The world has experienced unprecedented times with the COVID-19 public health emergency. In some areas of our country, healthcare facilities have been stretched to their limits in caring for these patients with staffing, beds, equipment, and emotional capacity. With the low incidence in Fillmore County that has not been our experience locally. However, nearby counties such as Hall, Adams, and Dawson have seen significant challenges to their healthcare system capacity. In late March, the Centers for Medicare and Medicaid Services (CMS) recommended that health care facilities limit non-essential, elective surgical care as well as elective appointments to medically necessary things only. Fillmore County Hospital and Fillmore County Medical Center complied with this mandate and notified specialty providers as well as patients of this change very early on. Formal letters were sent to providers to halt elective surgical care on March 23rd. Only essential, medically necessary appointments, procedures, and surgeries have continued during this time, at the discretion of the ordering physician.
For the past 6 weeks, both the Clinic and the Hospital have continued to postpone or cancel non-essential, elective medical appointments, procedures, and surgeries. Patients have continued to have ongoing healthcare needs that are currently being deferred. As certain parts of the country have begun to stabilize, states and local public health districts are beginning to have conversations about restarting what has been postponed. This includes certain surgeries and procedures, chronic disease care, post-surgical therapeutic care, and preventative care. CMS released guidelines for “Opening Up America Again” in late April, and within that are guidelines for re-opening healthcare facilities to provide non-emergent, elective healthcare.
At Fillmore County Hospital and Fillmore County Medical Center, planning has started to take a few steps towards getting back to normal. Following the CMS guidelines of “Opening Up America Again”, a committee was put together that is looking at a stepwise return to elective surgeries and procedures. There is currently a backlog of surgical procedures that were cancelled when the pandemic started. In addition there have been new patients identified during the past several weeks who also are in need of elective surgical procedures.
For surgical care, it has been determined that elective procedures will start again at FCH the week of May 11th. Those procedures will start slow with the lowest risk cases first and will include the following guidelines: COVID-19 incidence must be stable or trend downward in Fillmore County, adequate supply of PPE must be maintained, bed availability must be adequate, staffing must be available, and the ability to transfer patients to larger facilities in Lincoln or Omaha must be readily available. If any of these factors become compromised, FCH’s ability to do elective surgical care will be reevaluated.
The same criteria apply to outpatient “elective” visits, like routine clinic visits, check-ups, annual wellness visits or screenings, physical therapy, cardiac rehab, mental health, routine lab, and x-ray studies. Patients have put off these types of visits for several weeks and may need to resume these needed healthcare appointments. Patients are encouraged to call their primary care provider to help determine if it is safe for them to return to these types of appointments. Both the Clinic and Hospital will continue to provide COVID screening questions upon arrival and provide masking options if needed, until these mandates are lifted. Patients can also call their physical therapist, cardiac rehab nurse, respiratory therapist, mental health therapist etc. for clarification if it is safe to return to regular appointments.
In the coming weeks, new Directed Health Measures (DHMs) are likely to be announced. Fillmore County Hospital and Fillmore County Medical Center’s plans to resume some “normal” healthcare operations will depend on those measures becoming less restrictive. In the event that the incidence of COVID-19 in Fillmore County drastically increases, the plans to ramp up elective appointments, procedures, and surgeries will be delayed until it is deemed safe to resume.
We urge the public to closely watch what is going on in our region and to continue to adhere to the recommendations on social distancing, hand washing/sanitizing, and masking in public when appropriate. We also want to reassure the public that as things slowly return to normal and as you resume your regular healthcare appointments, your safety is our top priority. We will continue to screen all patients and visitors upon entry, continue to practice universal masking, and will practice social distancing within waiting areas and places where patients receive treatment as long as it is recommended to ensure your safety.