NQF), the skin integrity measure reports the percent of patients/short-stay residents with Stage 2-4 pressure ulcers that are new or worsened since admission.

For SNFs: The measure is restricted to the short-stay (100 or fewer days) patients and is calculated by examining all assessments during this time frame for reports of Stage 2-4 pressure ulcers that were not present or were at a lesser stage upon admission.

For LTCHs: This measure reports the percent of patient stays with reports of Stage 2-4 pressure ulcers that were not present or were at a lesser stage on admission for all patients in LTCHs.

For IRFs: This measure reports the percent of patient stays with reports of Stage 2-4 pressure ulcers that were not present or were at a lesser stage on admission for all Medicare Part A and Part C IRF patients.

For HHAs: This measure is calculated by examining all assessments during an episode of care for reports of Stage 2-4 pressure ulcers that were not present or were at a lesser stage since admission.


Post-Acute Provider

Skin Integrity Measure

Reporting Timeline

Penalty Timeline

Inpatient Rehabilitation Facilities (IRF)
% of Patients with Stage 2-4 Pressure Ulcers that are New or Worsened (Short-Stay) October 1, 2016 October 1, 2018

Long-Term Care Hospitals (LTCH)
% of Patients with Stage 2-4 Pressure Ulcers that are New or Worsened (Short-Stay) October 1, 2016 October 1, 2018

Skilled Nursing Facilities (SNF)
% of Patients with Stage 2-4 Pressure Ulcers that are New or Worsened (Short-Stay) October 1, 2016 October 1, 2018

Home Health Agencies
(HHA)
% of Patients with Stage 2-4 Pressure Ulcers that are New or Worsened (Short-Stay) January 1, 2017 January 1, 2019

 

How Should Post-Acute Providers Prepare for Skin Integrity Reporting?

It is important for all post-acute providers to focus on pressure ulcer management and prevention. These are a few steps to consider:

  1. Ensure accuracy of pressure ulcer staging
  2. Ensure accurate wound measurements
  3. Develop comprehensive wound program which includes prevention protocols
  4. Use a multidisciplinary team approach in the care of patients with wounds
  5. Perform registered dietician consults for dietary interventions to help promote wound healing
  6. Implement a Pressure Ulcer Prevention Program

How Can Corstrata Help?

Corstrata provides post-acute providers with access to scarce board-certified wound experts. We can assist your facility or agency with developing a wound program that includes evidence based, best practice wound treatments, staff education, pressure ulcer prevention program, and wound formulary redesign. Additionally, Corstrata provides wound image and video consults that include accurate identification of the wound type, accurate staging, accurate wound measurement, and recommended treatment and wound dressing. Contact us today for Expert Wound Care. Anywhere.

Chronic Wound Stats Infographic b