DPHHS issues emergency rule to ease capacity strain on Montana hospitals

GREAT FALLS — Governor Greg Gianforte on Friday announced that the Montana Department of Public Health & Human Services (DPHHS) has issued an emergency rule designed to ease the strain on hospital capacity across the state.

The number of people currently hospitalized in Montana due to COVID is 361, up from 355 on Thursday.

The temporary emergency rule waives regulations to make it easier for hospitals to transfer certain patients to other healthcare facilities, freeing up needed hospital beds.

Gianforte said in a news release: “As our hospitals and health care workers continue to work around-the-clock to deliver life-saving care to Montanans, this new tool will help reduce the burdens our providers face. We will continue to work with hospitals and providers to support their ongoing response.”

The news release states that hospital systems, including critical access hospitals that serve rural populations in Montana, are experiencing a surge of demand for medical services by Montanans infected with the COVID virus, in particular the highly contagious Delta variant which is now the predominant strain in Montana. In addition to facing the demand for medical services, hospitals are experiencing staff shortages and need to reduce administrative burden on staff in the management of available beds and services.

Within the last 72 hours, St. Peter’s Health announced they are in “crisis care” as its hospital critical care unit has reached full capacity; Bozeman Health said it is "dangerously close" to implementing surge plans due to COVID cases; and Billings Clinic is on the verge of implementing crisis care standards.

DPHHS has heard from hospital systems and other stakeholders that the administrative "swing bed" requirements impose a significant burden on hospitals in this challenging time. Because of these challenges, Montana hospitals need to be able to efficiently discharge patients when they otherwise become eligible for discharge to other care settings.

A swing bed hospital is a licensed hospital, critical access hospital, or licensed medical assistance facility that has federal approval to provide posthospital, skilled nursing care to patients. A swing bed is a bed approved under federal regulations to provide either acute care or extended skilled nursing care to a patient. A swing bed is used to transition a patient from acute care to skilled nursing care without leaving the hospital.

Under current rules, before transferring a Medicaid member to a swing bed, the swing bed hospital must determine that no appropriate nursing facility bed is available to the patient within a 25-mile radius of the hospital, and the hospital must maintain written documentation of inquiries made to nursing facilities about the unavailability of an appropriate bed.

When a nursing facility bed within a 25-mile radius of the hospital becomes available, the administrative rules require that the hospital discharge the Medicaid patient to the appropriate nursing facility bed within 72 hours of the nursing facility bed becoming available.

Gianforte says that the emergency rule is necessary because no other administrative action can be taken that would alleviate the burden imposed by the requirements being waived and enable hospitals and critical access hospitals to continue to address the COVID public health emergency in an effective and efficient manner.

The rule will remain in effect no longer than 120 days after the date of adoption, unless further action is taken.

From the DPHHS website on Friday, September 17, 2021:

The state website has county-specific data on vaccination rates, new/total cases, and more.