Conversion of a Skilled Nursing and Rehabilitation Facility into a Satellite Hospital in Response to a COVID-19 Surge

Abstract

Background: New York City was among the earliest and hardest hit areas during the COVID-19 pandemic. Prior to the peak of the surge in April 2020, a makeshift hospital was opened to address the growing need of overflow beds in Brooklyn, New York. A rehabilitation center was converted into a satellite hospital with a capacity of up to 425 patient beds in 10 days.

Design-build approach: Our institution worked in coordination with larger hospital systems and state and local governments, which allowed for a rapid lease of an underutilized structure, influx of supplies, and personnel. Hospital staff were voluntarily redeployed from their assigned services based on reduced need.

Outcomes: A total of 204 COVID-19 patients were accepted for transfer to the facility between April 6, 2020, and May 11, 2020. There were no major adverse outcomes and no deaths at the facility.

Lessons learned: When a surge of patients is projected to outnumber the available beds in a hospital, such as during a pandemic, it may become necessary to establish a satellite facility. Creativity with existing spaces, health care infrastructure, and reallocation of available resources, as well as having all stakeholders on board, is imperative. Providing mandatory emergency planning and response trainings to hospital staff and leadership can improve preparedness. By leaning on revised protocols established at the satellite facility during the initial surge, the hospital was able to lease and convert another nursing facility and make it patient-ready in less than one week during the second surge of COVID-19 patients.

Figure 1

The principles of emergency operations outlined here guided the response to the COVID-19 surge.

Figure 2

Stable patients who met these criteria were transferred to the facility to continue treatment prior to being discharged. SIRS, systemic inflammatory response syndrome; STEMI, ST segment elevation myocardial infarction; NSTEMI, non-ST segment elevation myocardial infarction; DNR/DNI, do not resuscitate/do not intubate.

Figure 3

The transfer protocol and criteria included communication between the main campus and satellite facility staff, written transfer documentation, and a reconciliation of orders. APP, advanced practice provider; SCM, Sunrise Clinical Manager.