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March 18, 2020 11:56 AM

N.Y. hospital CEOs devising surge plan to add thousands of beds

Jonathan LaMantia
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    Modern Healthcare Illustration / Getty Images

    New York Gov. Andrew Cuomo said Tuesday that the state will need federal support to handle an unprecedented wave of hospitalizations related to COVID-19.

    Cuomo said the state expects to need 55,000 to 110,000 hospital beds, including 18,600 to 37,200 intensive-care-unit beds.

    The state has about 53,000 hospital beds, including about 3,200 ICU beds. As the number of cases has grown, the governor has expressed doubts about whether that would be enough to handle patients.

    Hospital executives plan to discuss how they might increase the state's capacity for treatment today. Kenneth Raske, president of the Greater New York Hospital Association, and Northwell Health CEO Michael Dowling were named to lead a council to oversee hospitals' efforts to boost their capacity.

    They convened the CEOs of every hospital in New York City, Long Island and Westchester County on a conference call Tuesday to discuss how they can handle a surge. Economists at the hospital association have been working with an outside consultant to predict how many patients will need care and for how long. That analysis was shared during the call, and Raske and Dowling plan to report back to the governor.

    "Working together, we will take every necessary measure to ensure that we have enough beds, supplies, and staff to meet this enormous challenge in the weeks and months to come," Dowling and Raske said in a joint statement Tuesday night.

    Cuomo had issued an executive order Monday to create 9,000 additional hospital beds in anticipation of a surge of patients with COVID-19. The governor expects a peak in patient volume to occur in about 45 days.

    The project would be focused on downstate New York. There would be 5,000 additional beds in New York City, 2,000 in Westchester County and 1,000 each in Nassau and Suffolk counties.

    The governor is directing the National Guard, union builders and private developers to work on the project, which will retrofit dormitories, closed nursing homes and similar buildings to prep them for patient care.

    New York City Mayor Bill de Blasio gave a higher estimate. He said Monday that the city was working on making up to 8,300 new beds available through public and private hospitals. The first approximately 1,200 beds will come from four sites. There will be 600 beds at a recently completed, but unoccupied, nursing home in Brooklyn. The closed NYC Health and Hospitals Coler campus on Roosevelt Island will house 350, Montefiore's Westchester Square campus has 150 beds to offer, and Health and Hospitals/North Central Bronx has two vacant floors that can supply 120 beds, the mayor said. The city also has been buying temporary medical tents to distribute to hospitals.

    "This will be a race against time to create these facilities to get them up and running, to find the personnel and the equipment we need," de Blasio said.

    New York state is suspending regulations that limit hospitals from increasing their space and capacity. The rules typically are enforced through certificate-of-need applications and regulations that dictate the number of beds per room and how rooms must be designed.

    The number of COVID-19 cases confirmed in the state rose to 1,374 Tuesday morning, including 644 in New York City. Ten people in New York have died from the respiratory illness, according to data compiled by Johns Hopkins University.

    The governor said he may cancel elective surgeries at some point to make more beds available. Mayor Bill de Blasio has already announced plans to do so in New York City, and some health systems, including Health and Hospitals, New York–Presbyterian and Northwell Health, took that step during the weekend.

    Louis Shapiro, CEO of Hospital for Special Surgery, said the orthopedic hospital had devised a list of essential surgeries, which includes procedures to address fractures and infections. It created the list by asking its service-line chiefs to identify surgeries in which any delay could pose a threat to patients' lives or limbs.

    As more patients with COVID-19 arrive at area hospitals, HSS will make itself available to receive orthopedic cases that other hospitals can no longer handle, particularly with its partner New York–Presbyterian. It expects to soon be operating at 15% to 20% of its total capacity because of cancellations of joint replacements and sports injuries that can be postponed.

    "Our excess capacity, whether it's supplies, people or physical capacity, will be repurposed to help New York–Presbyterian maximize their ability to take care of this problem," Shapiro said.

    On Monday, Cuomo called for help from the Trump administration.

    "Deploy the Army Corps of Engineers to come work with states to build temporary medical facilities," Cuomo said. "Get us backup bays so when the hospital is overwhelmed, we can have some of the people who are in the hospital beds go to a backup medical facility."

    The governor noted that the economics of the healthcare system haven't allowed for hospitals to keep expensive medical equipment and staffing on hand in case of a global pandemic.

    "Our health system is basically a private system," he said. "They don't build capacity that they don't need. They don't build extra ICU beds just in case, and intensive-care beds are very expensive. They don't build a wing of ICU beds that sit vacant for 10 years on the off chance that there's going to be a public health emergency and you'll need the beds."

    "N.Y. hospital CEOs devising surge plan to add thousands of beds" originally appeared in Crain's New York Business.

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