Senate Medical Affairs Committee Amendment
S 858 - Session 125 (2023-2024)
Hospital at Home

The Committee on Medical Affairs proposes the following amendment (SR-858.KM0001S):

Amend the bill, as and if amended, by striking all after the enacting words and inserting:

SECTION 1. Section 44-7-130 of the S.C. Code is amended by adding:

 (25) "Acute hospital care at home" means acute-level hospital care to treat a subset of diagnoses that respond safely and effectively to home-based acute care, utilizing technology to provide continuous remote patient monitoring and connectivity to the patient and developing in-home services to ensure the same level of care in the home as in a traditional hospital stay as well as patient safety. Acute hospital care at home must be provided by a hospital licensed in this State pursuant to this article to eligible patients who have provided consent to such care, utilizing a multidisciplinary team to deliver the care.

SECTION 2. Section 44-7-170(A) of the S.C. Code is amended to read:

 (A) The following are exempt from Certificate of Need review:
  (1) the relocation of a licensed hospital in the same county in which the hospital is currently located, as long as:
   (a) any Certificate of Need issued to the hospital for a project to be located at the hospital's existing location has been fulfilled, withdrawn, or has expired in accordance with Section 44-7-230 and the department's implementing regulations; and
   (b) the proposed site of relocation is utilized in a manner that furthers health care delivery and innovation for the citizens of the State of South Carolina;
  (2) the purchase, merger, or otherwise the acquisition of an existing hospital by another person or health care facility;
  (3) crisis stabilization unit facilities. Notwithstanding subsection (C), crisis stabilization unit facilities will not require a written exemption from the department.;
  (4) acute hospital care at home programs and services delivered by a licensed acute care hospital. The delivery of acute hospital care at home programs and services by a licensed acute care hospital does not require a written exemption from the department. Additionally, patients enrolled in the hospital care at home program shall not be considered within the licensed bed capacity of the hospital participating in the program; and
  (5) a home health agency, as defined in Section 44-69-20(4).

SECTION 3. Article 3, Chapter 7, Title 44 of the S.C. Code is amended by adding:

 Section 44-7-267. The department shall promulgate regulations for licensing an acute care hospital's acute hospital care at home programs and services. At a minimum, the regulations must address:
 (1) diagnoses that respond safely and effectively to home-based acute care;
 (2) patient eligibility criteria and screening requirements, including patient consent;
 (3) multidisciplinary team requirements, including roles and responsibilities of team members;
 (4) standards for continuous remote patient monitoring and connectivity with the patient;
 (5) standards for the development of in-home services to ensure same level of care in the home as in a traditional hospital stay; and
 (6) standards for patient safety.

SECTION 4. Section 44-69-75 of the S.C. Code is amended to read:

 Section 44-69-75. (A) A home health agency shall obtain a certificate of need before licensure. Procedures for applying for a certificate must be in accordance with the "State Certification of Need and Health Facility Licensure Act". No certificate is required for home health agencies providing home health services before July 1, 1980.
 (B)(A)(1) A continuing care retirement community licensed pursuant to Title 37, Chapter 11, may provide home health services and is exempt from subsection (A) if:
   (1)(a) the continuing care retirement community furnishes or offers to furnish home health services only to residents who reside in living units provided by the continuing care retirement community pursuant to a continuing care contract;
   (2)(b) the continuing care retirement community maintains a current license and meets applicable home health agency licensing standards;
   (3)(c) residents of the continuing care retirement community may choose to obtain home health services from other licensed home health agencies.
  (2) Staff from other areas of the continuing care retirement community may deliver the home health services, but at no time may staffing levels in any area of the continuing care retirement community fall below minimum licensing standards or impair the services provided.
  (3) If the continuing care retirement community includes charges for home health services in its base contract, it is prohibited from billing additional fees for those services. Continuing care retirement communities certified for Medicare or Medicaid, or both, must comply with governmental reimbursement requirements concerning charges for home health services.
  (4) For purposes of this subsection "resident", "living unit", and "continuing care contract" have the same meanings as provided in Section 37-11-20.
 (C)(B) Subsection (B)(A) applies only to multi-level continuing care retirement communities which incorporate a skilled nursing facility.
 (D)(C) The continuing care retirement community shall not bill in excess of its costs. These costs will be determined on nonfacility-based Medicare and/or Medicaid standards.

SECTION 5. This act takes effect upon approval by the Governor.