New DPH guidance extends temporary hospital beds

Overburdened Massachusetts hospitals are allowed through next April to keep using temporary beds to bolster their capacity to care for patients, state public health officials said in recently extended guidance as the Healey administration also braces for the unpredictable fallout from the Steward Health Care crisis.

Hospitals can continue to deploy temporary adult medical and surgical inpatient beds, once their licensed beds are filled, in “alternative” care spaces until April 1, 2025, according to the Department of Health guidance shared with the News Service.

The pandemic-era policy will not be extended beyond that date, but officials in the coming months will develop new guidance tied to licensing beds and processes for hospitals to use surge beds “under certain conditions,” the DPH said in an April 23 memo to hospital executives, which was highlighted by the Massachusetts Health and Hospital Association earlier this week.

DPH allows temporary beds to be used “during periods of high demand when hospitals require additional beds for adult medical/surgical inpatients and adult medical/surgical patients awaiting admission, and/or to mitigate the spread of infectious diseases (including respiratory illness),” according to the memo.

A DPH spokesperson said 541 temporary beds have been approved as of April 27, and 275 medical/surgical beds are occupied.

Hospitals in Massachusetts are regularly seeing more patients than they have room for, and an MHA spokesperson said patients are also being admitted to hospitals sicker and staying longer compared to several years ago. Using temporary beds is “essential” for hospitals that have the ability to staff them, the spokesperson said.

Southeastern Massachusetts and Cape Cod hospital executives detailed capacity challenges at their facilities during a Senate hearing last week, including at Steward’s Morton Hospital in Taunton, where patient demand has exceeded the availability of beds for the past two years even after a surge unit opened there. Problems are exacerbated by the behavioral health boarding crisis and the threat of Steward hospitals shuttering as the for-profit company struggles to meet its financial obligations.

Fifteen hospitals are located in Barnstable, Bristol, Dukes, Nantucket and Plymouth counties, a region where the population has increased since 2010, said Sen. Marc Pacheco, chair of the Senate Post Audit and Oversight Committee.

In 2010, the region’s hospitals collectively had 3,132 licensed beds, 88 percent of which were staffed, Pacheco said, citing data from the Center for Health Information and Analysis. In 2020, the region had 3,148 licensed beds, with only 82 percent staffed.

By 2022, just over 78 percent of licensed beds in the region were staffed, said Pacheco, who called the staffing level a “significant concern.”

“If these population trends continue, it will come with increased needs for acute care, and our hospitals must meet that need in our communities to ensure equitable access to care that does not sacrifice quality,” Pacheco said.

Under the DPH guidance, temporary beds can be situated in places like post-anesthesia care and inpatient rehabilitation units.

But hospitals cannot remove beds meant for psychiatric, substance use disorder, maternal, newborn or pediatric care in order to add the temporary beds, according to the memo from Elizabeth Kelley, director of DPH’s Bureau of Health Care Safety and Quality. The beds also cannot be situated in a part of a hospital “that is not currently licensed for hospital services or does not otherwise meet applicable state and federal requirements.”

MHA, a hospital trade group, said the temporary bed policy initially helped facilities manage a “massive influx of patients” during the pandemic.

“Now, as most hospitals across the state are at full capacity and as patient volume increases, hospitals must continue to use alternate spaces to treat patients,” MHA said in its weekly newsletter Monday.

The supplemental budget Gov. Maura Healey signed Tuesday could provide a staffing boost to hospitals. Another pandemic-era flexibility, which is now permanent, allows graduate nurses and nursing students in their final semester to practice at the bedside under supervision before they have finished the licensing process.

“At a time when the entire healthcare sector is suffering from workforce shortages, the new nurse flexibility has proven invaluable to hospitals and their workers,” MHA said.

This is a developing story. Check back for updates as more information becomes available.

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