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On 16 September, 2016, the Centers for Medicare and Medicaid services (CMS) issued the national emergency preparedness requirements for Medicare and Medicaid participating providers and suppliers to plan appropriately for any potential man-made and/or natural disaster. The ruling stated that these participating entities also ensure that they have services that are coordinated with local, regional

state and federal emergency preparedness programs. The first thing to appreciate is that this final rule will apply to 17 Medicare and Medicaid suppliers and providers who will have to comply with these new requirements. Secondly this ruling will assist suppliers and providers in their preparation to help meet the needs of residents, patients and other participants during emergency situations or and any impending disaster.

The final Rule became effective on Nov. 15, 2016 but will not be enforced for compliance until November 15, 2017. The new Rule states that both the supplier and provider must at least annually review and update the emergency plans and all staff must be familiar and be updated with the procedure and policies in the operations manual of the facility that is experiencing an emergency.

This new Rule evolved after the past natural disasters such as the HINI influenza epidemic in 2009, Hurricane sandy in 2012, the Ebola virus outbreak of 2014, tornadoes that struck in 2011 and 2012 and the emergence of MERS in 2013. Upon review of these emergencies, it was concluded by CMS that the nation was simply not prepared to deal with all type of emergencies and more inclusive requirements were necessary to deal with all types of disasters.

Medicare and Medicaid services (CMS) MedtrainerThe one disaster that revealed the fragility of the nation and promoted this new ruling was the outbreak of the Ebola virus, which revealed that there were problems with communication, transportation and dealing with ill patients in emergency rooms. The Ebola virus outbreak also revealed how poorly the hospitals were equipped to deal with such a deadly virus. This outbreak emphasized the need for a more comprehensive hazards approach at the local, regional, state and federal level.

Key facts about emergency preparedness in the current ruling is making advanced preparations, developing a comprehensive policy and procedure for all the staff, ensuring that communication lines can remain open and providing employees with adequate training with use of personal protection equipment.

In the current Ruling, CMS has addressed many gaps in how previous disasters were handled and feels that the three key elements necessary to maintain access to healthcare services during an emergency include 1) protecting all physical resources 2) maintaining business continuity and 3) safeguarding human resources. With this new ruling it is vital that administration and risk management thoroughly assess their institution’s deficiencies, risks, legal responsibilities and readiness to all types of hazard emergencies.

This latest CSM Ruling has identified four essential elements that are key to a comprehensive and effective approach to emergency preparedness for certain Medicare and Medicaid participating providers and suppliers. These essential elements include the following:

1. Risk Assessment and Emergency Planning that is specific to that location 2. Develop policies and procedures that must be available to all staff 3. Have a comprehensive communication plan 4. Training and Testing program that include participating in exercises to test the emergency plan at least once every 12 months

To ensure compliance, CMS will audit each provider and supplier at random to ensure that the requirements have been met. CMS will start to perform mandatory enforcement of compliance with the ruling starting Nov. 15, 2017 and there will be no waivers given to any institution. For those not compliant, it may mean termination of any other conditions (contracts) of participation with CMS.

The list of providers and suppliers to whom CMS has issued the emergency preparedness regulations under the final ruling include the following:


  • Ambulatory Surgery Centers
  • Hospice
  • Hospitals
  • Inpatient & outpatient psychiatric services
  • Language pathology service
  • Long-term care facilities
  • Mental health centers
  • Nursing homes
  • Organ procurement centers
  • Rehabilitation facilities
  • Religious nonmedical health care institution
  • Renal failure Centers
  • Skilled Nursing Facilities
  • Transplant centers

Already some hospitals and external agencies have started to offer continuing education programs on how to start with the process of Emergency Preparedness and satisfy all the criteria required by CMS.

Contact MedTrainer today to learn more.