On June 9, 2020, the Centers for Medicare and Medicaid Services (CMS) issued a guide detailing considerations for resuming in-person, non-emergent, non-COVID-19 health care.

The guidance applies to states and regions with no evidence of a rebound in COVID-19 cases. CMS makes the following recommendations:

  • Optimization of telehealth services, when available and appropriate, continues to be recommended to minimize the need for in-person services.

  • All individuals at higher risk for severe COVID-19 illness should continue to shelter in place unless their conditions warrant in-person health care.

  • Non-emergent, non-COVID-19 care should be offered to patients, as clinically appropriate, in localities or facilities that have the resources to provide such care, as well as the ability to quickly respond to a surge in COVID-19 cases, if necessary. Decisions should be consistent with federal, state, and local orders, as well as Centers for Disease Control and Prevention (CDC) guidance, and should be made in collaboration with state and local public health authorities.

  • Health care systems and clinicians must preserve the capacity to care for potential surges of COVID-19 patients and ongoing fluctuations of COVID-19 needs, including plans for rapid deployment of alternative care sites through the Hospitals Without Walls program.

  • Hospitals must have the flexibility to resume non-emergent but clinically necessary care for patients with non-COVID-19 needs, in accordance with the following general considerations:

    • In coordination with state and local public health officials, evaluate the incidence and trends for COVID-19 in the area where in-person care is being considered, including metrics related to local and regional health care system capacity.

    • Evaluate the necessity of the care based on clinical needs:

      • Prioritize services that, if deferred, are most likely to result in patient harm.

      • Prioritize at-risk populations who would benefit most from those services (for example, those with serious underlying health conditions, those most at-risk for complications from delayed care, or those without access to telehealth).

  • Establish non-COVID-19 care zones where all patients can be screened for symptoms of COVID-19, including temperature checks.

  • Staff should continue to be routinely screened as should others who work in the facility, including physicians, nurses, housekeeping, delivery, and all people who enter the area.

  • Sufficient resources should be available to the facility across phases of care (e.g., post-acute and long-term care), including personal protective equipment (PPE), sufficient health care workers, facilities, supplies, and screening and testing capacity, without jeopardizing surge capacity.

  • Participation in a registry or national data collection system, such as the National Health Care Safety Network, is strongly encouraged to help track patient outcomes, facility and system impacts, and resource allocation.

Centers for Medicare and Medicaid Services (CMS). Centers for Medicare & Medicaid Services (CMS) Recommendations Re-opening Facilities to Provide Non-emergent Non-COVID-19 Health Care. June 9, 2020. Available at: click here. Accessed June 10, 2020.