Upstate launches Hospital at Home program

Upstate University Hospital has launched a new initiative that will allow patients to receive medical care in the comfort of their own home.

Upstate Hospital at Home allows for some patients who need inpatient care but are well enough to be home to safely finish their treatment in their own home. These patients receive two in-person nurse visits and one in-person or telemedicine visit from a provider daily, delivery of all necessary equipment, supplies and prescriptions, and 24/7 remote monitoring.

So far, seven patients have been admitted to the program.

“It makes sense to be able to extend care into the home setting,” said Nancy Daoust, chief ambulatory officer. “That’s where patients want to be.”

Programs like this have been in development across the country over the past several years and require approval from the Center for Medicare and Medicaid (CMS) to start them. In the past, the application process was lengthy and the requirements for nursing care were high: a nurse had to be at the home 24/7.

But the COVID-19 pandemic changed everything. Hospitals struggled to meet the demands of the patient surge and the federal government declared a Public Health Emergency. In conjunction, CMS issued a waiver approval for its Hospital Without Walls initiative. The waiver streamlined the process to apply and reduced the nursing requirement to two daily visits.

Daoust said these changes helped pave the way for Upstate to begin developing its program. A team was assembled in May of 2021 and Upstate’s program was approved by August. From there Daoust said, the program build began in earnest with policies and protocols development, vendor contracts, and education for staff involved. The systems were tested to ensure the correct pathways were followed.

“And since the CMS waiver is new, it took some time to be approved by NYS Department of Health as we worked to explain the model and provide sufficient documentation which demonstrated our ability to do this safely,” she said. “There has been a tremendous amount of program build that’s happening in the background,” Daoust said.