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Guidance to Hospices for the Admission of Non-Hospice Palliative Care Patients to Inpatient Facilities

 

 

Bureau of Regulatory Operations

Inpatient Hospice Facility Interim Guidance - Admission of Non-Hospice Patients for Palliative Care

 

 

Subject: 

Admission of Non-Hospice Palliative Care Patients to Hospice Inpatient Facilities

 

Summary: 

Due to the recent passage of House Bill 286 of the 132nd General Assembly, as of March 20, 2019, Hospice Care Programs with inpatient hospice facilities will be authorized to admit non-hospice palliative care patients to the hospice inpatient unit for medically necessary care on a short-term basis. 

 

Issue: 

The Ohio Department of Health (ODH) is currently in the process of developing state rules to implement the requirements of House Bill 286. This process will involve the participation of multiple stakeholders and organizations, input from clinical specialists, and the required rule hearings at both ODH and the Joint Committee on Agency Rule Review. While facilities will statutorily be able to admit non-hospice palliative care patients starting in March 2019, rules are not expected to be in place until fall 2019.  Interim guidance is necessary to ensure the health and safety of non-hospice palliative care patients admitted to hospice inpatient facilities until the implementation of state rules is complete.

 

Guidance: 

 

Effective March 20, 2019

 

  • A hospice care program that chooses to admit non-hospice palliative care patients must ensure that it continues to be primarily engaged as a hospice care program and at least 51% of all services provided by the program must be to hospice patients.

 

  • The admission of non-hospice palliative care patients to a hospice inpatient facility does not require the non-hospice palliative care patient to meet the definition of a “hospice care patient.”

 

  • Hospice care programs must ensure the availability of hospice inpatient care to hospice care program patients. This may be through admission to the hospice care program’s inpatient facility or through contract with an inpatient facility that meets the requirements of rule 3701-19-22 of the Ohio Administrative Code.

 

  • Admission of non-hospice palliative care patients must meet the intent of the legislation of providing care on a short-term basis and not admit non-hospice palliative care patients with the intent of providing long-term residential placement.

 

  • Inpatient services to hospice patients and non-hospice palliative care patients do not require separation.

 

  • Medicare certified hospice care programs must meet the Hospice Care Program Conditions of Participation for both hospice and non-hospice palliative care patients.

Timeframe:

Rules pertaining to the admission of non-hospice palliative care patients to inpatient hospice facilities are currently being developed as part of the five-year review of Chapter 3701-19 of the Ohio Administrative Code. Final rules may be different than the guidance presented in this document, as such, this guidance will remain in effect only until the effective date of the revisions incorporated into the Chapter 3701-19 Hospice Care Program rules.