Industry 01 of 27

Hospitals and Health Systems

The hospital industry is the one sector of the economy that governmental orders reached in every quarter of the claim period by name, by license and by federal condition of participation. 2020 Q2 (with the March 13-31, 2020 run-up): between March 17 and April…

EDemergency department and intake IPinpatient units and surge capacity SXsurgery and elective procedures OCoutpatient clinics and diagnostics VSvisitation and access ICinfection control SCsupply chain HRcredentialing, travel nurses…OFadministration and telework WFworkforce availability CBpatients and payers MKcommunity programs and events

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In plain terms: if you run a hospital, a health system or an emergency medicine group, the governmental orders of 2020 and 2021 did not merely touch your business. They named it. Between March 15 and April 10, 2020, more than thirty States ordered every hospital to stop its elective and non-urgent surgeries and procedures, the largest service line a general hospital has. Reopening came only on conditions the States wrote: bed reserves of 10 to 30 percent, protective-equipment self-sufficiency, patient testing and volume caps. Visitors were barred and supplies allocated by order. From September 2, 2020, every hospital's daily census became a condition of its Medicare participation. In the winter of 2020-21 twelve States cut elective procedures a second time, keyed to each hospital's own occupancy. In the summer of 2021 the Federal Government's only COVID-19 emergency workplace standard bound every hospital, thirteen jurisdictions ordered hospital workforces vaccinated by dates inside or just after the quarter, and two States activated crisis standards of care.

This page covers the twelve functions of a hospital, the layers of government whose orders reached each, the six quarters one by one, and the fourteen sentences the Internal Revenue Service (the "Service") uses in its letters, each answered from the public orders in this site's Orders Library (the "Library"). The statute's operative text, the "Suspension Clause", asks whether an operation was fully or partially suspended during a quarter due to such orders; Notice 2021-20 (the "Notice") is the Service's guidance on it; the "United States" is the Government as litigant. The quarter the Service's letters most often dispute is the third quarter of 2021, and the record answers it: the orders in force from July 1 to September 30, 2021 are listed below by name, date and operative clause.

Partial suspension, element by element

Every analysis on this site asks the same five questions in the same order. Here they are asked of Hospitals and Health Systems, from the industry's own record.

The order: issuer, instrument, date, exhibit.The Library holds 112 instruments from this industry's own regulators and sector authorities and 32 organizer notices. The earliest is Secretary of HHS, Determination that a Public Health Emergency Exists (Jan. 31, 2020, effective Jan. 27, 2020) and renewals (Apr. 21, July 23, Oct. 2, 2020; Jan. 7, Apr. 15, July 19, Oct. 15, 2021) (Ex. SEC-01-019). The State, metro and federal orders that reached it are set out on The orders by layer, each with its exhibit; the standing duties sit behind them on every day of the six quarters.
The function of the business it reached.The orders named the functions of the business in terms. Three of this industry's 12 function codes: EDemergency department and intakeIPinpatient units and surge capacitySXsurgery and elective procedures. The full key follows this panel, and Function by function reads the orders against each code.
The change it compelled: the operative words.The operative words of COVID-19 Emergency Declaration Blanket Waivers for Health Care Providers (hospitals: Hospitals Without Walls; EMTALA; verbal orders; discharge planning; medical staff; physical environment; surge sites) (Ex. SEC-01-010): “Emergency Medical Treatment & Labor Act (EMTALA). CMS is waiving the enforcement of [EMTALA]... Verbal Orders. CMS is waiving the requirements of 42 CFR 482.23, 482.24 and 485.635(d)(3)... to provide additional flexibility... Due to current hospital surge, CMS is waiving...” Each record page quotes the operative words in full, with the enforcement provision beside them.
The quarter: in force on which days.Every instrument carries the quarters it was in force. This industry's record runs across all six: 2020 Q280 2020 Q330 2020 Q418 2021 Q122 2021 Q218 2021 Q343 (the count is this industry's own instruments carrying the quarter). The six quarters sets out what was in force in each, and the third quarter of 2021 is listed instrument by instrument below.
The statute's answer.A partial suspension is a temporary delay, interruption or termination of a portion of the business's operations; the order need only be the but-for cause of it; and nothing in the Suspension Clause asks whether the business was essential, stayed open, could telework or served customers who were themselves under orders (Tri-State Memorial Hospital v. United States). The test and the method are stated once, for every industry, at Partial suspension, element by element.

The same five steps run through the report the site builds for your own State, metro and quarters.

Function codes

The analysis describes the business as twelve functions, each with a two-letter code that every page of this set uses without variation. An order “reached” a function when its operative words told the business what that part of it could do, when, where, for how many and on what conditions.

