On October 7, The Joint Commission (TJC) released a new Quick Safety alert on telemedicine and telehealth care. Since the COVID-19 pandemic began, the number of Americans participating in at least one telemedicine visit has increased from 14% to 57%, and telemedicine projected to account for 20% of medical visits in 2020.

Seriously ill coronavirus patients placed on extracorporeal membrane oxygenation life support have a similar mortality rate as other patients placed on ECMO with acute respiratory distress syndrome (ARDS), a recent research article says.

ECMO is a form of life support that features a machine that performs essential functions of the heart and lungs. The ECMO machine is connected to a patient through plastic tubes that are placed in large veins and arteries in the legs, neck, or chest, according to the American Thoracic Society. Blood flows through the ECMO machine, which adds oxygen to the blood and removes carbon dioxide, then the blood is returned to the patient.

U.S. coronavirus deaths are likely understated, and the United States has relatively high COVID-19 mortality compared to 18 similar countries, a pair of recent studies published by the Journal of the American Medical Association shows. The United States has led the world in reported coronavirus deaths. As of Oct. 15, more than 221,000 Americans had died of COVID-19, according to worldometer. The country with the next highest death count was Brazil at more than 150,000.

Surveys are resuming in areas deemed safe for on-site visits even as the coronavirus pandemic continues its waves of surge and decline. With COVID-19 still on everyone’s mind, expect to be asked for documentation of inspection, testing, and maintenance (ITM) of critical systems and to show lessons learned from the public health emergency (PHE).

CMS has permitted 1135 waivers during the PHE, which allow hospitals to delay such things as regular fire drills, ITM on some non-critical systems, the location of alcohol-based hand rub dispensers needed to ensure infection control, and certain requirements in temporary care locations. Other requirements are very much still in force, notes  Ernest E. Allen, ARM, CSP, CPHRM, CHFM, a former life safety surveyor and now a patient safety executive with The Doctor’s Company in Ohio.

Expect surveyors to require the same documentation of ITM on critical systems such as:

• Monthly elevator recall testing
• Monthly and annual emergency generator testing
• ATS testing
• Monthly and annual fire extinguisher testing
• Fire pump testing
• Daily inspection of means of egress during construction or implementation of Interim Life Safety Measures

As accreditation organizations (AO) have resumed surveys along with CMS, here are some of the things they have been looking at, according to Allen and other consultants, including Gayle Nash, RN, MPH, CEO of Nash Healthcare Consulting:

Be prepared to explain to surveyors how you will catch up with any inspection, testing, and maintenance (ITM) of non-critical systems that had been delayed because of the coronavirus pandemic.

Update logs and records for any ITM done on critical systems, and make sure you can show that your Emergency Operations Plan (EOP) was activated before you opted for any allowed waivers on maintenance of non-critical systems.

All accreditation organizations (AO) as well as CMS are working on backlogs of surveys delayed by the public health emergency (PHE) declared in March. Waivers will no longer be allowed once that PHE is lifted.

As many facilities have had their hands full with patient surges from COVID-19, the illness caused by the 2019 novel coronavirus, they’ll have work to do to ensure their environment of care is brought up to speed.

It’s not easy being an accrediting organization (AO) these days. DNV GL Healthcare has been in the business of deeming U.S. acute care and critical access hospitals for approval to bill Medicare for more than a decade.

But when the AO, whose parent company is in Norway, wanted to branch out to deem psychiatric hospitals—until recently the domain of only The Joint Commission (TJC) —DNV had to prove itself.

It had to show CMS that it could provide accreditation services to psychiatric hospitals, including working with CMS regional offices, across the country.

So how do you prove you can do what you don’t do yet?

DNV GL approached several psychiatric hospitals in various parts of the nation, offering to do a survey for free. Mostly they got turned down, says Patrick Horine, president of the U.S.–based company, the only for-profit AO authorized to accredit hospitals.

Finally, they were able to convince a few facilities of the benefits of having surveyors on site without any real penalty. These surveys helped both the hospitals and DNV become better at what they do, Horine says.

And, of course, the work paid off for DNV. As of July, it is now...

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