CMS releases FY 2025 proposed rule for long-term care hospitals 

The Centers for Medicare & Medicaid Services today proposed increasing long-term care hospital standard rate payments by 1.2% in fiscal year 2025 relative to FY 2024. This includes a 3.2% market basket update, reduced by a 0.4% productivity adjustment. In addition, CMS proposes to raise the fixed-loss amount for high-cost outlier payments to $90,921, which would reduce overall standard rate payments by 1.3%. CMS also proposes to rebase the LTCH market basket using a 2022 base year.  
 
In a statement shared with the media, Ashley Thompson, AHA’s senior vice president for public policy analysis and development, said AHA is “disappointed that CMS has proposed to increase the long-term care hospital outlier threshold, once again, by an extraordinary amount. Expecting LTCHs to absorb an additional $31,048 loss per patient would greatly exacerbate the resource challenges these hospitals face. Long-term care hospitals care for complex patients who require extended hospitalization – a population they provide care for already at a considerable financial loss. As such, we continue to call on CMS to modernize its high-cost outlier policy to ensure access to these essential services for some of Medicare’s most severely ill beneficiaries. Any loss of access would affect not only long-term care hospitals and patients, but also would have ripple effects across the care continuum, such as placing additional burdens on short-term acute care hospitals and their intensive care units (ICUs).” 
 
While CMS does not propose to adopt or remove any quality measures from the LTCH Quality Reporting Program, the agency proposes to adopt and modify certain patient assessment items related to health-related social needs; LTCHs would be required to collect and report specific data elements related to living situation, food and utilities beginning with the FY 2028 LTCH QRP. CMS also proposes to extend the window in which patient assessments must be done from three to four days after admission. Finally, CMS issues two Requests for Information, one related to future measure concepts and another on a potential star rating system for LTCHs. 
 
CMS will accept comments on the proposed rule through June 10. AHA members will receive a Special Bulletin with further details on the rule.