Hospital care at home? Orlando Health asks state for the OK

Four hospitals in the Orlando Health System are asking state regulators to approve their plans to provide hospital-level health care in their patients’ homes.

Orlando Health Dr. P. Phillips Hospital, Orlando Health South Seminole Hospital, Arnold Palmer Medical Center, and Orlando Health Orlando Regional Medical Center sent “variances” to the state last week, requesting the state authorize acute care at home programs.

Immediate attempts to contact Orlando Health System for a comment Monday were unsuccessful.

A review of state records shows the state Agency for Health Care Administration (AHCA) approved similar requests submitted by Tampa General Hospital; Cleveland Clinic Florida Martin North Hospital; Cleveland Clinic Florida Indian River Hospital; Cleveland Clinic Florida Weston Hospital; Cape Canaveral Hospital; Holmes Regional Medical Center; Palm Bay Hospital; and Viera Hospital.

Mayo Clinic in Jacksonville received approval from the state in December 2020, the first in the state.

The acute care at home program starts with approval from the Centers for Medicare and Medicaid Services (CMS). The Acute Hospital Care at Home program is an expansion of the CMS Hospital Without Walls initiative launched in March 2020 as a part of a comprehensive effort to increase hospital capacity, maximize resources and combat COVID-19 to keep Americans safe.

After hospitals have approval from CMS, they must file what’s called a petition of variance that allows the state to waive requirements that hospitals have “immediate availability of a registered nurse for bedside care of any patient when needed, and have a minimum of one licensed registered nurse on duty at all times on each nursing unit or similarly titled part of the hospital for rendering patient care services.”

The Legislature passed SB 1222 earlier this year, which allows hospitals to serve patients in their homes through the use of pharmacies and through the use of paramedics and hospital pharmacies. Specifically, the law authorizes a paramedic to provide basic life support services and advanced life support services to a patient receiving acute and post-acute hospital care at home under a program that has been approved by CMS and AHCA.

Sen. Aaron Bean sponsored the 2022 law, which was championed by Mayo Clinic Hospital Jacksonville Medical Director Michael Maniaci.