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proclamation followed by the Department of Health’s exercise of regulatory flexibility after those proclamations were rescinded.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 allows hospitals with active federal waivers from CMS to operate hospital at home programs between June 6, 2024 and the date the department adopts rules (by December 31, 2025).
The department filed a CR103 (PDF) on May 30, 2025, adopting rules that establish operating standards and an application process for hospital at-home programs by creating WAC 246-320-278, and amending WAC 246-320-199 to establish a one-time application fee that is necessary to cover the cost of reviewing hospital at-home applications. The rules become effective on October 1, 2025, and hospitals licensed under chapter 70.41 RCW will need to submit an application to the department to operate the program. Application information will be available August 2025.
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