This request is a collaboration with Maddy Varner of The Markup.

In November 2020, the Centers for Medicare & Medicaid Services (CMS) announced a new waiver program, called Acute Hospital Care At Home (AHCaH), aimed at “providing eligible hospitals with unprecedented regulatory flexibilities to treat eligible patients in their homes.”

The waiver, “which is granted at the individual hospital/CMS Certification Number (CCN) level, waives §482.23(b) and (b)(1) of the Hospital Conditions of Participation (CoPs) which require nursing services to be provided on premises 24 hours a day, 7 days a week and the immediate availability of a registered nurse for care of any patient.”

Hospitals approved for an AHCaH waiver must submit weekly or monthly “reporting measures,” monitoring information crucial to assessing the hospital’s performance with regards to the waiver — including patient volume, “unanticipated mortality” counts, “escalation” rates, a question relating the hospital’s safety committee, and a patient list.

Our FOIA request 📄 seeks all database records pertaining to AHCaH waiver requests, their processing by CMS, and the reporting measures submitted by participating hospitals, with the exception of personally-identifiable information. It also seeks all relevant database documentation.

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