Code	Function of the business
ED	emergency department and intake
IP	inpatient units and surge capacity
SX	surgery and elective procedures
OC	outpatient clinics and diagnostics
VS	visitation and access
IC	infection control (screening, testing, PPE, isolation, staff vaccination mandates)
SC	supply chain (PPE, drugs, ventilators, allocation orders)
HR	credentialing, travel nurses, training
OF	administration and telework
WF	workforce availability
CB	patients and payers
MK	community programs and events

Sector instruments in the Library

The 112 instruments filed under this industry's own sector: regulators' rules and orders, federal directives aimed at it, and the context documents that describe them, in date order. The first 80 are listed here; open the full list in the Library to filter by type and quarter, or download the exhibits.

Exhibit	Instrument	Issuer	Date	Types	Quarters
Ex. SEC-01-019	Determination that a Public Health Emergency Exists (Jan. 31, 2020, effective Jan. 27, 2020) and renewals (Apr. 21, July 23, Oct. 2, 2020; Jan. 7, Apr. 15, July 19, Oct. 15, 2021)Determination that a Public Health Emergency Exists	Secretary of HHS	Jan. 27, 2020	Emergency declaration	2020 Q22020 Q32020 Q42021 Q12021 Q22021 Q3
Ex. SEC-01-010	COVID-19 Emergency Declaration Blanket Waivers for Health Care Providers (hospitals: Hospitals Without Walls; EMTALA; verbal orders; discharge planning; medical staff; physical environment; surge sites)COVID-19 Emergency Declaration Blanket Waivers for Health Care Providers (Updated 5/24/21)	CMS	Mar. 1, 2020	Health care orders	2020 Q22020 Q32020 Q42021 Q12021 Q22021 Q3
Ex. SEC-01-006	QSO-20-13-Hospitals-CAHs (REVISED)Guidance for Infection Control and Prevention Concerning Coronavirus Disease (COVID-19): FAQs and Considerations for Patient Triage…	CMS, Quality, Safety & Oversight Group	Mar. 4, 2020	Health care orders	2020 Q22020 Q32020 Q42021 Q12021 Q22021 Q3
Ex. SEC-01-087	Executive Order 2020-07Temporary restrictions on entry into health care facilities, residential care facilities, congregate care facilities, and juvenile justice…	Governor Gretchen Whitmer	Mar. 14, 2020	Gathering capHealth care orders	2020 Q22020 Q32020 Q4
Ex. SEC-01-116	DC Health recommendation (Mar. 17, 2020) that all elective medical procedures, non-urgent hospital and outpatient visits and non-urgent dental procedures be postponed; DC Health guidance for resuming elective surgery (May 26, 2020)DC Health guidance on elective procedures	DC Health (Department of Health)	Mar. 17, 2020	Health care orders	2020 Q2
Ex. SEC-01-007	CMS Adult Elective Surgery and Procedures Recommendations (press release and tiered recommendations)CMS Releases Recommendations on Adult Elective Surgeries, Non-Essential Medical, Surgical, and Dental Procedures During COVID-19 Response	CMS	Mar. 18, 2020	Health care orders	2020 Q2
Ex. SEC-01-014	Executive Order 13909Prioritizing and Allocating Health and Medical Resources to Respond to the Spread of COVID-19, 85 Fed. Reg. 16227	President	Mar. 18, 2020	Supply chain	2020 Q22020 Q32020 Q42021 Q12021 Q22021 Q3
Ex. SEC-01-071	Order of the Commissioner of Public Health (March 15, 2020) (elective procedures)Order of the Commissioner of Public Health: Nonessential, Elective Invasive Procedures	Commissioner of Public Health (Department of Public Health), with the approval of the Public Health Council and the Governor	Mar. 18, 2020	Health care orders	2020 Q2
Ex. SEC-01-077	Director's Order for the Management of Non-Essential Surgeries and Procedures throughout Ohio	Director of Health Amy Acton (Ohio Department of Health)	Mar. 18, 2020	Health care orders	2020 Q2
Ex. SEC-01-118	CHFS/DPH Directive of March 23, 2020 (elective procedures): cessation of all non-emergent, non-urgent in-person medical, surgical, dental and other health care proceduresCHFS directive on elective medical procedures	Cabinet for Health and Family Services (Secretary Eric Friedlander), at the Governor's direction	Mar. 18, 2020	Health care orders	2020 Q2
Ex. SEC-01-053	Proclamation 20-24Restrictions on Non Urgent Medical Procedures (amending Proclamation 20-05)	Governor Jay Inslee	Mar. 19, 2020	Health care orders	2020 Q2
Ex. SEC-01-108	COVID-19 Health Mandate 005 (Mar. 19, 2020; revised Apr. 7 and Apr. 21, 2020)Health Mandate 005: Elective Medical Procedures (later: Health Care Providers and Facilities)	Governor Mike Dunleavy, Commissioner of Health and Social Services Adam Crum, Chief Medical Officer Anne Zink	Mar. 19, 2020	Health care orders	2020 Q2
