CMS on Sunday released guidelines for hospitals to restart elective surgeries while maintaining their ability to treat COVID-19 patients.
As state governments begin to look past the peak of the coronavirus pandemic, several have released phased plans for reopening businesses and workplaces and lifting stay-at-home orders. Hospitals will have to undergo similar, phased processes, CMS Administrator Seema Verma said.
"This isn't going to be like a light switch. It's more like a sunrise where it's a going to be a gradual process," Verma said during a Sunday news conference.
Before a hospital can reopen for non-emergent, non-coronavirus care, its state or region will have to meet certain criteria in terms of residents' symptoms and case loads. Hospitals in those areas can then provide care to patients who do not have COVID-19 "as clinically appropriate." Facilities must have adequate workforce, testing and supplies to restart in-person care. They should consider creating "Non-COVID Care zones" to screen patients for the virus, Verma said.
The CMS recommended physicians and staff wear surgical face masks at all times, and patients should be encouraged to wear masks as well.
"Many patients have waited, understanding what our priorities had to be, but hospitals and physicians realize non-COVID health issues also need to be addressed in a timely fashion," said Rick Pollack, CEO of the American Hospital Association. "It is important to recognize that so-called elective care or scheduled care often involves providing lifesaving treatments and procedures that are necessary to save lives and keep people healthy."
Hospitals have financially struggled as their revenue declined significantly without elective procedures. While CMS accelerated some Medicare payments and encouraged greater use of telehealth, health systems still have to furlough or lay off workers who couldn't transition to treat COVID-19.
"The reality is not everything can be addressed by telehealth," Verma said.
Still, hospitals will be encouraged to use telehealth as much as possible as they reach Phase 1 in the recovery plan.
CMS released separate requirements for nursing homes to tell patients, their families and the Centers for Disease Control and Prevention when they have positive coronavirus cases in their facilities. Nursing homes play a vital role in the next phase of COVID-19 recovery, but have also been hit with a significant number of coronavirus cases.
"It's important that patients and their families have the information that they need and they need to understand what's going on with the nursing home," Verma said.
CMS will make the collected data publicly available.
Ultimately, that transparency and surveillance will support the CDC's efforts to surveil COVID-19 and monitor the continuing spread across the country, she said.