What’s New: CMS Emergency Preparedness Rule in 2019

by | Jul 11, 2019

2019-cms-emergency-preparedness-updateUpdates to the CMS emergency preparedness final rule have been under discussion since it went into effect in September 2016. On February 1, 2019, CMS released an update to the emergency preparedness rule. This update went into effect immediately. In addition, other proposed changes remain works in progress. Here are some of the key changes, effective and proposed, that may affect your healthcare delivery organization.

2019 update to the CMS Emergency Preparedness Rule

An all-hazards approach is a central tenet of the CMS emergency preparedness rule. CMS urges healthcare providers to focus on risks that are relevant to their facilities and environment. A significant change in the February 2019 update to Appendix Z is an expanded definition of an all-hazard approach to emergency management planning. CMS specifies that emerging infectious diseases (EIDs), such as the Ebola and Zika viruses, should be considered in the all-hazard risk assessment.

Conducting a Hazard Vulnerability Analysis (HVA) on a regular basis as part of an emergency preparedness program helps healthcare facilities quantify the level of risk and the severity of impact for pandemics and other events.

Emerging infectious diseases, such as the Ebola and Zika viruses, should be considered in the all-hazard risk assessment.

Clarifications in the 2019 update that did not create new requirements but provide information to guide the interpretation of the CMS emergency preparedness final rule include:

  • The use of alternate energy sources and portable or mobile generators
  • Maintaining safe temperatures in critical areas of the facility
  • Following state and local mandates, including mandatory evacuation orders

[Read the full annotated text from CMS for Emergency Preparedness – Updates to Appendix Z of the State operations Manual (SOM) dated February 1, 2019.]

More proposed changes to the CMS emergency preparedness rule

Feedback from healthcare providers has suggested that some requirements in the CMS emergency preparedness final rule were burdensome and would divert time and resources away from high-quality patient care. As part of a package of proposed changes to the CMS emergency preparedness rule announced in September 2018, some of these requirements would be reduced. For example:

Emergency program review: The emergency program review consists of a review of the emergency plan as well as policies and procedures, communication plans, and training and testing requirements. Facilities would have the option to review their emergency program every two years, rather than annually. According to CMS, this change would give facilities “more time to focus on their unique needs and specific circumstances.”

Training and testing: Because the program review would be required biennially, training program review and execution also would be required biennially. If major revisions are made to the plan, however, new training should be provided as soon as possible.

Inpatient providers such as hospitals and long-term care facilities will still be required to conduct two testing exercises, but under the proposed changes would have the flexibility to conduct one test through a method of their choice, such as a workshop or desktop exercise. The other testing event would still be a full-scale community exercise. The requirement for outpatient providers would change from two to one exercise annually. Requirements to track and document training and testing using tools such as an after action report would remain.

Documentation of cooperation efforts: Documentation requirements deemed burdensome would be eliminated. For example, the CMS emergency preparedness rule asks facilities to document efforts to contact local, tribal, regional, state, and federal emergency preparedness officials and to document participation in collaborative and cooperative planning efforts. These documentation requirements would be removed, although the requirement to have a process for cooperation and collaboration with these entities in the emergency preparedness plan would remain.

The comment period has ended for these proposals, and it is likely that a future revision of the CMS emergency preparedness rule will reflect at least some of these proposed changes.

[Read the full text from CMS: Medicare and Medicaid Programs; Proposed Regulatory Provisions to Promote Program Efficiency, Transparency, and Burden Reduction, September 17, 2018]

Prioritizing healthcare emergency preparedness

Many healthcare providers say they are not fully prepared for a large-scale disaster, although the deadline for compliance with the CMS emergency preparedness final rule was November 2017. In a 2018 poll by the American College of Emergency Physicians, only 13 percent of those surveyed reported that their hospital has thoroughly reevaluated preparedness plans, compared to a combined 30 percent who had either “not really reevaluated plans” or not done it all.

As the emergency management regulations change, your healthcare organization will need to take stock of your emergency management plans and evaluate your emergency management program for emerging threats and compliance with the CMS emergency preparedness rule.

Our solutions

LiveProcess Emergency Manager is a proven system for emergency preparedness planning, mass mobilization, real-time coordination and tracking. Hospitals and health systems, ambulatory centers, skilled nursing facilities, long-term care organizations, home health agencies, and public agencies use Emergency Manager to prepare for and respond to disaster events and for everyday disruptions.

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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.