Ex. SEC-01-140	Orders of Mar. 19, 2020 closing businesses that are not life-sustaining, with the Industry Operation Guidance list ('Home Health Care Services - Yes - Elective procedures prohibited'; hospitals - Yes - elective procedures prohibited); DOH Guidance on Ambulatory Surgical Facilities' Responses to COVID-19 (Mar. 20, 2020)Pennsylvania life-sustaining business orders and list (elective procedures prohibited); DOH ASF guidance	Governor Tom Wolf and Secretary of Health	Mar. 19, 2020	Business closureHealth care orders	2020 Q2
Ex. SEC-01-064	Executive Order 20-72Emergency Management - COVID-19 - Non-essential Elective Medical Procedures	Governor Ron DeSantis	Mar. 20, 2020	Health care orders	2020 Q2
Ex. SEC-01-080	Addendum 3 to Executive Order 01-20Suspension of all Non-Essential Adult Elective Surgery and Medical and Surgical Procedures	Governor Philip B. Scott	Mar. 20, 2020	Health care orders	2020 Q2
Ex. SEC-01-061	Executive Order 2020-10Delaying Elective Surgeries to Conserve Personal Protective Equipment	Governor Douglas A. Ducey	Mar. 21, 2020	Health care orders	2020 Q2
Ex. SEC-01-086	Executive Order 2020-17Temporary restrictions on non-essential medical and dental procedures	Governor Gretchen Whitmer	Mar. 21, 2020	Health care orders	2020 Q2
Ex. SEC-01-120	LDH Healthcare Provider Notice 2020-COVID19-ALL-007 (Mar. 21, 2020; ACS lists Mar. 27)Directive limiting medical and surgical procedures to emergency medical conditions	Louisiana Department of Health (Secretary Courtney Phillips; State Health Officer Jimmy Guidry)	Mar. 21, 2020	Health care orders	2020 Q2
Ex. SEC-01-045	Executive Order GA-09Relating to hospital capacity during the COVID-19 disaster	Governor Greg Abbott	Mar. 22, 2020	Health care orders	2020 Q2
Ex. SEC-01-015	Executive Order 13910Preventing Hoarding of Health and Medical Resources to Respond to the Spread of COVID-19, 85 Fed. Reg. 17001	President	Mar. 23, 2020	Supply chain	2020 Q22020 Q32020 Q42021 Q12021 Q22021 Q3
Ex. SEC-01-040	Executive Order 202.10Continuing Temporary Suspension and Modification of Laws Relating to the Disaster Emergency (hospital capacity; cancellation of elective…	Governor Andrew M. Cuomo	Mar. 23, 2020	Gathering capHealth care orders	2020 Q2
Ex. SEC-01-066	Emergency Executive Order 20-09Directing Delay of Inpatient and Outpatient Elective Surgery and Procedural Cases	Governor Tim Walz	Mar. 23, 2020	Health care orders	2020 Q2
Ex. SEC-01-068	Executive Order 20-10Prohibition on Elective and Non-Urgent Procedures	Governor Kate Brown	Mar. 23, 2020	Health care orders	2020 Q2
Ex. SEC-01-103	Executive Order 20-03-23-01Order of the Governor of the State of Maryland Number 20-03-23-01: Various Health Care Matters (authorizing the Secretary of Health to order…	Governor Lawrence J. Hogan, Jr.	Mar. 23, 2020	Health care orders	2020 Q2
Ex. SEC-01-106	Proclamation Number 33 JBE 2020 (Stay at Home Order)Additional Measures for COVID-19 (Stay at Home)	Governor John Bel Edwards	Mar. 23, 2020	Stay-at-homeBusiness closureGathering cap	2020 Q2
Ex. SEC-01-113	Executive Order D 2020 009Ordering the Temporary Cessation of All Elective and Non-Essential Surgeries and Procedures and Preservation of Personal Protective…	Governor Jared Polis	Mar. 23, 2020	Health care ordersSupply chain	2020 Q2
Ex. SEC-01-122	Directive and Order Regarding Various Healthcare Matters (Mar. 23, 2020)Directive and Order Regarding Various Healthcare Matters (postponing elective and non-urgent medical procedures)	Secretary of Health Robert R. Neall	Mar. 23, 2020	Health care orders	2020 Q2
Ex. SEC-01-125	NCDHHS Secretary's letter to hospitals and ambulatory surgery centers (Mar. 20, 2020) requesting suspension of elective and non-urgent procedures effective Mar. 23, 2020NCDHHS request to suspend elective and non-urgent procedures and surgeries	Secretary of Health and Human Services Mandy Cohen (NCDHHS)	Mar. 23, 2020	Health care orders	2020 Q2
Ex. SEC-01-130	State Public Health Order (Mar. 23, 2020) postponing elective surgeries and proceduresState Public Health Order: elective surgeries and procedures	Utah Department of Health (Executive Director Joseph Miner)	Mar. 23, 2020	Health care orders	2020 Q2
Ex. SEC-01-073	Executive Order No. 18An Order Regarding Alternative Health Care Facilities, Suspension of Non-Emergency Dental and Elective Procedures	Governor Bill Lee	Mar. 24, 2020	Health care orders	2020 Q2
