How Senior Care Facilities Respond to New CMS Ruling on Emergency Preparedness

Emergency preparedness was a topic of great concern through much of 2016. The Zika virus seemed to move further north than anticipated. Terror threats rocked community foundations. Flooding in Louisiana left the state’s medical resources struggling, and while winter seemed to come late, the first major storm of the season brought sub-zero temperatures to much of the country, driving up the demand for health care.

This confluence of disasters impacting the medical community over 2016 highlighted a disconnect between different Medicare and Medicaid participating providers within communities. Thus, the Centers for Medicare and Medicaid Services (CMS) has implemented new rules relating to emergency preparedness, and failure to meet these standards could result in denial of Medicare or Medicaid payments for participating providers.

Senior care leaders and organizations are revamping existing senior care training for disaster and emergency response policies to meet the new requirements, and you need to know a few things about it.

Why Are New Emergency Preparedness Requirements Being Mandated?

The new emergency preparedness requirements are designed to enhance communication with other health care providers in cities and states, improve contingency planning and reinforce the need for emergency preparedness training of staff members. Upon receiving comments from stakeholders across the country, CMS implemented four additional best practice standards, which include the following:

• An emergency plan must have an all-hazards approach. In other words, any emergency preparedness actions must be developed to adapt to any type of disaster, including man-made and natural disasters.
• All policies and procedures should be based on evaluations following risk assessment. Risk assessment allows providers to determine how closely staff members adhered to emergency preparedness policies, identifying key concerns and areas in need of refinement.
• Providers must develop a means of communicating with Federal and State officials and other health care providers. This ensures an appropriate response to an emergency is available across all areas impacted.
• Training and testing programs must include initial and annual training programs, drills and exercises. Ultimately, repeated training and proficiency testing help prevent staff members from slipping through training requirements, eliminating risk for emergencies growing worse because of inexperienced staff members.

Originally, the proposed rule included a provision for additional hours of backup generator testing. However, the final rule allows participating facilities and providers, including senior care providers, to conduct annual testing requirements and allow outside entities to participate in a unified training environment. In other words, CMS authorized the collaboration of training between multiple providers and health care settings to count as individual training simultaneously.

What Happens When a Provider Fails to Meet Standards?

The 651-page final rule does not specifically list any penalties for failure to adhere to the new emergency preparedness requirements. However, according to JD Supra Business Advisor, past experiences involving new rule implementation and failure to meet standards resulted in delayed reimbursement payments from CMS. Therefore, providers may expect to see a reduction in payment amounts if requirements are not met.

Officially, emergency preparedness requirements went into effect on November 8, 2016, but the short time allotted for implementation implies many CMS participants already had similar standards in place.

How Will Emergency Preparedness Impact Senior Care?

The emergency preparedness rule will impact senior care with respect to preauthorization and training. As explained by the Office of the Federal Register, preauthorizations required for admission of a senior to a new skilled nursing facility will be suspended in the event of a disaster or emergency. However, participating providers must be able to obtain a 1135 Waiver, which relieves sanctions placed on providers for failure to obtain preauthorization, approval for self-referrals or performance deadlines.

Although the waiver’s full definition, available here, eliminates much of the stresses experienced during a natural or man-made disaster, it does not excuse the need to maintain performance standards and timetables. In other words, performance standards or timetables for outcome-based payments may be temporarily delayed, but overall adherence must be maintained.

Senior care training may also become more easily accessible as additional funds are likely to be diverted to participating providers to ensure all staff members understand their roles and responsibilities in the event of a disaster. If training equipment is required, such as mannequins for CPR certification, facilities may be able to begin purchasing and applying for reimbursement on this equipment without preauthorization.

Essentially, CMS is making it simpler and more affordable for care facilities, including clinical settings, home health agencies, hospitals, specialized senior care environments and skilled nursing facilities to prepare for emergencies.

What Does It Mean to You?

If you have not yet started working to improve your emergency preparedness plan for 2017, you are behind the learning curve. The requirements have already been enacted, and additional penalties may become evident in the coming months. To help your organization maintain its role in caring for seniors, you need to immediately re-evaluate your existing emergency management and response plan, determine what risks or holes it may contain and adjust your policies to reflect a community-wide, city-wide and state-wide response to an emergency.

Additional ways of implementing emergency preparedness throughout your organization include helping seniors prepare for emergencies themselves. In fact, the California Department of Aging offers multi-lingual downloads for dealing with floods, hot weather, winter, power outages, wildfires and more online. You may also contact your local emergency medical services’ department to access additional resources and information about emergency preparedness in your area.

Emergency preparedness can only function if you take the time to prepare because an emergency has no warning and does not stop for anyone. Ensure your organization aligns with the standards set by the new emergency preparedness rule, and involve your employees in this venture. Emergency preparedness does save lives.