Early in the COVID-19 pandemic, Washington state and the federal government took steps to allow health care facilities to rapidly expand to meet the demands for acute hospital beds. Under the federal Public Health Emergency (PHE), the Centers for Medicare & Medicaid Services (CMS) created an Acute Hospital Care at Home program. This program allowed licensed acute care hospitals to treat some patients in their home with similar services that would be provided in the hospital. At a state level, hospitals were permitted to participate in this program pursuant to waivers in Gov. Inslee’s COVID-19 emergency proclamation followed by the Department of Health’s exercise of regulatory flexibility after those proclamations were rescinded.
In 2024, Substitute House Bill 2295 passed the legislature (PDF), providing a permanent pathway for hospitals to provide acute care hospital services in a patient’s home. This legislation went into effect on June 6, 2024. The law allowed hospitals with active federal waivers from CMS to operate hospital at home programs between June 6, 2024 and the date the department adopts rules.
Beginning October 1, 2025, hospitals licensed under chapter 70.41 RCW will need to submit an application to the department to operate the program.
How to submit a hospital at home application
Adding the hospital at home service requires an amendment to the hospital license. Submit a cover letter indicating changes, an amended hospital application (PDF), and a hospital at home application (PDF).
- There is a one-time Hospital at Home application fee of $5,800.
- Hospitals do not need a Certificate of Need or Construction Review to add the hospital at home service to their license. But if the hospital is making other changes at the same time, Certificate of Need or Construction Review may be needed.
- The application processing timeline may vary and depends on the completeness of the applications and how quickly licensing requirements are met.
- You can find more information about amending a hospital license on the Department of Health’s Amending a License webpage.
Submit the Hospital at Home supplemental application, amended hospital license application, and check or money order payable to:
Department of Health
P.O. Box 1099
Olympia, WA 98507-1099
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