In response to the recent surge of alternate care sites hospitals are erecting to increase capacity during the COVID-19 pandemic several concerns have been brought to the attention of American Society for Health Care Engineering (ASHE) in regard to inspection, testing and maintenance.

In addition, questions have been raised on the scheduling of fire drills during the pandemic. James Peterkin, PE, SASHE, senior fire protection engineer of TLC Engineering Solutions, who is an ASHE member and also chair of the NFPA Health Care Section, invites ASHE members to submit feedback through a message board post available on My ASHE.

On March 13, the Centers for Medicare & Medicaid Services (CMS) issued its memo allowing for regulatory flexibility “to help health care providers and states respond to and contain the spread of 2019 Novel Coronavirus Disease (COVID-19).”

Among the measures were included temporary suspension of survey inspections to allow providers to focus on containing the safety threat and permitting providers to administer care in alternative settings.

Following CMS’s lead, local governments have issued guidance to help health care organizations meet a surge in patient care demand.

The City of Chicago on March 23 states it is allowing medical organizations to use several items to support health care functions without the need to obtain a permit, such as trailers, shipping containers and tents for the next 90 calendar days following the announcement.

Massachusetts Department of Public Health sent out a letter March 6 detailing best practices for hospitals needing to accommodate a surge in patients requiring COVID-19 screening, and encourages the use of alternate space to do so.

In Florida, the state’s Department of Financial Services administered a directive to all local authorities having jurisdiction to “partner with hospitals and health care providers to identify all equivalencies, modifications and creative solutions afforded within the Florida Fire Prevention Code to accommodate the erection of temporary health care facilities.” The directive is effective until at least May 8.

Despite these directives this still leaves a lot of ambiguity on code compliance with surge capacity, according to senior leaders within ASHE.

“Right now, with our facilities staff working the front lines to provide proper space for those that are sick, compliance with the ‘letter of the code’ is difficult to come by,” says Chad Beebe, AIA, CHFM, CFPS, CBO, FASHE, deputy executive director, advocacy.  “We are currently in unchartered territory when it comes to using hotels and temporary structures for health care.”

Beebe says ASHE is currently seeking guidance from The Joint Commission, CMS and other organizations on how to address routine practices, and to balance the risk between fire safety and life safety when it comes to managing increased patient demand due to COVID-19.