Ex. SEC-01-128	Fourth Amended Executive Order 2020-07 (Mar. 24, 2020), as further amended Apr. 15, 2020Amended Executive Order 2020-07 (postponement of elective surgeries, minor medical procedures and non-emergency dental procedures)	Governor Kevin Stitt	Mar. 24, 2020	Health care orders	2020 Q2
Ex. SEC-01-139	Order of the Secretary Requiring Hospitals to Make Daily Reports of Specified Data Regarding Supplies and Equipment (Mar. 24, 2020), as amended July 10, 2020, Jan. 27, 2021 (SEC-01-094) and Aug. 13, 2021 (effective Aug. 18, 2021)Pennsylvania hospital daily reporting order and its Aug. 13, 2021 amendment	Secretary / Acting Secretary of Health	Mar. 24, 2020	Health care ordersWorkplace rules	2020 Q22020 Q32020 Q42021 Q12021 Q22021 Q3
Ex. SEC-01-092	Order of Public Health Emergency TwoOrder of Public Health Emergency Two: Elective Surgery Delays	Governor Ralph S. Northam and State Health Commissioner M. Norman Oliver	Mar. 25, 2020	Health care orders	2020 Q2
Ex. SEC-01-022	Executive Order 13911Delegating Additional Authority Under the Defense Production Act With Respect to Health and Medical Resources to Respond to the Spread of…	President	Mar. 27, 2020	Supply chain	2020 Q22020 Q32020 Q42021 Q12021 Q22021 Q3
Ex. SEC-01-042	Executive Order No. 109 (2020)Suspension of elective surgeries and invasive procedures; PPE inventory reporting	Governor Philip D. Murphy	Mar. 27, 2020	Health care ordersSupply chain	2020 Q2
Ex. SEC-01-105	Proclamation of Disaster Emergency (Mar. 26, 2020), section on nonessential surgeries; Proclamation of Apr. 24, 2020 (effective Apr. 27)Proclamation of Disaster Emergency (elective surgeries and procedures)	Governor Kim Reynolds	Mar. 27, 2020	Capacity limitHealth care orders	2020 Q2
Ex. SEC-01-126	Public Health Emergency Order (Mar. 27, 2020) prohibiting non-essential health care services, procedures and surgeries (following the Mar. 24, 2020 order)Public Health Order: non-essential health care services, procedures and surgeries prohibited	Secretary of Health Kathyleen Kunkel (Department of Health)	Mar. 27, 2020	Health care orders	2020 Q2
Ex. SEC-01-104	Order of the State Health Officer Suspending Certain Public Gatherings Due to Risk of Infection by COVID-19 (Mar. 19, 2020, amended Mar. 27, Apr. 3, 2020; Safer at Home Apr. 28, 2020)State Health Officer Order (postponing dental, medical and surgical procedures; barring hospital and nursing home visitation)	State Health Officer Scott Harris (Alabama Department of Public Health)	Mar. 28, 2020	Gathering capHealth care orders	2020 Q2
Ex. SEC-01-076	Executive Order 20-13Directive to postpone elective and non-urgent surgical or invasive procedures (superseding EO 20-04 para. 7)	Governor Eric J. Holcomb	Apr. 1, 2020	Health care orders	2020 Q2
Ex. SEC-01-133	Executive Order 16-20Prohibiting all elective medical procedures	Governor Jim Justice	Apr. 1, 2020	Health care orders	2020 Q2
Ex. SEC-01-096	Executive Order 2020-12Postponement of non-essential elective surgeries to conserve PPE	Governor Kristi Noem	Apr. 6, 2020	Health care orders	2020 Q2
Ex. SEC-01-114	Executive Order D 2020 027Amending and Extending Executive Order D 2020 009 (elective surgeries suspended to Apr. 26, 2020)	Governor Jared Polis	Apr. 6, 2020	Health care orders	2020 Q2
Ex. SEC-01-008	Non-Emergent, Elective Medical Services, and Treatment RecommendationsNon-Emergent, Elective Medical Services, and Treatment Recommendations (tiered framework)	CMS	Apr. 7, 2020	Health care orders	2020 Q2
Ex. SEC-01-013	Temporary Final Rule, Prioritization and Allocation of Certain Scarce or Threatened Health and Medical Resources for Domestic Use, 44 C.F.R. part 328, 85 Fed. Reg. 20195Prioritization and Allocation of Certain Scarce or Threatened Health and Medical Resources for Domestic Use	FEMA, Department of Homeland Security	Apr. 7, 2020	Supply chain	2020 Q22020 Q32020 Q42021 Q12021 Q2
Ex. SEC-01-074	Executive Order No. 25An Order Extending the Suspension of Non-Emergency Dental and Elective Procedures	Governor Bill Lee	Apr. 8, 2020	Health care orders	2020 Q2
Ex. SEC-01-088	Executive Order 1470 (extending the Shelter in Place order and postponing non-essential procedures)Executive Order 1470	Governor Tate Reeves	Apr. 10, 2020	Stay-at-homeHealth care orders	2020 Q2
Ex. SEC-01-009	Re-opening Facilities to Provide Non-emergent Non-COVID-19 Healthcare: Phase ICMS Recommendations: Re-opening Facilities to Provide Non-emergent Non-COVID-19 Healthcare: Phase I	CMS	Apr. 19, 2020	Health care orders	2020 Q2
