Member Article

On April 27, 2020, the Ohio Department of Health (ODH) Director Amy Acton, M.D., MPH, and Governor Mike DeWine announced surgeries that do not require an overnight stay may proceed on May 1, 2020. Other surgeries that meet current essential standards may continue to be performed. Additionally, dental offices and veterinary offices can resume operations on May 1, 2020.

ODH has asked that ambulatory surgical centers and hospitals ensure that certain COVID-19 mitigation procedures are in place and that patients provide informed consent of the risks of contracting COVID-19 as a result of undergoing a surgery or procedure during the ongoing pandemic. On April 29, 2020, ODH released a checklist for health care procedures that should be implemented by all Ohio health care providers that wish to proceed with surgeries and procedures during the COVID-19 pandemic. The new ODH checklist is available here.

Beginning May 1, 2020, all medically necessary procedures and medical care that do not require an overnight stay in a health care facility or do not require inpatient hospital admission and minimize use of personal protective equipment (PPE) may move forward. This includes regular doctor visits, well-care checks, well-baby visits, outpatient surgeries, imaging procedures, and diagnostic tests. Dental services and veterinary services may also proceed if done in a safe environment. Health care providers and facilities that plan to resume providing these services must adhere to infection control practices, have sufficient PPE, and talk with patients about the risk of contracting COVID-19. It is expected that ODH or the Governor’s office will release a new public health order on Thursday, April 30, 2020 that will be consistent with ODH guidance and statements released earlier this week.

In March, ODH ordered the cancellation/postponement of such procedures in an effort to conserve PPE and hospital beds in anticipation of a significant spike in COVID-19 patients. At that time, ODH stated these cases could move forward if postponing the procedure would cause either: (1) a threat to the patient’s life; (2) threat of permanent extremity/organ dysfunction; (3) threat of worsening of disease or condition; (4) the risk of metastasis or progression or (5) risk of rapidly worsening to severe symptoms.

On April 22, 2020, ODH recommended that hospital and ambulatory surgical facility providers reach out to patients who had a case postponed to reassess the need for the surgery or procedure based on the above listed criteria. If the provider recommends that the surgery or procedure can proceed because the patient now meets one of the four criteria above, then ODH and Governor DeWine want the provider to make sure a full assessment is done before proceeding with the case. During this reassessment, the patient’s current health situation and quality of life are to be considered.

In addition, ODH recommends that hospital and ambulatory surgical facilities inform patients of the risk of contracting COVID-19 and how that could impact the post-operative recovery process and provide all information necessary for patients to make informed decisions. For new or other chronic conditions that may have a significant impact on a patient’s health or quality of life, providers are to consider moving forward with diagnostic procedures. Additionally, ODH asks that hospitals and ambulatory surgical facilities: (1) pay greater attention to the effectiveness of non-surgical options; (2) use clinical judgment to make responsible decisions about what procedures are necessary; and (3) make a joint decision with the patient as to whether to proceed.

Finally, hospital and ambulatory surgical facility providers should assess their social distancing protocol, PPE supplies, and testing protocol by:

(1) Ensuring adequate supply of PPE, other equipment, and supplies are available across their regions to cover anticipated sites of surge, including congregate care settings;

(2) Ensuring COVID-19 testing capability in the community is adequate to cover the additional routine testing of patients and health care personnel; and

(3) Implementing infection control and environmental mitigation strategies, including social distancing, disinfection of common areas, and other precautions necessary to minimize the spread of disease.

The full ODH announcement is available here.

If you have any questions regarding ODH’s announcement or the resumption of certain surgeries in Ohio or need assistance with developing policies that are necessary to re-open, please contact your Dinsmore Health Care attorney.