Palo Alto, Calif.-based Stanford Health Care recently received a federal waiver to provide acute hospital care at home — even though the state of California doesn't allow it.
CMS approved the academic health system for hospital at home in March, but the California Department of Public Health does not have licensing statutes in place for the care model.
"We think this is the right thing to do, and we are ready to do it should the state reverse its position," Stanford Health Care Chief Medical Information Officer Christopher Sharp, MD, told Becker's. "We want to be ready for this opportunity when and should it occur."
For now, Stanford is building up its home-based care overall, including patients transitioning from a hospital stay and 24/7 virtual visits.
"When acute care in the home ideally becomes an option, we will already have a number of capabilities in that domain that we can just move the acute care entity into," Dr. Sharp said.
Executive orders in California paved the way for hospital at home during the pandemic but have since expired. The California Department of Public Health no longer has the "authority to approve these programs," an agency spokesperson told Becker's. "There is no authorization for an acute hospital care at home program within our licensing statutes, and these programs cannot meet the general acute care licensing requirements that are in place."
A change would require a new executive order or legislation, the spokesperson said.
Stanford Health Care is "disappointed" in the state's inaction on hospital at home, and has been voicing its support for the care model on the policy and advocacy fronts, Dr. Sharp said. CMS has granted hospital-at-home waivers to several other California health systems, including Los Angeles-based Cedars-Sinai and San Francisco-based UCSF Health.
For now, Stanford continues to boost its digital footprint to one day provide a full suite of services in the home. That includes "virtual care platforms, remote patient monitoring, logistics management, scheduling management — things that require pretty substantial technology advancements in places and contexts we haven't done them in before," Dr. Sharp said.