Issues Impacting Postacute Care

Course Description

This session focuses on the regulatory issues that affect physical therapists who work in home health, skilled nursing, inpatient rehabilitation, and long-term care hospitals. the presenters will discuss the latest developments of the IMPACT Act and implementation of standardized quality measures across the respective settings. Discussion also will include the latest developments of MedPAC’s work on the postacute care (PAC) unified payment system and ways that PAC physical therapists can prepare themselves to survive in this new era of reform. Other topics that may be covered are Medicare conditions of participation and the CJR bundled payment initiative.

Key resource: National Quality Forum; APTA Post Acute Care Reform

Meet our presenters

Kara Gainer joined APTA in 2017 and provides leadership and strategic direction to the regulatory affairs team on key programs, initiatives, and policy development in the federal regulatory space. She has extensive knowledge and experience working on policies related to Medicare, Medicaid, health care reform, and provider billing and reimbursement. Prior to joining APTA, Kara was a health care consultant with Drinker Biddle & Reath, where she developed and executed comprehensive public policy strategies for her clients that integrated legislative, regulatory, and communications efforts. She also served as attorney advisor for the US Department of Health and Human Services Office of Medicare Hearings and Appeals, and clerked with the US Senate Sergeant at Arms. Kara received her bachelor’s degree in psychology from the University of Montana and law degree from the University of Montana, School of Law, and is a member of the District of Columbia Bar.

Heather Smith, PT, MPH, currently serves as director of quality for APTA. In her current role, Heather coordinates quality initiatives for the association and develops and implements key member resources related to quality. Two areas of focus in her work include the physician quality reporting system (PQRS) and the functional limitation reporting (FLR) requirements for therapist services under Medicare. She also serves as staff lead on the Physical Therapy Outcomes Registry. Heather previously worked for New York Presbyterian Hospital and University of Pennsylvania Health System, where she served in quality improvement. Her transition into quality was facilitated in part by the acquisition of her master’s degree in public health from Drexel University. Previous to her role in quality improvement, she was a practicing clinician for more than 10 years, with the majority of her focus on orthopedics in the outpatient setting.

Jeramy D. Kuhn, PT, is a physical therapist and Iowa licensed attorney, employed with Care Initiatives since 2000. He has worked at a variety of Care Initiatives locations as a clinical physical therapist and, since 2005, as its corporate compliance officer/privacy officer. He has more than 20 years of health care experience, primarily focused in long-term care. He is a member of the American Bar Association, Iowa Bar Association, and the American Health Lawyers Association. He also maintains active membership in the American Physical Therapy Association and Iowa Physical Therapy Association (IPTA), most recently serving as the Southwest District Ethics Committee chair for IPTA. He holds a Certified in Health Care Compliance (CHC) designation from the Health Care Compliance Association.

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Completion Instructions

  • Review the pre-recorded session and compile questions for the live Q and A session.
  • Following the Q and A, complete the assessment with a 70% or higher score.
  • Submit your evaluation feedback.
  • Print your certificate.

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Delivery method



Heather Smith, PT, MPH; Kara Gainer, JD; Jeramy D. Kuhn, PT

Learning objectives

  1. Explain Medicare’s proposed changes to the PAC payment systems and how it may impact physical therapist services.
  2. Demonstrate understanding of changes coming to PAC assessment tools and awareness of coming changes.
  3. Identify opportunities for becoming involved in CJR and SHFFT models and assess CJR or SHFFT collaborator value for the physical therapist/physical therapist practice.
  4. Demonstrate understanding of the new requirements for long-term care facilities and interpret how to speak the language of compliance, as skilled nursing facilities and nursing facilities do.


Genesis Rehab

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1Issues Impacting Post-acute Care.mp4
Type:E-Learning Course
Credit Categories
Tags:acute care
Available discounts:
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    (until 12/31/2030)
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    (until 12/31/2030)
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