Safety First: Five Steps to Better Life Safety and Emergency Preparedness
It seems like only yesterday that the Centers for Medicare & Medicaid Services (CMS) updated its regulations to improve life safety in facilities that care for beneficiaries. The final rule, titled “Medicare and Medicaid Programs; Fire Safety Requirements for Certain Health Care Facilities” and published on May 4, 2016, requires long-term care facilities, inpatient hospices, and similar organizations to meet the requirements of the 2012 edition of National Fire Protection Association (NFPA) 101, the Life Safety Code®, and the 2012 edition of NFPA 99, the Health Care Facilities Code. In the same year, CMS published the emergency preparedness requirements final rule, which requires facilities to establish and regularly update their own emergency preparedness plans.
While these regulations impact facilities nationwide, an incident in New York has shed a light on the difficulties that many are experiencing. In a series of unannounced compliance audits, the Office of Inspector General found that among 20 surveyed nursing homes, all had severe deficiencies. These included 205 issues related to life safety and 219 issues related to emergency preparedness. In an August 2019 report, the department cited inadequate management and lack of standardized training as the main causes for noncompliance.
However, the problem is not limited to New York. CMS finds that nursing homes across the United States often have six to seven deficiencies per inspection. While noncompliance can result in substantial fines, the consequences can also prove deadly for patients. Facilities with a pattern of serious problems over the span of three years or longer may be placed in a Special Focus Facility (SFF) program, meaning more frequent inspections, public disclosure of their status, and, if the problems are not corrected, termination from Medicare and/or Medicaid. Currently, there are between five and 30 SFF-enrolled facilities in each state nationwide.