IMPACT Act of 2014

The Improving Medicare Post-Acute Care Transformation Act of 2014 (the IMPACT Act) was passed by Congress on September 18, 2014 and signed into law by President Obama on October 6, 2014. The Act requires the submission of standardized data by Long-Term Care Hospitals (LTCHs), Skilled Nursing Facilities (SNFs), Home Health Agencies (HHAs) and Inpatient Rehabilitation Facilities (IRFs).

The IMPACT Act standardized the reporting of:

  • Quality measures domains—In addition to existing quality measures the Act calls for these additional measures to be reported:
  • Skin integrity and changes in skin integrity;
  • Functional status, cognitive function, and changes in function and cognitive function;
  • Medication reconciliation;
  • Incidence of major falls;
  • Transfer of health information and care preferences when an individual transitions;

  • Resources use domains—This area is intended to capture the full cost of the post-acute care and will include:
  • Resource use measures, including total estimated Medicare spending per beneficiary;
  • Discharge to community; and
  • All-condition risk-adjusted potentially preventable hospital readmissions rates.
  • Assessment Categories:
  • Functional status
  • Cognitive function and mental status
  • Special services, treatments, and interventions
  • Medical conditions and co-morbidities
  • Impairments
  • Other categories required by the Secretary
  •  

    Through the use of standardized quality measures and standardized data, the intent of the Act, among other obligations, is to enable interoperability and access to longitudinal information for such providers to facilitate coordinated care, improved outcomes, and overall quality comparisons.

    To achieve the standardization of data across settings, the following post-acute care facilities are required by the IMPACT Act to submit data on specific quality measures: Long-Term Care Hospitals (LTCHs), Skilled Nursing Facilities (SNFs), Home Health Agencies (HHAs) and Inpatient Rehabilitation Facilities (IRFs). Specific information about each setting and reporting tools can be found on CMS’ website at:

    Long-Term Care Hospitals (LTCHs)
    Skilled Nursing Facilities (SNFs)
    Inpatient Rehabilitation Facilities (IRFs)
    Home Health Agencies (HHAs) 

    Reporting of Quality Measures

    To the extent possible, the Secretary shall require reporting of such new quality measures through the PAC assessment instruments.

    Timeline for New Quality Domains*

    Functional Status

  • HHAs - 1/1/2019
  • SNFs - 10/1/2016
  • IRFs - 10/1/2016
  • LTCHs - 10/1/2018
  •  

    Skin Integrity

  • HHAs - 1/1/2017
  • SNFs - 10/1/2016
  • IRFs - 10/1/2016
  • LTCHs - 10/1/2016
  •  

    Medical Reconciliation

  • HHAs - 1/1/2017
  • SNFs - 10/1/2018
  • IRFs - 10/1/2018
  • LTCHs - 10/1/2018
  •  

    Major Falls

  • HHAs - 1/1/2019
  • SNFs - 10/1/2016
  • IRFs - 10/1/2016
  • LTCHs - 10/1/2016
  •  

    Patient Preference

  • HHAs - 1/1/2019
  • SNFs - 10/1/2018
  • IRFs - 10/1/2018
  • LTCHs - 10/1/2018
  • *Displayed dates are deadlines for measure specification and data collection. Confidential feedback reporting and public reporting is required one and two years, respectively, after the dates displayed above.

    Society Nominations for Measure Development Panels

    The Society has successfully nominated members to participate CMS measure development panels for the IMPACT Act measure development. Below is the current list of liaisons. While the Society nominates the liaisons to participate on the measure development panels, these liaisons represent themselves as individuals with expertise on the panels, not the Society.

  • Readmission Measure: Dr. Arif Nazir
  • Drug Regimen Review: Dr. Susan Levy
  • Skilled Nursing Facility Prospective Payment System: Dr. Cari Levy
  • Transfer of Health Information and Care Preferences When an Individual Transitions (Admission/Discharge): Dr. Wayne Saltsman
  • Helpful Links

    IMPACT Act Data Standardization presentation

    CMS Post-Acute Care Quality Initiatives website