CMS Rule Overview

The Centers for Medicare and Medicaid Services (CMS) issued the Emergency Preparedness Requirements for Medicare and Medicaid Participating Providers and Supplier Final Rule to establish consistent emergency preparedness requirements for healthcare providers as a condition of participation in the Medicare and Medicaid programs. This rule was published in September 2016 and outlines requirements for all 17 provider types.

This list of provider types has been expanded from what types were previously covered under these rules. The provider types include inpatient, outpatient, short term and long term care providers. The Tristate Disaster Preparedness Coalition is a network created to link providers with the Regional Healthcare Coordinator to prepare for, respond to and recover from emergencies.

17 Provider Types included in the Rule:

  1. Hospitals
  2. Religious Nonmedical Health Care Institutions (RNHCIs)
  3. Ambulatory Surgical Centers (ASCs)
  4. Hospices
  5. Psychiatric Residential Treatment Facilities (PRTFs)
  6. All-Inclusive Care for the Elderly (PACE)
  7. Transplant Centers
  8. Long-Term Care (LTC) Facilities
  9. Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID)
  10. Home Health Agencies (HHAs)
  11. Comprehensive Outpatient Rehabilitation Facilities (CORFs)
  12. Critical Access Hospitals (CAHs)
  13. Clinics, Rehabilitation Agencies, and Public Health Agencies as Providers of Outpatient Physical Therapy and Speech-Language Pathology Services
  14. Community Mental Health Centers (CMHCs)
  15. Organ Procurement Organizations (OPOs)
  16. Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs)
  17. End-Stage Renal Disease (ESRD) Facilities

All provider types are required to meet four core elements common to all provider types. The ASPR TRACIE “Resources at your fingertips” document describes the 4 core elements below:

  1. Risk assessment and emergency planning—Develop an emergency plan based on a risk assessment and using an “all hazards” approach, which will provide an integrated system for emergency planning that focuses on capacities and capabilities.
  2. Policies and procedures—Develop and implement policies and procedures based on the emergency plan and risk assessment that are reviewed and updated at least annually. For hospitals, Critical Access Hospitals (CAHs), and Long-Term Care (LTC) facilities, the policies and procedures must address the provision of subsistence needs, such as food, water and medical supplies, for staff and residents, whether they evacuate or shelter in place.
  3. Communication plan—Develop and maintain an emergency preparedness communication plan that complies with federal, state and local laws. Patient care must be coordinated within the facility, across healthcare providers, and with state and local public health departments and emergency management systems to protect patient health and safety in the event of a disaster.
  4. A training and testing program—Develop and maintain training and testing programs, including initial training in policies and procedures. Facility staff will have to demonstrate knowledge of emergency procedures and provide training at least annually. Facilities must conduct drills and exercises to test the emergency plan or participate in an actual incident that tests the plan.

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