New CMS Emergency Preparedness Rule

New CMS Emergency Preparedness Rule

September 2016

The Centers for Medicare and Medicaid Services (CMS) issued a final rule establishing emergency preparedness requirements for Medicare and Medicaid participating providers.

The rule, which can be viewed in its entirety at https://www.federalregister.gov/documents/2016/09/16/2016-21404/medicare-and-medicaid-programs-emergency-preparedness-requirements-for-medicare-and-medicaid, is effective November 15, 2016 and must be implemented by November 15, 2017.

According to CMS, the purpose of the new rule is to “provide consistent emergency preparedness requirements, enhance patient safety during emergencies for persons served by Medicare- and Medicaid-participating facilities, and establish a more coordinated and defined response to natural and man-made disasters.”

The four required elements of the new Emergency Preparedness Rule are as follows:

1. Risk assessment and emergency planning: Requiring facilities to perform a risk assessment that uses an “all-hazards”approach prior to establishing an emergency plan. The all-hazards risk assessment will be used to identify the essential components to be integrated into the facility emergency plan. An all-hazards approach is an integrated approach to emergency preparedness planning that focuses on capacities and capabilities that are critical to preparedness for a full spectrum of emergencies or disasters.  See FEMA National Preparedness System Web site located at: https://www.fema.gov/​threat-and-hazard-identification-and-risk-assessment. 
2. Policies and procedures: We are requiring that facilities develop and implement policies and procedures that support the successful execution of the emergency plan and risks identified during the risk assessment process. 
3. Communication plan: We are requiring facilities to develop and maintain an emergency preparedness communication plan that complies with both federal and state law. Patient care must be well-coordinated within the facility, across healthcare providers, and with state and local public health departments and emergency management agencies and systems to protect patient health and safety in the event of a disaster. See FEMA’s comprehensive preparedness guide to develop and maintain emergency operations plans at: https://www.fema.gov/​media-library-data/​20130726-1828-25045-0014/​cpg_​101_​comprehensive_​preparedness_​guide_​developing_​and_​maintaining_​emergency_​operations_​plans_​2010.pdf
4. Training and testing: We are requiring that a facility develop and maintain an emergency preparedness training and testing program. A well-organized, effective training program must include initial training for new and existing staff in emergency preparedness policies and procedures as well as annual refresher trainings. The facility must offer annual emergency preparedness training so that staff can demonstrate knowledge of emergency procedures. The facility must also conduct drills and exercises to test the emergency plan to identify gaps and areas for improvement.  See FEMA Training and Exercise Planning Workshop (TEPW) at: http://www.fema.gov/​media-library-data/​20130726-1914-25045-8890/​hseep_​apr13_​.pdf.

According to McKnight’s at http://www.mcknights.com/news/emergency-power-systems-a-must-for-nursing-homes-under-cms-final-rule/article/521751/, long-term care facilities will be required to:

1. Have emergency and standby power systems;
2. Create plans regarding missing residents regardless of whether there is a national, local,natural or man-made disaster;
3. Develop a method of sharing “appropriate” information from the emergency plan with residents and their families or representatives.