OIG Reports on Hospital Challenges During Pandemic; Trump Questions Report’s Reliability
- April 10, 2020
Hospitals reported significant challenges in testing and caring for patients with known or suspected COVID-19 and keeping their staff safe during brief telephone interviews conducted March 23–27, 2020, by the Department of Health and Human Services Office of Inspector General (OIG).
OIG then reported on the results of its conversations with hospital administrators from 323 hospitals across 46 States, the District of Columbia, and Puerto Rico in a report released April 6.
President Trump questioned the report’s reliability in an April 6 press briefing, reportedly suggesting it was politically motivated and saying the report was “just wrong.”
In a Tweet on April 7, Trump continued to disparage the report, writing “Why didn’t the I.G., who spent 8 years with the Obama Administration (Did she Report on the failed H1N1 Swine Flu debacle where 17,000 people died?), want to talk to the Admirals, Generals, V.P. & others in charge, before doing her report,” and calling it “Another Fake Dossier!”
In an April 6 statement, Rick Pollack, President and CEO, American Hospital Association, supported the report as “important and timely." The report “accurately captures the crisis that hospitals and health systems, physicians and nurses on the front lines face of not having enough personal protective equipment (PPE), medical supplies and equipment in their fight against COVID-19,” Pollack said.
According to Pollack, “Hospitals, health systems, physicians and nurses immediately need more PPE and testing supplies so they can diagnose their patients and additional beds and other critical equipment and supplies for patients such as oxygen, ventilators and IV poles.”
OIG’s Findings
According to OIG, hospitals reported that severe shortages of testing supplies and extended waits for test results limited hospitals’ ability to monitor the health of patients and staff. Hospitals said they were unable to keep up with COVID-19 testing demands because they lacked complete kits and/or the individual components and supplies needed to complete tests.
Hospitals reported that widespread shortages of PPE put staff and patients at risk. They also reported shortages of critical supplies and materials, such as IV poles, medical gas, linens, toilet paper, and food. Isolated and smaller hospitals faced special challenges maintaining the supplies they needed and restocking quickly when they ran out of supplies, OIG said.
In addition, anticipated shortages of ventilators were identified as a major challenge for hospitals.
The report relayed some strategies that hospitals have been pursuing to address the reported deficiencies.
- In order to secure the necessary PPE, equipment, and supplies, hospitals reported turning to new, sometimes un-vetted, and non-traditional sources of supplies and medical equipment, the report said.
- To ensure adequate staffing to treat patients with COVID-19, some hospitals said they are training medical staff such as anesthesiologists, hospitalists, and nursing staff to help care for patients on ventilators.
- To manage patient flow and hospital capacity, some hospitals were providing ambulatory care for patients with less severe symptoms, offering telehealth services when possible, and setting up alternate facilities such as fairgrounds, vacant college dorms, and closed correctional facilities as additional spaces for patient care.
- According to the report, many hospitals noted that they were competing with other providers for limited supplies, and suggested that government intervention and coordination could help reconcile this problem nationally.
- The government could allow reassignment of licensed professionals and realignment of duties as needed, provide flexibility with respect to licensed professionals practicing across state lines, and provide relief from regulations that may restrict using contracted staff or physicians based on business relationships.
- The government could relax rules around bed designations, the ability to establish surge facilities in non-traditional settings, and expanded flexibilities in telehealth, such as the types of services, caregivers, and modalities eligible to receive reimbursement.
In addition, the report said all types of hospitals, and especially small rural hospitals, requested financial assistance, including faster and increased Medicare payments, and loans and grants.
Read the report, Hospital Experiences Responding to the COVID-19 Pandemic: Results of a National Pulse Survey March 23-27, 2020 (OEI-06-20-00300).