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CMS Updates the Emergency Preparedness Rule

  • 28 February 2019 |
  • Published in News

CMS updates its Emergency Preparedness Rule Changes to the rule touch on infectious disease and emergency standby power systems
Reference: https://www.hfmmagazine.com/articles/3563-cms-updates-its-emergency-preparedness-rule

Discussion: CMS is adding “emerging infectious diseases” to the current definition of all-hazards approach. After review, CMS determined it was critical for facilities to include planning for infectious diseases within their emergency preparedness program. In light of events such as the Ebola Virus and Zika, we believe that facilities should consider preparedness and infection prevention within their all-hazards approach, which covers both natural and man-made disasters.

Additionally, since the release of the Interpretive Guidelines for Emergency Preparedness in 2017, stakeholders and providers have asked for additional clarifications related to portable/mobile generators. CMS has added guidance under Tag E0015- Alternate Source Power as well as clarifications under Tag E0042- Emergency Standby Power Systems. Facilities should use the most appropriate energy source or electrical system based on their review of their individual facility’s all-hazards risks assessment and as required by existing regulations or state requirements. Regardless of the alternate sources of energy a facility chooses to utilize, it must be in accordance with local and state laws, manufacturer requirements, as well as applicable Life Safety Code (LSC) requirements.

If a facility risk assessment determines the best way to maintain temperatures, emergency lighting, fire detection and extinguishing systems and sewage and waste disposal would be through the use of a portable and mobile generator, rather than a permanent generator, then the LSC provisions such as generator testing, maintenance, etc. outlined under the National Fire Protection Association (NFPA) guidelines requirements would not be applicable, except for NFPA 70 - National Electrical Code.

However, the revisions, as the provisions under emergency preparedness themselves, do not take away existing requirements under LSC, physical environment or any other Conditions of Participation that a provider type is subject to (for example to maintain safe and comfortable temperatures). Finally, in addition to minor technical edits, CMS has also made the change to the HHA citations from 482.22 to reflect the regulatory citation 484.102.
Contact: For questions regarding the Emergency Preparedness Rule, please contact This email address is being protected from spambots. You need JavaScript enabled to view it..

Effective Date: Immediately. The information provided in this memorandum should be communicated with all survey and certification staff, their managers and the State/Regional Office training coordinators within 30 days of this memorandum.

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CMS Emergency Preparedness Rules

The Centers for Medicare & Medicaid Services (CMS) finalized rules to establish consistent emergency preparedness requirements for 17 types of health care providers participating in Medicare and Medicaid. The purpose of these rules are to increase patient safety during emergencies, and establish a more coordinated response to natural and man-made disasters. These rules require certain participating providers and suppliers to plan for disasters and coordinate with federal, state, tribal, regional, and local emergency preparedness systems to ensure that facilities are adequately prepared to meet the needs of their patients during disasters and emergency situations. The implementation date for these rules is November 16, 2017.

CMS encourages the covered healthcare providers to engage with their local Healthcare Coalition (HCC) to achieve greater organizational and community effectiveness and financial sustainability through a more inclusive preparedness community.  The HCCs function as an accessible source of preparedness and response best practices as newly engaged provider types adapt to the new requirements. 

The full copy of the finalized CMS rules can be downloaded from the attachments shown below. 

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CMS Emergency Preparedness Rules & Regulations

The Department of Health and Human Services, Centers for Medicare and Medicaid Services (CMS) published the Emergency Preparedness Requirements for Medicare and Medicaid Participating Providers and Suppliers, Final Rule on September 16, 2016

This final rule establishes national emergency preparedness requirements for Medicare and Medicaid participating providers and suppliers to plan adequately for both natural and man-made disasters and coordinate with federal, state, tribal, regional, and local emergency preparedness systems.

It will also assist providers and suppliers to adequately prepare to meet the needs of patients, residents, clients, and participants during disasters and emergency situations. Despite some variations, these regulations will 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. 

These regulations were effective as of November 16, 2016.

The regulations must be implemented by November 15, 2017.

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CMS Guidance on New Training and Testing Requirements of the Emergency Preparedness Requirements for Medicare & Medicaid Participating Providers and Suppliers Final Rule

  • 18 April 2017 |
  • Published in News

Background

The Emergency Preparedness Requirements for Medicare and Medicaid Participating Providers and Suppliers Final Rule became effective on November 15, 2016 with an implementation date of November 15, 2017 (a correction notice was published on November 15, 2016 (81 FR 80594) correcting technical, typographical errors and did not alter the effective date). This means that as of November 15, 2017, all affected providers and suppliers must meet all of the applicable requirements of the rule. For additional background information, providers and suppliers may reference policy memorandum SC-17-05 Information on the Implementation Plans for the Emergency Preparedness Regulation published, on October 28, 2016.

