The Centers for Medicare and Medicare Services (CMS) posted its final rule in September entitled “Emergency Preparedness Requirements for Medicare and Medicaid Participating Providers and Suppliers”. The rule is set to go into effect on November 16, 2016, with health care providers and suppliers affected by this rule required to comply and implement all regulations one year after the effective date, on November 16, 2017, according to the CMS.
This rule will affect 72,315 American health care providers and suppliers – from hospitals and nursing homes and other long-term care facilities to home healthcare and hospice to dialysis facilities and care homes for those with intellectual disabilities.
The goal of the rule, according to the CMS, is to prevent severe breakdown in patient care that has followed past disasters, including Hurricane Katrina and Super Storm Sandy, and most recently the flooding in Louisiana. The rule is also designed to strengthen the ability to provide services during other types of emergencies, such as pandemics and terrorist attacks. The rule is unusual in that it has provisions for 17 different provider types, among them those that patients rely on to live at home, like outpatient surgery sites, physical therapy offices and home health care agencies.
The rule “will make it more likely that facilities will be able to stay open and able to care for patients, and if they need to close or stop work temporarily, get back up and able to care for patients quickly,” said Dr. Nicole Lurie, the assistant secretary for preparedness and response at the Department of Health and Human Services. ”The need for patient care doesn’t stop because streets are flooded or trees are down. In fact disasters often increase the need for health care services.”
Although the majority of organizations have had to adhere to at least some emergency preparedness requirements for accreditation, others were not subject to any, including hundreds of residential psychiatric facilities, nearly 200 community mental health centers, dozens of organ procurement organizations and nearly 4,000 outpatient hospices, which treat patients with limited life expectancies. “It’s going to have a big impact on these facilities,” said Emily Lord, the executive director of Healthcare Ready, a nonprofit focused on preparedness that provided feedback to the government on the implications of the rule,” in an article in the New York Times.
Some feel the requirements under the new rule will be difficult for smaller facilities. Barbara B. Citarella, president of health care consulting group RBC Limited, was cited in the Times article as saying: ‘My concern is that compliance for some providers, especially home care and hospice, will be financially impossible.”
The new as it relates to Medicare and Medicaid participating providers and suppliers specifically requires the following:
1. Emergency plan: Based on a risk assessment, develop an emergency plan using an all-hazards approach focusing on capacities and capabilities critical to preparedness for a full spectrum of emergencies or disasters specific to the location of a provider or supplier.
2. Policies and procedures: Develop and implement policies and procedures based on the plan and risk assessment.
3. Communication plan: Develop and maintain a communication plan that complies with both federal and state law. Patient care must be well coordinated within the facility, across health care providers, and with state and local public health departments and emergency systems.
4. Training and testing program: Develop and maintain training and testing programs, including initial and annual training, and conduct drills and exercises or participate in an actual incident that tests the plan.
These standards, according to the CMS, are adjusted to reflect the characteristics of each type of provider and supplier. For example: outpatient providers and suppliers such as ambulatory surgical centers and end-stage renal disease facilities will not be required to have policies and procedures for provision of subsistence needs. Hospitals, critical access hospitals, and long-term care facilities will be required to install and maintain emergency and standby power systems based on their emergency plan.
Caitlin Morgan specializes in insuring long-term care facilities, including nursing homes and assisted living facilities and home health care agencies. We can help you put together a robust insurance solution for these providers as well as assist in developing business continuity programs that include disaster planning. This is particularly critical in light of the new CMS rule that will affect Medicare and Medicaid participating providers. For more information about our products and services, please contact us at 877.226.1027.