The State of CMS Emergency Preparedness Readiness in Long-Term Care Facilities

by | Oct 15, 2018

Over the last few months, LiveProcess, in conjunction with Certified Emergency Manager Mike Boucher, MSN, RN, has offered webinars to help long-term care facilities ensure that they are meeting the standards for compliance with the CMS emergency preparedness rule. During the live webinars, we asked attendees how ready they were to meet the CMS emergency preparedness requirements and to activate their emergency management plans. Overall, the responses reflect the participants’ emergency preparedness readiness.

For example, only 3 percent of respondents said they were not ready to meet the requirements of the CMS emergency preparedness rule. The vast majority, 78 percent, described their facilities as somewhat ready, while 19 percent described their facilities as completely prepared. To understand where long-term care facilities are succeeding and where the opportunities lie for improvement, we asked about specific elements of preparation, execution and evaluation of their emergency preparedness plans.

Readiness for the CMS emergency preparedness rule

These first questions uncovered that many facilities still had work to do in the areas of community collaboration and communication. For example, only 38 percent of respondents felt that their current emergency plans were well integrated with community agencies and partners. That number is not surprising, given that CMS identified improved collaboration with emergency management partners as a specific need to be addressed by the new rule.

When asked if their facility could reach every employee within 15 minutes, most participants responded either No or Not Sure. In a crisis, that could represent a great deal of human effort spent to initiate contact, delaying the mobilization of emergency response teams — with damaging results. The CMS emergency preparedness rule requires organizations to have a specific communication plan as part of their written emergency plan. The requirement gives facilities an opportunity to devise better systems for both rapid mass notifications and targeted response coordination.

On a positive note, a majority of respondents noted that they were already active members of a local healthcare coalition. For facilities in locations where participation is available, these coalitions often have resources to help with emergency management planning.

 

Building a CMS-compliant emergency preparedness program

Many facilities were prepared to build on existing emergency preparedness plans in order to achieve compliance with the new CMS rule. For example, when asked “Do you have a written, all-hazards emergency plan that specifically includes risk to business continuity?” 73 percent of respondent said yes. In other words, these providers stated that they had emergency preparedness plans and the plans were consistent with the CMS-stated goals of an all-hazards risk assessment with attention to continuity of operations (COOP) planning.

A significant majority of respondents said that they were making use of available tools to build and evaluate their emergency preparedness program. It is easy for organizations to become overwhelmed by trying to create every element of an emergency preparedness program from scratch. Implementing an incident command system (ICS) or adopting templates from outside resources streamlines efforts while standardizing procedures.

When asked about areas of challenge, collaboration and training were the most frequently mentioned areas of concern. Specifically, “Developing instruction, education and training plans” and “Coordinating with external responders and partners” were the top two areas of emergency preparedness planning that participants felt would take the most time to implement at their facilities.

 

Testing and training an emergency preparedness plan

A majority of participants (68 percent) reported that their facilities had both an annual training plan or program and a testing program with two qualifying drills or exercises per year. A slightly larger number (70 percent) had participated in a full-scale, community-based exercise within the past year. This contrasts somewhat with the percentage of respondents at our first webinar who felt that their plans were well-integrated with community partners (38 percent).

Well over half of respondents answered yes to the question “Do you have written procedures for evaluating plan activations, emergency responses and exercises?” Yet the 35 percent who do not or are unsure is a large minority. Given the significant effort and expense involved in emergency management plan activations and exercises, forgoing consistent, thorough evaluation misses a major opportunity for improvement. Moreover, a written procedure for evaluation and review is required for compliance with the CMS emergency preparedness rule.

Taking advantage of emergency management technology

A surprising number of respondents, 60 percent, said that they did not use automated systems to execute their emergency preparedness program and maintain documentation. Another 10 percent said they were not sure. An emergency management platform such as LiveProcess automates tasks such as mass notification and creating an event log, saving valuable time during a planned or crisis situation. The LiveProcess solution also automates much of the documentation needed to evaluate the organization’s response.

An emergency management platform can also help with the other areas participants identified as challenges, including streamlining coordination with internal and external emergency preparedness partners and accelerating time-to-contact with key staff. Enhancing emergency preparedness plans with appropriate technology could help many long-term care providers who feel only somewhat ready for a CMS emergency preparedness compliance survey to join those who know they are completely prepared.

terry-zysk-100x100Terry Zysk, CEO of LiveProcess, has more than two decades of experience in leading organizations that provide innovative solutions to the healthcare industry.