Ex. SEC-01-030	COVID-19: Executive Orders by State on Dental, Medical, and Surgical Procedures (as updated April 21, 2020; Wayback capture May 1, 2020)ACS State executive-order tracker, spring 2020 suspension orders	American College of Surgeons (secondary source)	Apr. 21, 2020	Health care orders	2020 Q2
Ex. SEC-01-046	Executive Order GA-15Relating to hospital capacity and personal protective equipment	Governor Greg Abbott	Apr. 21, 2020	Capacity limitHealth care orders	2020 Q2
Ex. SEC-01-131	State Public Health Order (Apr. 22, 2020) (health care facility protocols; Utah Roadmap for Resuming Elective Procedures)State Public Health Order: protocols for covered healthcare providers and resumption of elective procedures	Utah Department of Health	Apr. 22, 2020	Face-covering requirementHealth care ordersOther	2020 Q2
Ex. SEC-01-090	Executive Order D 2020 045Permitting the Limited Recommencement of Voluntary or Elective Surgeries and Procedures (amending and extending D 2020 009 and D 2020 027)	Governor Jared Polis	Apr. 27, 2020	Health care orders	2020 Q2
Ex. SEC-01-091	Executive Order 20-22Extension of stay-at-home order; conditions for resuming clinically indicated procedures (effective Apr. 27, 2020)	Governor Eric J. Holcomb	Apr. 27, 2020	Stay-at-homeHealth care orders	2020 Q2
Ex. SEC-01-121	LDH Healthcare Provider Notice 2020-COVID19-ALL-010 (Updated Order, Apr. 20, 2020)Time-sensitive medical and surgical procedures permitted on conditions; discontinuance on notice of the State Health Officer	Louisiana Department of Health	Apr. 27, 2020	Capacity limitHealth care orders	2020 Q22020 Q3
Ex. SEC-01-041	Executive Order 202.25Continuing Temporary Suspension and Modification of Laws (permitting elective outpatient treatments in eligible counties)	Governor Andrew M. Cuomo	Apr. 29, 2020	Health care orders	2020 Q2
Ex. SEC-01-134	Executive Order 30-20Resumption of elective procedures by clinics and offices under Chapter 30 board guidance; hospitals and ASCs under Section 1 conditions	Governor Jim Justice	Apr. 30, 2020	Health care orders	2020 Q22020 Q3
Ex. SEC-01-047	Executive Order GA-19Relating to hospital capacity during the COVID-19 disaster	Governor Greg Abbott	May 1, 2020	Capacity limitHealth care orders	2020 Q22020 Q3
Ex. SEC-01-063	Executive Order 2020-32Requesting Exemption from Executive Order 2020-10 Elective Surgeries	Governor Douglas A. Ducey	May 1, 2020	Capacity limitHealth care orders	2020 Q22020 Q3
Ex. SEC-01-069	Executive Order 20-22Resuming Non-Urgent Medical Procedures (framework from May 1, 2020)	Governor Kate Brown	May 1, 2020	Health care orders	2020 Q22020 Q3
Ex. SEC-01-127	Public Health Emergency Order (Apr. 30, 2020)Public Health Order permitting gradual resumption of medical and surgical operations under DOH guidelines	Secretary of Health	May 1, 2020	Health care orders	2020 Q22020 Q3
Ex. SEC-01-065	Executive Order 20-112Phase 1: Safe. Smart. Step-by-Step. Plan for Florida's Recovery (medical procedures section)	Governor Ron DeSantis	May 4, 2020	Capacity limitHealth care orders	2020 Q22020 Q3
Ex. SEC-01-102	Amended Directive and Order Regarding Various Healthcare Matters (May 6, 2020)Amended Directive and Order Regarding Various Healthcare Matters (resumption of elective and non-urgent procedures)	Secretary of Health Robert R. Neall (Maryland Department of Health)	May 7, 2020	Health care orders	2020 Q22020 Q3
Ex. SEC-01-067	Emergency Executive Order 20-51Requiring Facilities to Safely Resume Elective Surgeries and Procedures That Utilize Personal Protective Equipment or Ventilators During the…	Governor Tim Walz	May 10, 2020	Health care orders	2020 Q22020 Q32020 Q42021 Q12021 Q2
Ex. SEC-01-095	IDPH Guidance: Elective Surgery and Procedures (Apr. 24, 2020) (following IDPH's Mar. 19, 2020 direction to postpone)IDPH guidance permitting hospitals and ASTCs to resume elective procedures from May 11, 2020 on stated criteria	Illinois Department of Public Health	May 11, 2020	Health care orders	2020 Q22020 Q3
Ex. SEC-01-107	Directed Health Measure Order 2020-011 (consolidated: Cass, Douglas and Sarpy Counties, with statewide sections II and III)Directed Health Measure Order 2020-011	Nebraska Department of Health and Human Services (Chief Medical Officer/Director of Public Health Gary Anthone)	May 11, 2020	Gathering capHealth care ordersQuarantine and isolation	2020 Q2
