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CMS issues guidelines for resuming non-COVID-19 elective care

por John R. Fischer, Senior Reporter | April 22, 2020
Operating Room
CMS has issued guidelines for safely resuming elective procedures as some states gear up to loosen restrictions on non-COVID-19 care.
The Centers for Medicare and Medicaid Services issued guidelines Sunday to assist hospitals in safely resuming elective surgeries, as a number of states consider allowing non-emergency procedures as part of their plans to reopen the economy and pull back COVID-19 restrictions.

CMS is recommending that non-COVID-19 care be offered “as clinically appropriate” within a state, locality, or facility equipped with resources to provide such care and where providers can quickly respond to surges in COVID-19 cases, if necessary.

“Decisions should be consistent with public health information and in collaboration with state public health authorities,” said the U.S. agency in its guidelines. “Careful planning is required to resume in-person care of patients requiring non-COVID-19 care, and all aspects of care must be considered.”

Guidelines call for the availability of adequate facilities, testing and supplies, as well as adequate workforces of clinicians, nurses, anesthesia, pharmacy workers, imaging specialists, pathology support, and post-acute care. Staff should be routinely screened for COVID-19, with those showing symptoms tested and quarantined.

Healthcare systems are encouraged to work with state and local officials to evaluate incidences and trends of COVID-19 in areas where resuming in-person care is being considered, and to evaluate the necessity of care based on clinical needs, with surgical/procedural care and high-complexity chronic disease management prioritized. They should also set up NON-COVID Care (NCC) zones to screen all patients for symptoms, including temperature checks.

Adequate supplies of equipment and resources for PPE, healthy workforces, facilities, supplies, testing capacity, post-acute care and other phases of care must be ensured without interfering with surge capacity. In addition, face coverings such as surgical face masks should be worn by providers and staff at all times, and protocols for sanitation and decontamination of equipment, social distancing, and adequate testing capability should be in place.

State governors are setting their sights on reopening their individual economies, in accordance with a three-phase plan released last week by the Trump administration. The first phase calls for outpatient elective operations to resume, followed by inpatient elective procedures in the second phase. Exercising it lies with the discretion of each state government.

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