Conditions for Performing Non-Essential and Elective Medical Procedures

April 27, 2020

By: Eric N. Fischer, Jason L. Giles, Willard L. Boyd III

On April 24, 2020 Iowa Governor Kim Reynolds issued a Disaster Proclamation in response to the ongoing COVID-19 pandemic (the “Proclamation”). Section One of the Proclamation provides that subject to certain conditions, a “hospital, outpatient surgery provider, or outpatient procedure provider may conduct in-patient surgeries and procedures that, if further delayed, will pose a significant risk to quality of life” (“Outpatient Procedures”) and any outpatient surgeries or procedures (“Inpatient Procedures” and together with the Outpatient Procedures, the “Procedures”).


In order to conduct Procedures, a hospital or provider must:


  1. Have adequate inventories of personal protective equipment (“PPE”) and access to a reliable supply chain without relying on state or local government PPE stockpile for ongoing operations or a response to an unexpected surge in demand.
  2. Have plan to conserve PPE consistent with guidance from the CDC and Iowa Department of Public Health.
  3. Have plan for timely COVID-19 testing of symptomatic patients and staff. This plan must comply with all relevant guidance related to testing requirements issued by Iowa Department of Public Health, CDC or a specific healthcare provider’s professional specialty society. Scheduled surgeries should have a negative COVID-19 test within 48 hours of the surgery date.
  4. Continue to accept and treat COVID-19 hospital patients.
  5. No transfer of COVID-19 hospital patients to create capacity for elective procedures.
  6. Reserve at least 30% of hospital’s ICU and medical/surgical beds for COVID-19 patients
  7. Have a plan to monitor compliance with the requirements of the Proclamation and to reduce or suspend Procedures.
  8. Limit individuals present in the area of the Procedure to those who are essential.
  9. Establish an internal governance structure to ensure the requirements of the Proclamation are followed.


Unless all of the conditions above are complied with, all nonessential or elective procedures that use PPE may not be conducted. The Proclamation defines a nonessential procedure as “one that can be delayed without undue risk to the current or future health of the patient”, considering all relevant factors including, but not limited to: threat to the patient’s life, threat of permanent dysfunction, risk of metastases or progression of staging and risk of rapidly worsening to severe symptoms.


While the Proclamation provides flexibility for Iowa healthcare providers to perform nonessential and elective procedures, it also imposes documentation and planning requirements on providers performing those procedures. If you have questions please contact your Nyemaster Goode attorney.