Ohio Allows Hospices to Provide Inpatient Palliative Care

New rules in the state of Ohio will allow hospices to admit non-hospice palliative care patients into their inpatient facilities on a short-term basis when medically necessary.

About half of the community-based palliative care providers in the United States are hospices, according to recent research from the Center to Advance Palliative Care (CAPC). CAPC developed an online survey to which 890 palliative care providers responded.

Ohio has also revised its statutory definition for palliative care.

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Palliative care is “specialized care for patients of any age with a serious or life-threatening illness that is provided at any stage of the illness by an interdisciplinary team, including those seeking to cure the illness, that aims to relieve symptoms of stress and suffering; improve the patient’s quality of life; address the patient’s physical, emotional, social and spiritual needs; and facilitate patient autonomy, access to information and medical decision-making,” according to a memorandum written by Selina Jackson, a health policy researcher with the Bureau of Regulatory Operations at the Ohio Department of Health. 

The policy change is pursuant to the state’s House Bill 286, which was passed in March 2019, with a 2020 implementation date.

Interest in palliative care has been rising in recent years among health care providers, payers and policymakers, driven by the benefits to patients, the need to engage patients earlier in the course of their illnesses, and the potential cost savings from reduced hospitalizations, readmissions and emergency department visits.

Although hospices in the state may now admit palliative care patients to their facilities, they much attest in writing to the Ohio Department of Public Health that 51% of the inpatient care they provide will go to hospice patients, and that they will ensure the availability of inpatient care to hospice patients. Hospices must submit the attestation by April 1.

The hospice must also obtain the patient’s informed consent and explain the scope and limitation of the services they will receive, and include considerations for palliative care patients in quality assessment and performance improvement processes.

Among other provisions, The rules also require providers to educate staff, including volunteers about palliative care, its goals, and associated physiological and psychosocial aspects.

“The hospice medical director or their designee must determine the appropriateness of the admission of the non-hospice palliative care patient to the facility or unit; the facility must have the services and staff necessary to meet the needs of the non-hospice palliative care patient,” Jackson indicated. “… And all care must be provided by an interdisciplinary team and documented in the patient’s clinical record.”