CMS issues guidance for hospitals and healthcare systems looking to reopen

The Centers for Medicare and Medicaid Services has released a guide for patients and beneficiaries as they consider their in-person care options.

During the height of the pandemic, many healthcare systems and patients postponed non-emergency, in-person care in order to keep patients and providers safe, and to ensure the capacity to care for COVID-19 patients.

As states and regions across the U.S. see a decline in coronavirus cases, CMS said it is providing these recommendations to ensure that nonemergency healthcare resumes safely and that patients are receiving needed in-person treatment that may have been postponed due to the public health emergency.

WHAT'S THE IMPACT?

On April 19, CMS issued Phase 1 recommendations to safely resume in-person care in areas with a low incidence or a relatively low and stable incidence of COVID-19 cases. CMS is also providing more information as healthcare systems, providers and facilities further expand in-person care delivery.

Recommendations cover a range of topics to ensure patient and clinician safety, including facility considerations, testing and sanitation protocols, personal protective equipment and supplies, and workforce availability. As with Phase 1 recommendations, decisions to reopen should be consistent with federal, state and local orders, CDC guidance, and in collaboration with state and local public health authorities.

A full list of the recommendations can be found here.

Among them are the optimization of telehealth services, whenever available and appropriate, to minimize the need for in-person services. CMS also recommends that those with a high or severe risk of contracting COVID-19 should continue to shelter in place unless their conditions warrant in-person care.

The agency is urging organizations to evaluate the necessity of a patient's care based on clinical needs and to prioritize services that, if deferred, are most likely to result in patient harm. At-risk populations who would most benefit from these services should also be prioritized, especially those with underlying conditions or who don't have access to telehealth services.

Additional recommendations include:

• viral testing of patients 24 hours prior to a procedure 
• wearing facemasks at all times around patients, unless delivering care that would require a respirator 
• conserving PPE and medications
• maintaining a workforce sufficient to quickly respond to COVID-19 care
• ensuring that there's an established plan for thorough cleaning and disinfection prior to using spaces or facilities for patients with non-COVID needs

THE LARGER TREND

CMS has been issuing a number of guidances and recommendations as the pandemic continues to affect hospitals. In May, it set guidance for the reopening of nursing homes. In April it issued guidance on providing non-COVID-19 care to patients without symptoms in regions with a low and stable incidence of the virus. Those recommendations updated earlier guidance provided by CMS on limiting nonessential surgeries and medical procedures.

ON THE RECORD

"Thanks to President Trump's unprecedented expansion of telehealth, many patients have been able to access their clinicians while staying safe at home," said CMS Administrator Seema Verma. "But while telehealth has proven to be a lifeline, nothing can absolutely replace the gold standard: in-person care. Americans need their healthcare, and our healthcare heroes are working overtime to deliver it safely. Those needing operations, vaccinations, procedures, preventive care, or evaluation for chronic conditions should feel confident seeking in-person care when recommended by their provider."
 

Twitter: @JELagasse

Email the writer: jeff.lagasse@himssmedia.com