Ex. SEC-01-132	Amendment to Addendum 3 to Executive Order 01-20 (May 4, 2020)Authorizing the Commissioner of Health to permit resumption of clinic visits, diagnostic imaging and outpatient procedures with minimal…	Governor Philip B. Scott	May 15, 2020	Health care orders	2020 Q22020 Q3
Ex. SEC-01-054	Proclamation 20-24.1Reducing Restrictions on, and Safe Expansion of, Non-Urgent Medical and Dental Procedures	Governor Jay Inslee	May 18, 2020	Health care orders	2020 Q22020 Q32020 Q42021 Q12021 Q22021 Q3
Ex. SEC-01-072	Order of the Commissioner of Public Health (May 18, 2020) (resumption of urgent elective invasive procedures by attested providers)Order of the Commissioner of Public Health (Phase 1 reopening of health care)	Commissioner of Public Health	May 18, 2020	Health care orders	2020 Q22020 Q32020 Q42021 Q12021 Q2
Ex. SEC-01-089	Executive Order 2020-96Safe Start Order (rescinding EO 2020-17 as of May 28, 2020 at 11:59 p.m.)	Governor Gretchen Whitmer	May 21, 2020	Stay-at-homeHealth care orders	2020 Q2
Ex. SEC-01-043	Executive Order No. 145 (2020)Rescinding the suspension of elective surgeries and invasive procedures subject to Department of Health policies	Governor Philip D. Murphy	May 26, 2020	Health care orders	2020 Q22020 Q3
Ex. SEC-01-119	Kentucky Healthcare Reopening (Apr. 27, 2020): Phases 1-4Healthy at Work: Healthcare Reopening phases	Cabinet for Health and Family Services	May 27, 2020	Capacity limitHealth care orders	2020 Q22020 Q3
Ex. SEC-01-031	COVID-19: Executive Orders by State on Dental, Medical, and Surgical Procedures (as updated June 8, 2020; Wayback capture Dec. 3, 2020)ACS State executive-order tracker, spring 2020 reopening orders	American College of Surgeons (secondary source)	June 8, 2020	Health care orders	2020 Q22020 Q3
Ex. SEC-01-048	Executive Order GA-27Relating to hospital capacity during the COVID-19 disaster (Bexar, Dallas, Harris and Travis Counties)	Governor Greg Abbott	June 25, 2020	Health care orders	2020 Q22020 Q3
Ex. SEC-01-004	CMS-3401-IFC, 85 Fed. Reg. 54820 (Sept. 2, 2020): 42 C.F.R. 482.42(e) and 485.640(d) (hospital and CAH COVID-19 reporting as a condition of participation); 483.80(h) (LTC testing); 493.41 (laboratory SARS-CoV-2 test reporting)Medicare and Medicaid Programs, Clinical Laboratory Improvement Amendments (CLIA), and Patient Protection and Affordable Care Act…	Centers for Medicare & Medicaid Services, HHS	Sept. 2, 2020	Health care ordersWorkplace rules	2020 Q32020 Q42021 Q12021 Q22021 Q3
Ex. SEC-01-049	Executive Order GA-31Relating to hospital capacity during the COVID-19 disaster (areas with high hospitalizations)	Governor Greg Abbott	Sept. 17, 2020	Capacity limitHealth care orders	2020 Q32020 Q42021 Q1
Ex. SEC-01-050	Executive Order GA-32Relating to the continued response to the COVID-19 disaster as Texas reopens (areas with high hospitalizations)	Governor Greg Abbott	Oct. 14, 2020	Capacity limitHealth care ordersAlcohol and bars	2020 Q42021 Q1
Ex. SEC-01-138	Directed Health Measure (Nov. 16, 2020) pausing elective surgeries statewideStatewide DHM: elective surgeries and procedures reduced/paused (winter 2020-21 tiers)	Nebraska DHHS at the Governor's direction	Nov. 16, 2020	Capacity limitHealth care orders	2020 Q42021 Q1
Ex. SEC-01-093	Order of the Secretary of the Pennsylvania Department of Health Requiring Reduction of Elective Procedures in Regions with Low Acute Care Treatment CapacityOrder Requiring Reduction of Elective Procedures in Regions with Low Acute Care Treatment Capacity	Secretary of Health Rachel Levine (Department of Health)	Nov. 23, 2020	Capacity limitHealth care orders	2020 Q42021 Q12021 Q2
Ex. SEC-01-057	Hospital Surge Public Health OrderOrder of the State Public Health Officer: Hospital Surge	State Public Health Officer (CDPH)	Dec. 17, 2020	Capacity limitHealth care orders	2020 Q42021 Q1
Ex. SEC-01-094	Amendment (Jan. 27, 2021) to the Order of the Secretary Requiring Hospitals to Make Daily Reports of Specified Data Regarding Supplies and Equipment (Mar. 24, 2020), as amended July 10, 2020Amendment to the Order of the Secretary Requiring Hospitals to Make Daily Reports of Specified Data Regarding Supplies and Equipment	Secretary of Health (Department of Health)	Jan. 27, 2021	Health care ordersWorkplace rules	2021 Q12021 Q22021 Q3
Ex. SEC-01-081	House Bill 702 (2021)An Act Prohibiting Discrimination Based on a Person's Vaccination Status or Possession of an Immunity Passport	Montana Legislature (Governor Greg Gianforte signed)	May 7, 2021	Workplace rulesVaccination or testingOther	2021 Q22021 Q3

