Health Law Monitor

The Issue of Hospital Capacities in the Wake of COVID-19

December 7, 2020

By: Eric R. Holway

Gov. Jared Polis entered Executive Order D 2020 249 to clarify the order of operations for the increasing hospital capacity in the State of Colorado. Hospitals were directed to increase their capacity internally by utilizing unused space and supplementing their staffing. If further capacity is needed, the hospitals were directed to decrease the number of elective procedures being performed at the hospital. In the event the hospital patient load continued to increase after these steps have been taken, the hospitals were directed to utilize an inter-hospital transfer system. As a last resort, alternative care sites are to be utilized.

Per the Governor’s Executive Order, all general hospitals were to submit a plan to the state with their maximum surge bed count by Wednesday, November 18^th. A complete surge plan was to be submitted to the CDPHE by Friday, November 20^th to include:

1. A detailed plan to potentially increase bed capacity by at least fifty percent (50%) and provide staffing and medical equipment for such increase; 
2. Strategies to increase the number of ICU beds by transitioning medical and surgical beds to ICU beds if needed; 
3. A detailed staffing plan, sufficient to provide adequate care for all beds, including those in use or available to patients other than COVID-19 patients; and 
4. A plan to reduce or stop voluntary or elective surgeries and procedures if there is a surge of COVID-19 infections in the county or municipality in which the Facility is located. CDPHE will determine the conditions that constitute a surge.

The Executive Order also directs that all hospitals report, at 10:00 a.m. and 8:00 p.m. daily:

1. The maximum number of staffed intensive care unit (ICU) beds that can be made available for patients in need of ICU level care; and
2. The maximum number of staffed medical and surgical beds available for patients in need of non-ICU hospitalization. 

Under current public health orders, hospitals that are at more than 70% capacity, or have less than a two-week supply of public protective equipment must monitor and regulate the number of elective procedures being scheduled and performed to ensure they have adequate capacity for a further increase in the number of patients.

According to the latest figures from the Colorado Department of Public Health and Environment (“CDPHE”), more than 228,000 people have become infected with COVID-19 since the start of the pandemic.  The number of cases has increased by more than 30,000 since November 22, 2020.  The number of COVID-19 patients hospitalized has increased by approximately 944, during that same timeframe.  With this recent surge in cases, the number of hospital beds being utilized across the state – particularly those in the ICU - continues to increase.  

More than 1 in 3 hospitals and facilities in the state anticipate a staff shortage in the next week. Nearly half of the state’s adult critical care ventilators are currently in use. Additionally, 79% of ICU beds are in use across all Colorado facilities, and 12% of those facilities are anticipating ICU bed shortages within the next week. In fact, Mesa County reportedly had no ICU beds available as of November 18th. On November 24th, there were only 25 ICU beds available in Denver, 14 in Colorado Springs, five in Pueblo, and three in Weld County.