The California Department of Health's new All Facilities Letter (AFL 20-90) provides guidance for General Acute Care Hospitals (GACH) interested in providing acute hospital care at home services. The Centers for Medicare and Medicaid Services (CMS) is offering individual waivers to allow GACHs to provide acute care to patients in their homes, increasing hospital capacity. GACHs must obtain waiver approval from CMS and meet GACH licensing requirements, as well as receive approval for program flexibilities from the California Department of Public Health (CDPH). The new waivers allow patients' homes to be considered hospital departments, addressing the urgent need to increase hospital capacity. GACHs must coordinate with CDPH to operate under the state's emergency preparedness or pandemic plan during the COVID-19 public health emergency. Hospitals seeking to offer acute hospital care at home services may not begin providing this service until they have received approval from CDPH. The waivers will last until the end of the public health emergency.

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