On Wednesday, November 25, the Centers for Medicare & Medicaid Services (CMS) announced its new Acute Hospital at Home program and additional regulatory flexibility in its Hospitals Without Walls program.
The Acute Hospital Care at Home program is for beneficiaries who require acute inpatient admission to a hospital and who require at a minimum daily rounding by a physician and a medical team monitoring their needs on an ongoing basis. CMS has launched an online portal for hospitals to submit individual waiver requests (not a blanket waiver) to waive the Medicare Hospital Conditions of Participation that require nursing services to be furnished on premises 24 hours a day, 7 days a week and the immediate availability of a registered nurse for care of any patient. Waiver requests must be for individual CMS Certification Numbers (CCNs) and not entire hospital systems. For those hospitals that have provided at home acute hospital services to at least 25 patients, CMS has an expedited waiver approval process that includes hospital attestations to specific existing beneficiary protections and reporting requirements. Hospitals that have not to-date performed at home acute hospital services to a minimum 25 patients will have to submit more detailed waiver requests.
CMS is also revising its Hospitals Without Walls program to only require ambulatory surgery centers (ASCs) enrolled as hospitals to provide 24-hour nursing services when there is one or more patients receiving services in the facility. This program change will provide ASCs enrolled as hospitals the flexibility to increase their staffing only when needed and not mandate nurses be present when there are no patients in the ASC.
The CMS press release announcing the Acute Hospital Care at Home program and the additional flexibility for ASCs enrolled as hospitals in the Hospitals Without Walls program is available at link here. The CMS press release includes links to the online portal for Acute Hospital Care at Home program waiver requests and revised Guidance for Processing Attestation Statements from ASCs Temporarily Enrolling as Hospitals during the COVID-19 Public Health Emergency.