In December 2018, Ohio lawmakers passed Substitute House Bill 286 (H.B. 286) in an effort to develop and implement palliative care initiatives and education in the state. The bill, which took effect on March 20, 2019, changes Ohio law governing the ability of hospices to provide palliative care to non-hospice patients in an inpatient hospice care facility. The Ohio Department of Health (ODH) is in the process of working with providers to develop rules for hospice care programs with inpatient hospice facilities to admit non-hospice palliative care patients to the hospice inpatient unit for medically necessary care on a short-term basis. Final rules are expected this fall.

What can you do now? Effective March 20, 2019, H.B. 286 authorizes a hospice care program to provide inpatient, medically necessary palliative care on a short-term basis to non-hospice patients—even without final rules. In the interim, ODH has issued guidance to ensure health, safety and quality of care of both hospice and non-hospice patients. This guidance remains in effect until the effective date of new rule requirements.

To summarize the ODH guidance: 

• A hospice care program must remain primarily engaged in the provision of hospice care to hospice patients with at least 51 percent of all services provided by the program being given to hospice patients.
• Non-hospice patients admitted to the hospice care program inpatient facility for palliative care are not required to meet the definition of a “hospice care patient.”
• The hospice care program must ensure the availability of inpatient hospice care to hospice patients.
• Admission of non-hospice palliative care patients must meet the intent of the legislation of providing care on a short-term basis and not admit non-hospice patients with the intent of providing long-term residential placement.
• Inpatient services to hospice patients and non-hospice palliative care patients do not require separation.
• Care provided to non-hospice palliative care patients in Medicare-certified hospice care programs must meet CMS hospice care program conditions of participation for both hospice patients and non-hospice palliative care patients.

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