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CMS Announces Acute Hospital Care At Home Program

The Centers for Medicare & Medicaid Services (CMS) Nov. 25 announced the Acute Hospital Care at Home program to further increase hospital capacity during the COVID-19 public health emergency (PHE), in response to a rising number of hospitalizations nationwide.

This new program builds on Hospitals Without Walls, which was introduced in March to expand hospital care outside brick-and-mortar facilities. CMS identified more than 60 acute conditions — such as asthma, pneumonia, and congestive heart failure — that could be safely treated outside of a hospital setting with the proper protocols.

As part of these protocols, participating hospitals will be required to:

  • engage in screening before care at home begins, assessing both medical and nonmedical factors;
  • perform an in-person physician evaluation before care is delivered at home;
  • perform daily evaluation of each patient by a registered nurse either in person or remotely;
  • conduct two daily in-person visits by either a registered nurse or mobile integrated health paramedics, based on nursing plans and hospital policies; and
  • report quality and safety data to CMS.

The model is designated for beneficiaries who require acute inpatient admission to a hospital and who require at least daily rounding by a physician and a medical team monitoring their care needs on an ongoing basis.

Hospitals can submit waiver applications for the Acute Hospital Care at Home program through CMS’ new online portal dedicated to this program. Waiver requests will be divided into two categories based on a hospital’s prior experience. For hospitals which have provided at home acute hospitals services to at least 25 patients previously, an expedited process will be conducted. A more detailed waiver process will be used for hospitals which have never provided at home acute care or less than 25 patients previously.

CMS already approved six hospital systems with extensive experience in providing acute care at home, including: Brigham and Women’s Hospital, in Massachusetts; Huntsman Cancer Institute, in Utah; Massachusetts General Hospital; Mount Sinai Health System, in New York; Presbyterian Healthcare Services, in New Mexico; and UnityPoint Health, and Iowa.

CMS also announced an update to flexibilities for ambulatory surgery centers (ASCs) enrolled as hospitals during the COVID-19 PHE. The agency clarifies that participating ASCs need only provide 24-hour nursing services when there is actually one or more patient receiving care onsite.

Contact Senior Director of Policy Erin O’Malley at or 202.585.0127 with questions.


About the Author

Abigail Painchaud is a policy associate at America's Essential Hospitals.

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