Third quarter of 2021: the instruments in force

The quarter the Service's letters most often dispute. The record shows these instruments in force on this industry's functions between July 1 and September 30, 2021; an order in force on any day of the quarter is an order in force during it, and the State, metropolitan and federal layers on the quarter page add to the list.

In force, July 1 – Sept. 30, 2021

SEC-01-001
SEC-01-002
SEC-01-003
SEC-01-004
SEC-01-010
SEC-01-016
SEC-01-044
SEC-01-051
SEC-01-052
SEC-01-055
SEC-01-056
SEC-01-058
SEC-01-059
SEC-01-060
SEC-01-070
SEC-01-075
SEC-01-078
SEC-01-079
SEC-01-081
SEC-01-082
SEC-01-083
SEC-01-084
SEC-01-085
SEC-01-100
SEC-01-101 (Sept. 16, 2021 statewide activation; secondary)
SEC-01-109 (Sept. 27, 2021)
SEC-01-110 (OR OAR 333-019-1011; secondary)
SEC-01-112 (NM PHO Aug. 17, 2021; secondary)
SEC-01-115 (CO Board of Health emergency rule Aug. 30, 2021; secondary)
SEC-01-117 (DC Mayor's Order 2021-099; secondary)
SEC-01-123 (MD Aug. 18, 2021; secondary)
SEC-01-129 (OR OAR 333-019-1010; secondary)
SEC-01-135 (DE DHSS orders eff. Sept. 30, 2021; secondary)
SEC-01-139
SEC-01-141 (Philadelphia Bd. of Health HCW regulation Aug. 16, 2021; metro exhibit)
SEC-01-017 and SEC-01-020 (CMS announcements; context)
HHS PHE renewal July 19, 2021 (FED-A)
CDC conveyance mask order and TSA directives (FED-A)

The third quarter of 2021 across every State, and this industry's quarter analysis.

Group meetings, trade shows and seasons disrupted

The organizers' own notices of the trade shows, conventions, conferences and seasons of this industry that the orders cancelled, postponed or moved online: 32 notices, each graded and sourced. The Suspension Clause names “group meetings” in terms.

