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CMS Expands Hospitals Without Walls Program

​The Centers for Medicare and Medicaid Services (CMS) has expanded the Hospitals Without Walls program to include Acute Hospital Care at Home and additional flexibility for the use of Ambulatory Surgical Centers (ASCs) as inpatient hospitals.

The Acute Hospital Care at Home program allows hospitals to provide inpatient care for over 60 different acute conditions at home. Participating hospitals must have appropriate screening protocols before beginning care at home to assess both medical and non-medical factors including working utilities, physical barriers, and domestic violence concerns. Patients may only be admitted to the Acute Hospital Care at Home program from emergency departments or inpatient hospital beds with an in-person physician evaluation prior to starting care at home. A registered nurse is required to evaluate the patient once daily either in person or remotely, and two in-person visits are required by either a registered nurse or a mobile integrated health paramedic. CMS is accepting waiver requests of the Hospital Conditions of Participation for hospitals wanting to participate in the program.

A waiver application is required and can be accessed here.

 

CMS has also clarified flexibility for ASCs enrolled and acting as inpatient hospitals through the Hospitals without Walls Program. CMS will only require ASCs enrolled as inpatient hospitals to provide 24-hour nursing services when there is one or more patient receiving care onsite. This allows ASC to flex their staffing when needed. CMS expects this will allow additional ASCs to provide communities with the ability to maintain surgical capacity and other life-saving non-COVID-19 treatment by allowing treatment to occur in designated ASCs while hospitals manage COVID-19 surge.

More information about the Hospitals Without Walls program is available here.

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