Persichilli breaks down NJ’s tiered hospital bed capacity system

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New Jersey Health Commissioner Judith Persichilli presented details of the department’s tiered system to expand bed capacity, which allows hospitals to care for the most critically ill patients while care is provided for others in alternative settings based on their level of need.

At a press conference Saturday afternoon with Gov. Phil Murphy, Persichilli said Tiers 1 and 2 are units in hospitals for the most critically ill and those graduating out of critical care but still requiring an intensive level of care.

Tier 3 is for patients who require medical or surgical interventions and are appropriate for a hospital stay.

“These patients will go to the alternative care sites, we’re calling them the bricks and mortar care sites of closed hospitals that we’re setting up to receive these patients. That will be in Woodbury, East Orange, and Barnert Hospital,” Persichilli said.

Tier 4 is for patients who need vigilance for one to five days, or what the department calls lower acuity medical care.

Those patients will receive care in the three field medical sites – spread across North, Central and South Jersey – set up by the United States Army Corps of Engineers and the New Jersey State Police.

At the time of the briefing, there were 20 patients at the Meadowlands Convention Center Field Medical site in Secaucus, which has a capacity for 250. The department expected that site to be caring for 50 patients by end of day Saturday.

The Edison Exposition Center Field Medical site opened on Saturday with a capacity of 500, while the Atlantic City Convention Center will have a capacity of 250 beds.

Tier five, according to Persichilli, will handle convalescent care – that which can be rendered safely in hotels for health care workers where they get rest or for health care workers who have tested positive, but are asymptomatic and need to isolate.

Tier six will include dormitories like Rutgers University, and they will accommodate asymptomatic individuals who may not have a place to go – such as the homeless or other vulnerable populations – or those who need to be quarantined for up to 14 days.

Also, the USNS Comfort, a U.S. Navy hospital ship, said it would accept admissions from hospitals in New Jersey for mid-acuity med/surge patients.

Navigating nursing homes

On Saturday, the NJDOH issued new guidance for nursing home facilities.

• COVID-capable facilities are those that can care for residents while implementing all of the infection control protocols including, but not limited to, cohorting and sufficient staff to do so; these facilities can admit new patients or readmit residents back.
• COVID-struggling facilities are those that are not able to cohort due to, but not limited to, the inability to implement infection control protocols or physical plant constraints; these facilities will not be allowed to admit any residents or readmissions.
• COVID-negative facilities are those few facilities that have no negative patients; they can admit patients, or unless they cannot implement infection control protocols.

Any facility that cannot implement infection control protocols cannot admit or readmit residents. These facilities should admit residents or readmissions again only if they can meet all of the infection control protocols.

“We are working with long term care facilities that can allocate 100 to 200 beds in the northern and central part of the state so that hospitals can safely transfer their nursing home facility patients into those facilities when they cannot be admitted to COVID facilities that are struggling to maintain infection control protocols and need a place to convalesce,” said Persichilli.

At the four state psychiatric hospitals there have been a total of 160 staff and 80 patients that have tested positive for COVID-19, and there have been five deaths among residents who have tested positive.

“We are working with those hospitals to conduct surveillance and implement infection control protocols to reduce exposure,” Persichilli said.

As of Sunday, there was a total of 61,850 positive COVID-19 tests reported statewide and a total of 2,350 deaths. Total hospitalizations were 7,604 with 1,091 patients in critical care, 823 in intensive care and 658 COVID-19 discharges. Statewide there were 1,644 ventilators in use and the lab positive rate was 44.5 percent.