CMS Mandate: emergency preparedness planning

Effective September 9, 2016: Home health and hospice providers must have emergency plans in place to deal with patient care.  The new rule, which is going to be phased in gradually to allow agencies to prepare, is meant to deal with situations that current regulations fail to address.


Not letting an opportunity go to waste, CMS Deputy Administrator and Chief Medical Officer used the devastating flooding in Baton Rouge, Louisiana to push the new regulations.  “Situations like the recent flooding in Baton Rouge, Louisiana, remind us that in the event of an emergency, the first priority of health care providers and supplies is to protect the health and safety of their patients. Preparation, planning, and one comprehensive approach for emergency preparedness is key.”


CMS, upon review of existing regulations, found that three critical components from coordinated planning were missing.

  1. Communication to coordinate with other systems of care within cities or states.
  2. Contingency planning.
  3. Training of personnel.


Agencies who participate in Medicare and Medicaid programs are required to implement the new best practices.  All four are requirements of the newly updated rule.


  1. Emergency Plan: Agencies must perform a risk assessment and then develop an emergency plan using an all-hazards approach, focusing on capabilities and capacities that are critical to being prepared for a full spectrum of emergencies and disasters that are specific to your agency.


Based on your geographic area, your agencies will need to be ready for your most severe weather.  East coast and Gulf coast agencies would be preparing for hurricanes and flooding while Northeastern agencies would prepare for hurricanes, flooding, blizzards or severe snowstorms, and icing situations.  Central and Midwestern states would prepare for flooding, blizzards, icing, and severe snowstorms as well as tornadoes. Western states would need to prepare for flooding, wildfires, and snowstorms.

  1. Policies and Procedures: Develop and implement policies and procedures for your agency to use based on the risks identified that affect your service area.


Having policies and procedures are great – but you need to make sure your staff know where they are located, understand them, and can use them in reality.  Sometimes what looks great on paper for a surveyor to gush over and get excited about, may not work in the real world.  Common sense planning comes into play with this requirement.


  1. Communication Plan: Agencies must develop and maintain a plan to communicate which complies with both federal law and your state’s applicable law. Patient care must be coordinated within the agency, but also with other partners throughout the health care community, along with state and local health departments and emergency systems.

For agencies like yours, you will need to make sure that your staff have methods of communication to ensure that patients who need to be seen, are seen or have some form of treatment if necessary.  If your agency is unable to reach patients due to a disaster, some other form of reaching those patients, or reaching someone who can get to the patients is necessary.


  1. Training and Testing Program: Develop and maintain training and testing programs at the beginning and throughout the year, conduct drills and exercises or participate in an event that actually occurs.


This goes back to common sense planning – make sure your program works and make sure your agency’s staff know what to do and whom to see.  In-services and continuing education are all part of this process, once you write the plan.


Now that we know what you must have in an emergency plan, it’s time to make sure your disaster plan meets these requirements.  All agencies have some form of disaster planning within their basic policies and procedures manual. However, CMS is now making sure you take it a step further with realistic planning and policies to ensure patient safety.


Please contact us if you would like more information on how we can help your agency update your emergency plan so that a survey deficiency can be avoided, while ensuring patients receive that critical care.