More than 200 days after it closed, Insight Hospital & Medical Center Trumbull returned to the practice of health care Tuesday morning.

To do so, Insight Health System officials had to address a scathing facility assessment, secure Medicare and Medicaid licensing, reengage a dispersed workforce and navigate a federal shutdown.

“It’s been quite a process,” Warren Mayor Doug Franklin said Tuesday. “There probably hasn’t been a day that’s gone by that I haven’t been working with both U.S. senators — Sen. (Jon) Husted and Sen. (Bernie) Moreno — along with our commissioners and Insight representatives.”

In its news release, Insight said emergency department services are available 24 / 7.

Inpatient and outpatient services are available 8 a.m. to 8 p.m. Monday through Friday; 8 a.m. to 4 p.m. Saturday; and 9 a.m. to 1 p.m. Sunday and holidays.

Insight said approximately 50 staff are in place.

“We are grateful for the continued partnership of our community, staff, nurses, doctors and leaders at every level of government as we reopen,” the Insight spokesperson said.

Trumbull County Commissioner Rick Hernandez and Franklin said Moreno’s office contacted them for a status meeting Tuesday on the East Market Street hospital. Hernandez was joined by Commissioners Denny Malloy and Tony Bernard.

Hernandez and Franklin said the gathering was not open to the public.

“It was basically informational,” Hernandez said. “There was nothing from the commissioners, no voting. … It was just to sit down with the senator who made a couple phone calls to the sources that would have enabled (Insight) to open.”

Moreno came to Insight Trumbull to oversee the 9 a.m. meeting, both officials said. Within 45 minutes, Insight received state and federal permissions to operate.

An Ohio Department of Health spokesman said the agency “gave the facility approval to reopen under state licensure regulations at about 9:30 this morning.”

Moreno called Dr. Mehmet Oz, head of the Centers for Medicare and Medicaid Services, to obtain federal licensing, Hernandez said.

“So happy to see this finally happen after seven months of anxiety,” Moreno said in a social media post. “This was a total team effort and the Mayor, the Trumbull County Commissioners, the Ohio Department of Health, and our great Director of CMS, @DrOz, made it happen!”

“We received, in approximately 40 minutes, confirmation that (Insight) passed all inspections and were given the certifications to operate from Medicare,” Franklin said. “They needed that to actually begin operations at the emergency department.”

On its website, the Centers for Medicare and Medicaid Services said the federal shutdown may limit or delay updates to information it provides.

“Mission-critical activities of CMS will continue as the Trump Administration works to reopen the government for the American people,” it said.

Franklin said the work to reopen Insight was a joint effort.

“We just kept plowing through the process,” he said.

“When Sen. Moreno showed up and made those crucial calls, that really put the icing on the cake,” Hernandez said. “I have to commend him for going the distance.”

While Insight is offering emergency services, the type of cases arriving by ambulance will be determined by dispatchers at the Trumbull County 911 center.

“That is going to be the test,” Hernandez said. “We’ve already spoken with our 911 director (Tacy McDonough) and discussed with her about delegating certain (cases) at this point in time.

“Probably within the next few weeks, they’ll be able to handle a lot more than just opening the doors today.”

Franklin said Insight’s physicians, nurses, maintenance workers, other staff and union representatives exhibited extraordinary patience throughout the wait.

“This is the beginning of a new chapter,” he said.