Many providers and suppliers have asked whether they will be expected to have completed the “exercises” per the training and testing requirements in each standard (d) of the Final Rule, by the implementation date. Because the Final Rule has an implementation date of November 15, 2017, one year following the effective date, providers and suppliers are expected to meet the requirements of the training and testing program by the implementation date.

Exercise Requirements and Recommendation

When referring to the standard (d) Training and Testing Program provisions, we are referencing the following requirements under §403.748(d), §416.54(d), §418.113(d), 

§441.184(d), §460.84(d), §482.15(d), §483.73(d), §483.475(d), §484.22(d), §485.68(d), §485.625(d), §485.727(d), §485.920(d), §486.360(d), §491.12(d), §494.62(d) of the Final Rule.

In order to meet these requirements, we strongly encourage providers and suppliers to seek out and to participate in a full-scale, community-based exercise with their local and/or state emergency agencies and health care coalitions and to have completed a tabletop exercise by the implementation date. We realize that some providers and suppliers are waiting for the release of the interpretive guidance to begin planning these exercises, but that is not necessary nor is it advised. Providers and suppliers that are found to have not completed these exercises, or any other requirements of the Final Rule upon their survey, will be cited for non-compliance.

While providers and suppliers are encouraged to partner with local and state emergency agencies and health care coalitions to conduct full-scale community exercises, not all agencies and coalitions will have the ability or resources to engage with all providers and suppliers. Therefore, we understand that a full-scale, community-based exercise may not always be possible for some providers and suppliers. In such cases, we expect those who have been unable to complete a full-scale exercise by November 15, 2017 to complete an individual facility-based exercise and document the circumstances as to why a full-scale, community-based exercise was not completed. The documentation should include what emergency agencies and or health care coalitions the provider or supplier contacted to partner in a full-scale community exercise and the specific reason(s) why a full-scale exercise was not possible.

Resources

To assist providers and suppliers in meeting the requirements of the new Final Rule, CMS has developed a website that contains various resources such as checklists, links to emergency preparedness agencies, planning templates and many other valuable resources. The website also provides a State-by-State listing of Health Care Coalitions. The information can be found at our website at https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertEmergPrep/Emergency-Prep-Rule.html.

To view the CMS Letter to State Survey Agency Directors of March 24, 2017 download the attachment shown below.

 

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News CMS Emergency Preparedness Rules

  • 09 November 2016 |
  • Published in News

Today, the Centers for Medicare & Medicaid Services (CMS) finalized rules to establish consistent emergency preparedness requirements for health care providers participating in Medicare and Medicaid, increase patient safety during emergencies, and establish a more coordinated response to natural and man-made disasters. These new rules will require certain participating providers and suppliers to plan for disasters and coordinate with federal, state, tribal, regional, and local emergency preparedness systems to ensure that facilities are adequately prepared to meet the needs of their patients during disasters and emergency situations. The effective date will be November 16, 2016 and the implementation date will be November 16, 2017.

HPP anticipates that health care entities that have not previously engaged in community preparedness will seek to do so through participation in HCCs. The CMS rules offer HCCs a tremendous opportunity to achieve greater organizational and community effectiveness and financial sustainability through a more inclusive preparedness community.  Although the over 26,000 health care organizations already engaged in community preparedness through HCCs may already meet or exceed the baseline level of preparedness in the CMS rules, HCCs will also function as an accessible source of preparedness and response best practices as newly engaged provider types adapt to the new requirements.

In addition, ASPR TRACIE has a dedicated page with links to resources that can help health care entities start or  update their planning processes. ASPR TRACIE will work closely with CMS to gather and share relevant resources and help with assistance requests. ASPR TRACIE and CMS will also host a joint presentation on Wednesday, December 14, 2016, to discuss the CMS Emergency Preparedness Regulations. Additional details to come.

The finalized CMS rules can be accessed here: https://www.federalregister.gov/public-inspection

The CMS press release can be accessed here: https://www.cms.gov/Newsroom/MediaReleaseDatabase/Press-releases/2016-Press-releases-items/2016-09-08.html

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