AHCA Secretary Defends ICU Capability, Reporting Changes
Florida has more intensive-care unit capability than a state website indicates, a top health-care regulator said Tuesday, as the DeSantis administration defended a decision to change how hospitals report available ICU beds to the state.
In a statewide phone call with hospitals, Agency for Health Care Administration Secretary Mary Mayhew said a system that tracks the available number of hospital ICU beds doesn’t provide the public with a full picture of the ability to provide intensive-level care because it only includes the current number of beds and not the potential number of beds facilities could offer if they converted unused hospital space.
“Hospitals still have adequate capacity around the state. What we are not seeing captured is the ability (for hospitals) to convert beds to ICU to have a level of ICU surge capacity if needed,” Mayhew said.
Mayhew’s agency is charged with regulating hospitals and nursing homes. She said the state is closely tracking hospital admissions as the number of people with COVID-19 spikes. An average of 20 percent of hospital inpatient admissions have been to ICU units, Mayhew said.
An Agency for Health Care Administration website Tuesday afternoon showed an average of 24.7 percent of hospital beds were available statewide and that an average of 23.3 percent of adult ICU beds were available. But availability varies by county, and some counties have less available space than others.
The News Service of Florida reported Friday that during a June 16 call, state Surgeon General Scott Rivkees asked hospital officials to change how they were reporting available ICU beds in the state’s “Emergency Status System” and to only include patients who required what he described as an "intensive level of care."
The news of the reporting change caused a stir on social media Monday, with state Agriculture Commissioner Nikki Fried posting a link to the News Service story and asking, “what is the need for this change now?”
Former Democratic Congresswoman Gwen Graham on her Twitter account posted: “Wow. The level of #COVID deception in the @GovRonDeSantis administration is appalling. If intensive care unit beds are full, the beds are full and unavailable. This is a dangerous change, folks.”
The change also drew national attention. Appearing on MSNBC’s "Morning Joe" show Tuesday, Washington state pulmonologist Vin Gupta said the change amounted to “data manipulation.”
“Let’s just be clear on that,” Gupta, who treats COVID-19 patients in Washington state, said when asked about the change. “That’s fudging the data so they can report better numbers.”
Hospitals, nursing homes and other providers are required to enter information into the Emergency Status System, which tracks available resources. The state has encouraged the public to use the website to get the latest information about hospital and nursing home capacity, whether during the COVID-19 pandemic or during hurricane season.
The change in reporting switches the emphasis from the number of available beds to the acuity and illnesses of the patients in the beds, a move DeSantis spokeswoman Helen Aguirre Ferre defended on Twitter.
“There is a difference between the number of critical care patients needing an ICU bed as opposed to those occupying an ICU bed for COVID quarantining which is why @GovRonDeSantis is ensuring the data accurately reflects that difference. Smart!” she tweeted.
If hospitals are using ICU beds for patients who aren’t in critical care, it could at least partly be because of state decisions.
To abate the spread of COVID-19 in nursing homes and slow the death rate among long-term care residents, Florida regulators in May required nursing homes that did not have advanced health-care capabilities to transfer residents with COVID-19 to hospitals.
It also required nursing homes that could not properly isolate residents to transfer them to hospitals or to one of seven state-designated COVID-19 long-term care facilities. Those seven facilities can hold a maximum of 529 residents.
According to state data, 2,640 residents have been transferred, which means the majority of them have been transferred to hospitals.
At a news conference Tuesday in Orlando, DeSantis defended Rivkees’ decision to switch reporting requirements, saying hospitals that told his administration “they were just using their ICU wing as their COVID wing.”