The New York State Department of Health (DOH) has issued a Dear Administrator Letter (DAL) (attached) to advise hospitals and diagnostic & treatment centers on the process for obtaining emergency approvals of plans for alternative facilities or additional capacity to accommodate COVID-19 surge planning. This DAL supersedes the March 18 DAL.

Facilities seeking to create additional capacity for COVID-19 response must submit a written notice to the appropriate DOH Regional Office. Certificate of Need (CON) applications are not required, but the CON number should be included if one was already submitted.

Hospitals in the metropolitan region should submit their requests to in the DOH Metropolitan Area Regional Office. Here is a listing of other DOH regional office contacts.

Upon notification to the DOH regional office, providers are authorized to immediately move forward with the project. The notice must include the following information, as applicable:

  • Description of the project including the areas being constructed, modified or repurposed, including PFI and operating certificate number(s) as applicable;
  • Anticipated purpose, capacity, and type of space (e.g., screening and testing, treatment rooms, inpatient space, triage areas, airborne isolation rooms/areas);
  • Assurances that the space and plan have been reviewed and approved by hospital and infection control leadership, and that the project will comply with the most current State and Federal guidance related to treatment of patients with known or suspected COVID-19.

We have heard from members that the following language is also requested:

  • This space has been reviewed and approved by hospital and infection control leadership, and the project will comply with the most current Federal and State guidance related to the treatment of patients with known or suspect COVID-19.
  • We will maintain compliance for the management of patients presenting in the hospital’s emergency department as required by the Emergency Medical and Treatment Labor Act (EMTALA).
  • We acknowledge that the Centers for Medicare & Medicaid Services may be issuing updated guidance on EMTALA requirements as they relate to the COVID-19 response, and we will make our best efforts to modify anything outlined in this space to comport with new guidance as soon as it is shared.

The following are examples of the types of actions that would be subject to this approval process:

  • Installation of tents, trailers, or other temporary spaces
  • Repurposing of existing space within a hospital or on the hospital campus
  • Use of alternative sites outside a hospital, hospital campus, or other facility
  • Requests to exceed bed capacity or modify bed types

The DAL further details various factors that should be considered in connection with these plans, including environmental services, air exchange, infection control, staffing and training, fire protection, privacy and confidentiality, and local permits or approvals. However, this information is not required as part of the notification.

DOH notes it is committed to having a rapid turnaround time for these approvals.