Source: http://www.nahc.org/NAHCReport/nr160915_2/
Timestamp: 2017-05-24 00:28:51
Document Index: 622771337

Matched Legal Cases: ['§418', '§418', '§418', '§418', '§418', '§418', '§418', '§418', '§418', '§418', '§418', '§418', '§418', '§484', '§484', '§484', '§484', '§484', '§484', '§484', '§484', '§484', '§484', '§484', '§484']

CMS Releases Final Emergency Preparedness Rule | National Association for Home Care & Hospice
CMS Releases Final Emergency Preparedness Rule September 16, 2016 09:42 AM
As NAHC has previously reported, CMS released proposed emergency preparedness rules in late 2013 for which The National Association of Home Care & Hospice (NAHC) submitted comments. CMS has three years from the date of publication of a proposed rule to finalize it or the rule-making process must be initiated again. With a little time to spare, CMS published the final emergency preparedness rule in the Federal Register on September 8. Much of the requirements are the same or similar to the proposed rule. The below provides you a summary of the proposed rule for hospice and home health. In addition, NAHChas developed a side by side comparison of the requirement as proposed and finalized for both home health and hospice organizations. Changes are outlined in bulleted format below.
All provider types covered by this final rule have what CMS considers to be the four core elements to an effective and comprehensive emergency preparedness plan structure, which can be used across provider types while tailoring requirements to provider specifics:
Risk assessment and emergency We are 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. This approach is specific to the location of the provider or supplier and considers the particular types of hazards most likely to occur in their areas. These may include, but are not limited to, care-related emergencies; equipment and power failures; interruptions in communications, including cyber-attacks; loss of a portion or all of a 12 facility; and, interruptions in the normal supply of essentials, such as water and food. Additional information on the emergency preparedness cycle can be found at the Federal Emergency Management Agency (FEMA) National Preparedness System website located at: https://www.fema.gov/threat-and-hazard-identification-and-risk-assessment.
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.
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. The following link is to FEMA’s comprehensive preparedness guide to develop and maintain emergency operations plans: https://www.fema.gov/media-library-data/20130726-1828-25045- 0014/cpg_101_comprehensive_preparedness_guide_developing_and_maintaining_emergency_o perations_plans_2010.pdf
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 13 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. The Homeland Security Exercise and Evaluation Program (HSEEP), developed by FEMA, includes a section on the establishment of a Training and Exercise Planning Workshop (TEPW). The TEPW section provides guidance to organizations in conducting an annual TEPW and developing a Multi-year Training and Exercise Plan (TEP) in line with the (HSEEP): http://www.fema.gov/media-library-data/20130726-1914- 25045-8890/hseep_apr13_.pdf
There are additional links to resources in the final rule including the National Communication System
http://www.hhs.gov/ocio/ea/National%20Communication%20System/ and a myriad of others that will be helpful to providers as they put together their plans.
There are also cost estimates of the burden to providers of implementing these emergency preparedness plans. At this point, regardless of cost, providers must process but do have some relief in that they are able to work with other providers who are also required to meet these requirements.
Hospice Changes:
Revising the introductory text of §418.113 by adding the term "local" to clarify that hospices must also coordinate with local emergency preparedness requirements.
Revising §418.113(a)(4) to delete the term "ensuring" and to replace the term "ensure" with "maintain."
Revising §418.113(b)(1) to remove the requirement for home-based hospices to track staff and patients.
Revising 418.113(b)(1) to clarify that in the event that there is an interruption in services during or due to an emergency, home based hospices must have policies in place for following up with on-duty staff and patients to determine services that are still needed. In addition, they must inform State and local officials of any on-duty staff or patients that they are unable to contact.
Revising §418.113(b)(5) to delete the term "ensure" and to replace it with the term "maintain."
Revising §418.113(b)(6)(iii)(A) by adding that hospices must have policies and procedures that address the need to sustain pharmaceuticals during an emergency.
Revising §418.113(b)(6) by adding a new paragraph (v) to require that inpatient hospices track on-duty staff and patients during an emergency, and, in the event staff or patients are relocated, inpatient hospices must document the specific name and location of the receiving facility or other location to which on-duty staff and patients were relocated to during the emergency.
Revising §418.113(c) by adding the term "local" to clarify that the hospice must develop and maintain an emergency preparedness communication plan that also complies with local laws.
Revising §418.113(c)(5) to clarify that hospices must develop a means, in the event of an evacuation, to release patient information, as permitted under 45 CFR 164.510(b)(1)(ii).
Revising §418.113(d) by adding that each hospice's training and testing program must be based on the hospice's emergency plan, risk assessment, policies and procedures, and communication plan.
Revising §418.113(d)(1)(ii) to replace the phrase "Ensure that hospice employees can demonstrate" to "Demonstrate staff."
Revising §418.113(d)(2)(i) by replacing the term "community mock disaster drill" with "full-scale exercise."
Revising §418.113(d)(2) to allow a hospice to choose the type of exercise it will conduct to meet the second annual testing requirement.
Adding §418.113(e) to allow separately certified hospices within a healthcare system to elect to be a part of the healthcare system's emergency preparedness program.
Home Health Changes:
Revising the introductory text of §484.22 by adding the term "local" to clarify that HHAs must also comply with local emergency preparedness requirements.
Revising §484.22(a)(4) by deleting the term "ensuring" and replacing the term "ensure" with "maintain."
Revising §484.22(b)(3) to require that in the event that there is an interruption in services during or due to an emergency, HHAs must have policies in place for following up with patients to determine services that are still needed. In addition, they must inform State and local officials of any on-duty staff or patients that they are unable to contact.
Revising §484.22(b)(4) to change the phrase "ensures records are secure and readily available" to "secures and maintains availability of records."
Removing §484.22(b)(6) that required that HHAs develop arrangements with other HHAs and other providers to receive patients in the event of limitations or cessation of operations to ensure the continuity of services to HHA patients.
Revising §484.22(c) by adding the term "local" to clarify that the HHA must develop and maintain an emergency preparedness communication plan that also complies with local laws.
Revising §484.22(c)(1) to remove the requirement that HHAs include the names and contact information for "Other HHAs" in the communication plan.
Revising §484.22(d) by adding that each HHA's training and testing program must be based on the HHA's emergency plan, risk assessment, policies and procedures, and communication plan.
Revising §484.22(d)(1)(ii) by replacing the phrase "Ensure that staff can demonstrate knowledge" to "Demonstrate staff knowledge."
Revising §484.22(d)(2)(i) by replacing the term "community mock disaster drill" with "full-scale exercise."
Revising §484.22(d)(2)(ii) to allow a HHA to choose the type of exercise it will conduct to meet the second annual testing requirement.
Adding §484.22(e) to allow a separately certified HHA within a healthcare system to elect to be a part of the healthcare system's emergency preparedness program.
Hospice Side by Side
Home Health Side by Side