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Massachusetts COVID-19 Updates and Guidance Issued

Massachusetts regulators issued several updates since last Friday.

Hospital Bed License Expansion

On Sunday, March 22, 2020, the Massachusetts Department of Public Health (DPH) announced it is allowing bed license expansion within hospitals to accommodate the surge of patients requiring care for COVID-19 and indicated it would accelerate any requests to license units in buildings that are not currently licensed for hospital services. The announcement referenced the March 13, 2020, “COVID-19 Emergency Declaration Health Care Provider’s Fact Sheet” issued by the Centers for Medicare and Medicaid Services (CMS), which waived certain requirements in order to allow acute care hospitals to house acute care patients in excluded distinct part units containing beds that would be appropriate for acute care inpatient care.

Under the DPH guidance:

If acute care hospitals have more patients requiring admission than licensed inpatient beds, then hospitals may use alternate acute inpatient space and increase their capacity to higher than the licensed bed count in accordance with their emergency management plan. Acute care hospitals may use alternate acute inpatient space that would be appropriate for inpatient care, including but not limited to:  post-anesthesia care unit beds, beds out of service, and inpatient rehabilitation units.

The beds are required to:

  • be equipped with medical gases (one oxygen outlet and one vacuum outlet for each bed),
  • be spaced at least six feet apart from another bed, and
  • have access to hand washing sinks and privacy partitions.

As DPH noted, this “does not authorize a hospital to establish beds or units in a building that is not currently licensed for hospital services. DPH will accelerate any requests to license units in buildings that are not currently licensed for hospital services.”

Hospitals are also encouraged to group confirmed cases of COVID-19 in the same care area(s) and create dedicated healthcare personnel care teams.  If, in an effort to create dedicated care areas and healthcare personnel care teams, identified intensive care units and general care units are consolidated as a functional unit, then patients with confirmed cases of COVID-19, regardless of their acuity, may be cared for in any bed in this functional unit. Acute care hospital providers should use their clinical judgment to determine the appropriate number of healthcare personnel and competencies needed to safely care for patients in this functional unit.

Personal Protective Equipment

On March 22, DPH also posted additional guidance for providers and first responders on recommended use of PPE, and government efforts to coordinate additional PPE resources for providers and first responders. Links have been posted below.

Guidance For Prioritization of Personal Protective Equipment (PPE) in Massachusetts 

MA COVID-19 PPE Guidelines and Priorities (3/22/20) 

MA COVID-19 PPE Request Process Chart 

Allowance of Ambulance Transport to Designated Alternate Sites on Hospital Grounds

On March 20, 2020, DPH issued guidance to Massachusetts-licensed ambulance services clarifying, among other things, that any tents or alternate spaces designated by hospitals on their grounds for receiving suspected COVID-19 patients, will be deemed extensions of the hospital emergency department for this purpose. According to the guidance, EMS personnel are authorized to bring suspected COVID-19 patients by ambulance to such alternate sites.  DPH referenced Circular Letter DHCQ 20-03-701: Authorization and Guidelines for Use of Alternate Space for Treatment of Ambulatory Patients Presenting with Possible COVID-19.  In that guidance, DPH encouraged hospitals to identify appropriate alternate space to accommodate a surge in patients requiring COVID-19 screening as part of emergency management/disaster planning.  Per DPH, hospitals may identify and use existing inpatient, outpatient, and non-patient space for this, consistent with the guidelines attached to the Circular Letter.

Copyright © 2020 Robinson & Cole LLP. All rights reserved.

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About this Author

Melissa Lisa Thompson Health Lawyer Robinson Cole Law Firm
Partner

Lisa Thompson advises companies, senior management, and their boards of directors, with a focus on the health care, life sciences and technology industries. She is a member of the firm’s Health Law Group and Data Privacy + Cybersecurity Team.  She is also an arbitrator on the Commercial panel and the Health Care panel of the American Arbitration Association.  

Health Care, Life Science and Technology Industries

Lisa represents domestic and international clients in the health care, life science and technology industries, including pharmaceutical companies,...

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Anna Gurevich Healthcare Attorney Robinson Cole Law Firm
Associate

Anna Gurevich advises hospitals, physician groups, community providers, and other health care entities on a variety of health law and general business issues. She is a member of the firm's Health Law Group. Her practice focuses on counseling health care providers in complex business arrangements and regulatory issues. Prior to joining Robinson+Cole, Anna worked at a health care law firm and a large academic medical center. 

Regulatory

Anna provides legal counsel to health care clients on a variety of state and federal regulatory matters, including compliance with the Health Insurance Portability and Accountability Act (HIPAA) and similar state data privacy laws, Medicare and Medicaid program compliance, and fraud and abuse laws. Anna also counsels health care clients on federal and state tax-exemption, provider and facility licensing, and scope of practice issues. 

Transactional 

Anna represents health care clients in corporate transactions, particularly those between or among physician groups, hospitals and health systems. She also advises clients in matters such as provider recruitment agreements, professional services agreements, employment, and business partnership agreements. Anna also supports 340B pharmacy contracting initiatives for 340B-covered entities. 

Community Involvement

Anna has been active in the Boston community, including volunteering with the Big Sister Association of Boston, and serving on the Health Law Section of the Boston Bar Association. 

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