Gov. Bill Lee visits an alternative care site established at Nashville General Hospital.


Since Oct. 1, the COVID-19 outbreak has more than doubled in size in Tennessee and the number of people hospitalized for the virus has risen 86 percent.

As of Wednesday night, public health officials reported a record number of hospitalizations — more than 1,700 patients and counting — and aggressive outbreaks in almost every county in the state. 

Tennessee Hospital Association President and CEO Wendy Long said area hospitals are having to free up bed space by any means, including suspending elective surgeries, converting unlicensed beds and turning to post-acute rehabilitation options. But with surges happening across the country, most health systems and independent hospitals are struggling to find reinforcements to staff their surge plans. 

“Almost all hospitals can find additional beds but we have to have the nursing and other staff able to provide that care and it’s getting to that point where we are stretched incredibly thin,” Long told the Post. “At this point, most hospitals are trying to tap into resources in their areas as well as the use of staffing agencies. The concern there is that — unlike the peaks we’ve experienced in the past that were localized, when these staffing agencies that work across the country were able to get additional staff to go to those hard-hit areas — this is starting to look like a much broader surge in terms of the number of locations and states that are being affected. So it’s getting harder and harder to find staffing through those agencies."

Hospitals across the nation and within Tennessee have already halted taking in out-of-state transfers to focus on supporting their immediate service zones. Long said if the outbreak persists, that rule could extend to stop transfers within the state — most likely blocking overwhelmed rural hospitals from sending patients to larger facilities in urban areas. 

To help free up bed space, THA worked in conjunction with the state to set up several COVID-specific nursing homes that serve as transfer sites for recovering patients who cannot yet return to their home facilities. That initiative tackled a major backlog by giving patients who no longer need hospital-level treatment a lower-acuity setting to recover. Long believes those facilities will see maximum usage in the coming months and said discussions to establish other such care sites are fluid but have not yet been initiated by the state.

Alternative care sites are one of several measures local hospitals and the state have taken to expand bed capacity amid COVID. In place of field hospitals originally established in city centers across the state, the state funded the creation of smaller, lower-acuity care sites to provide extra beds when needed. Care organizations have put processes in place to expand bed capacity as much as possible and are able to scale their resources like never before. And nine months into the pandemic, doctors have a better understanding of how to care for patients. These factors are helping keep hospitals afloat for now, but Long said Tennessee is already tapping into those built-up new resources — and flu season has just begun. 

“We are so much better prepared today than we were. If we were experiencing these numbers back in April or May, they would have already more than crippled the system,” Long said. “A whole lot of that preparedness is working very well to help us increase capacity but that ability to increase capacity is not limitless. You reach a point where you have all the resources there are to have.”

This post originally appeared in our partner publication, the Nashville Post

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