Date	Organizer notice	Grade	Exhibit and source
	ACS Clinical Congress 2020	Primary source read	Ex. SEC-01-GM-010
	Emergency Nursing 2020 and Emergency Nursing 2021	Primary source read	Ex. SEC-01-GM-023
	RSNA 2020 Scientific Assembly and Annual Meeting (106th)	Primary source read	Ex. SEC-01-GM-025
	American Heart Association Scientific Sessions 2020	Confirmed from a secondary source	Ex. SEC-01-GM-027
	AAMC Learn Serve Lead 2020	Confirmed from a secondary source	Ex. SEC-01-GM-034
	SAEM 2020 Annual Meeting	Confirmed from a secondary source	Ex. SEC-01-GM-036
Mar. 4, 2020	Accreditation and certification surveys (on-site surveyor teams)	Primary source read	Ex. SEC-01-GM-042
Mar. 4, 2020	Accreditation and certification surveys (on-site surveyor teams)	Primary source read	Ex. SEC-01-GM-043 Open
Mar. 9, 2020	ACC.20 Together With World Congress of Cardiology (ACC.20/WCC)	Primary source read	Ex. SEC-01-GM-004 Open
Mar. 9, 2020	ACC.20 Together With World Congress of Cardiology (ACC.20/WCC)	Primary source read	Ex. SEC-01-GM-061 Open
Mar. 10, 2020	ACP Internal Medicine Meeting 2020	Primary source read	Ex. SEC-01-GM-062 Open
Mar. 12, 2020	AONL 2020 Annual Conference	Primary source read	Ex. SEC-01-GM-019 Open
Mar. 12, 2020	AONL 2020 Annual Conference	Primary source read	Ex. SEC-01-GM-070 Open
Mar. 12, 2020	AONL 2020 Annual Conference	Primary source read	Ex. SEC-01-GM-071 Open
Mar. 16, 2020	AHA Annual Membership Meeting 2020	Primary source read	Ex. SEC-01-GM-002 Open
Apr. 3, 2020	Becker's Hospital Review 11th Annual Meeting	Primary source read	Ex. SEC-01-GM-022 Open
May 1, 2020	AHA Leadership Summit 2020 and 2021	Primary source read	Ex. SEC-01-GM-046 Open
May 1, 2020	AHA Leadership Summit 2020 and 2021	Primary source read	Ex. SEC-01-GM-055 Open
May 11, 2020	Residency and fellowship interview seasons 2020-21 and 2021-22 (the industry's hiring pipeline)	Primary source read	Ex. SEC-01-GM-039 Open
May 11, 2020	Residency and fellowship interview seasons 2020-21 and 2021-22 (the industry's hiring pipeline)	Primary source read	Ex. SEC-01-GM-066 Open
May 11, 2020	Residency and fellowship interview seasons 2020-21 and 2021-22 (the industry's hiring pipeline)	Primary source read	Ex. SEC-01-GM-069 Open
May 26, 2020	USMLE Step 2 Clinical Skills examination (physician licensing)	Confirmed from a secondary source	Ex. SEC-01-GM-040
Aug. 1, 2020	RSNA 2020 Scientific Assembly and Annual Meeting (106th)	Primary source read	Ex. SEC-01-GM-074 Open
Aug. 11, 2020	AAP National Conference and Exhibition 2020	Primary source read	Ex. SEC-01-GM-031 Open
Jan. 1, 2021	ACS Clinical Congress 2020	Primary source read	Ex. SEC-01-GM-067 Open
Jan. 15, 2021	California Hospital Volunteer Leadership Conference 2021 (hospital volunteer and auxiliary programs as a class)	Primary source read	Ex. SEC-01-GM-072 Open
Jan. 15, 2021	NAEMSP Annual Meeting 2021	Primary source read	Ex. SEC-01-GM-076 Open
Feb. 1, 2021	NRHA Rural Health Policy Institute (32nd) and Annual Rural Health Conference	Primary source read	Ex. SEC-01-GM-073 Open
Aug. 1, 2021	ACS Leadership and Advocacy Summit 2020 and 2021	Primary source read	Ex. SEC-01-GM-078 Open
Aug. 14, 2021	Emergency Nursing 2020 and Emergency Nursing 2021	Primary source read	Ex. SEC-01-GM-065 Open
Sept. 3, 2021	Emergency Nursing 2020 and Emergency Nursing 2021	Primary source read	Ex. SEC-01-GM-064 Open
Jan. 1, 2022	ACS Clinical Congress 2020	Primary source read	Ex. SEC-01-GM-068 Open

All cancelled meetings in the Library.

Read the analysis

The analysis of this industry runs to seven further pages. Each carries its own notes and exhibit links.

Part 1 of 7How a typical employer operatesThe functions of the business, its revenue lines, its workforce, its suppliers and counterparties, its seasons, and how the orders reached each of them.Part 2 of 7The orders by layerFederal, State, metro, sector regulator, standing duty and counterparty: the instruments that reached this industry, layer by layer, with exhibit links.Part 3 of 7The six quartersWhat was in force on this industry's functions in each quarter from 2020 Q2 through 2021 Q3, with the third quarter of 2021 answered instrument by instrument.Part 4 of 7Function by functionEach function of the business, the orders that reached it and the change they compelled, one function at a time.Part 5 of 7The interconnected economyHow orders on suppliers, customers, carriers and workers reached this industry, and why an order's effect on a business outlasts the order's end date.Part 6 of 7The Service's positions, answeredThe fourteen sentences the Service's letters use, each quoted and answered for this industry from the public record.Part 7 of 7FindingsThe conclusions for each of the six quarters and the standard of proof they meet.