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Bill Summary · HB 945

Summary of HB 945 (136th General Assembly, Regular Session)

Purpose and intent

  • The bill aims to regulate hospice care programs more comprehensively in Ohio. It modifies existing licensing and oversight provisions, adds new requirements related to ownership, operations, diversion of controlled substances, performance measures, and monitoring, and creates new sections governing additional hospice-related programs (pediatric respite care and pediatric transition care).

Key provisions and changes

  • Definitions and scope (Sec. 3712.01)

    • Defines “hospice care program” and clarifies included services (nursing, therapies, social services, home health aides, medical supplies, physician’s services, short-term inpatient care, counseling, bereavement services, volunteers).
    • Excludes pediatric respite care and pediatric transition care programs from being classified as hospice care programs.
    • Introduces and clarifies terms: hospice patient, hospice patient’s family, interdisciplinary team, palliative care, attending physician, pediatric respite care program, pediatric transition care program, pediatric respite care patient, pediatric transition care patient, and related roles (social worker, nurse, physician, etc.).

  • Licensing, rules, and fees (Sec. 3712.03 and 3712.04)

    • The Department of Health will license hospice care programs, establish renewal and inspection processes, set license and inspection fees (initial/licensing up to $700; renewal fee $700; inspection fee up to $1,750; overall caps and rules in place; waivers possible for therapy requirements under certain hardship conditions).
    • Creates fee flexibility with director-approved exceptions (not to exceed 50% above maximums).
    • Requires licensees to post a $100,000 surety bond for five years after initial licensure; bond covers civil penalties or enforcement costs.
    • Establishes criteria for license approval, including criminal background checks for those with substantial ownership, chief administrators, and medical directors; bar on licenses for entities with Medicare/Medicaid exclusions or healthcare fraud convictions.
    • Renewal must include evidence of compliance with opioid diversion provisions (3712.062) if hospice services are provided in the patient’s home.
    • Sets grounds for suspension or revocation (e.g., misrepresentation, ownership changes, multiple licenses at same address, failure to meet quality or reporting requirements, high aggregate cap utilization, etc.).
    • Prohibits certain ownership changes without notification and requires new ownership surveys within six months of change.

  • Operational requirements and responsibilities (Sec. 3712.06)

    • Requires continuous, physician-directed hospice care; nurse availability 24/7; creation and periodic review of an interdisciplinary plan of care; bereavement services; non-discrimination regarding payment; central clinical records; home/outpatient/inpatient service provision.
    • Allows use of pharmacists in hospice programs and permits contracting with other licensed entities to furnish components of care; outlines information-sharing requirements and record-keeping with contractors.
    • Encourages hospitals to offer temporary limited privileges to the attending physician during in-hospital inpatient care.
    • Requires notification to veterans’ representatives about potential VA benefits and directs access to veterans service organizations for assistance.

  • Controlled substances and diversion prevention (Sec. 3712.062)

    • Requires hospice programs serving patients at home to establish a written policy to prevent opioid diversion, including disposal procedures for opioids no longer needed, documentation, and methods for disposal (employee witnessed, patient/family witnessed, or joint witnessing).
    • Mandates compliance steps: distributing policy to patient/family, assessing risk factors, maintaining counts and records, monitoring prescriptions, investigating suspected diversion, reporting results to local law enforcement, and obtaining relinquishment of opioids after patient death or when no longer needed.
    • Provides civil-action protections for programs and personnel against lawsuits related to diversion actions, except in cases of willful or wanton misconduct.
    • Requires patient-family relinquishment requests and enforcement of reports to law enforcement.

  • Performance monitoring and data (Sec. 3712.21)

    • The Department of Health must develop, in consultation with hospice associations, a set of performance measures (e.g., live discharge rates, length of stay, family satisfaction, service delivery, transitions of care) using CMS data.
    • Establishes thresholds that would trigger a survey within six months to ensure compliance.
    • Department will monitor these measures quarterly and may contract with a data management company to perform this monitoring.

  • Temporary implementation and transition (Section 3)

    • Imposes a six-month moratorium on issuing new hospice licenses or accepting change-of-ownership applications, with limited exceptions if there is demonstrated geographic need.
    • Changes in ownership applications filed within 15 months have an extended survey deadline (up to 24 months from the effective date) to complete required surveys.

  • Additional notes on pediatric programs

    • Explicitly distinguishes pediatric respite care and pediatric transition care programs from standard hospice programs, with separate definitions and governance implications.

Who would be affected

  • Hospice care programs and their owners, administrators, and medical directors: Subject to licensing, bonding, background checks, ownership rules, and potential restrictions on holding multiple licenses.
  • Hospice patients and families: New policies on care coordination, interdisciplinary plans, bereavement services, and enhanced informed consent related to opioid management and diversion policies.
  • Providers contracting with hospice programs: Clear expectations for integrating with the hospice plan of care, sharing medical records, and maintaining continuity of care when using contracted services.
  • Hospice programs serving home-based patients: Must implement opioid diversion policies and related reporting requirements; must ensure 24/7 nursing availability and proper care planning.
  • Regulators and boards: Department of Health to monitor performance measures, conduct surveys following thresholds, and oversee compliance with new rules.
  • Rural hospice programs: Potential exemptions from certain ownership restrictions for medical directors in rural areas.

Timeline and procedural aspects

  • Licensing and rulemaking: The Department of Health to adopt/modify rules under Chapter 119; rules anticipated within six months for exigent standards (e.g., diversion, licensing procedures, and renewal standards).
  • Moratorium: Six months after effective date, with limited exceptions for demonstrated need.
  • Renewal and ownership surveys: New and renewal processes require documentation and surveys within specified windows (renewals at 90 days before expiration; change in ownership surveys within six months of approval; enhanced survey timelines for ownership changes).
  • Compliance and penalties: Possible suspension up to six months and fines up to $20,000 upon renewal review for noncompliance.

Note: The bill repeals existing sections and replaces them with new framework sections (3712.01, 3712.03, 3712.04, 3712.06, 3712.062) and adds 3712.20 and 3712.21. The bill is sponsored by Representatives White and Roemer.

Compiled from official sources — confirm details with the bill’s official record.

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