The U.S. Centers for Medicare & Medicaid Services (CMS) has published the final rule requiring seventeen of the provider types governed under Medicare and Medicaid programs to establish a comprehensive emergency preparedness plan. The regulations go into effect on November 15, 2016 with an implementation date of November 15, 2017. The two major requirements in the regulation are:
1. development of an emergency preparedness program, and
2. specialized provisions dealing with emergency and backup power supplies for certain health care facilities.
National Fire Protection Association (NFPA) codes and standards that are relevant for this rule are: NFPA 99: Health Care Facilities Code, NFPA 101: Life Safety Code® and NFPA 110: Standard for Emergency and Standby Power Systems.
A related component of the rule is the need for hospitals, transplant centers, critical access hospitals and long-term care facilities to carefully evaluate their emergency and standby power systems. Generator capacity and fuel supplies will need to be assessed with particular attention paid to the policy/procedure section of the rule.
“The new rule requires specific providers to evaluate the sources of energy and related provisions that impact building temperature, emergency lighting, fire protection systems, sewage and waste disposal,” said Jonathan Hart, senior fire protection engineer for NFPA. “Compliance with the emergency power criteria, including inspection, testing and maintenance of the systems, is specifically referenced in the rule but with the added provisions to manage the other building support systems noted.”
The CMS rule cited a number of both natural hazards and human-caused events that triggered the need for the new provisions. Catastrophic events such as the September 11 terrorist attacks, Hurricane Katrina and recent pandemic outbreaks can challenge a provider’s ability to carry out its day-to-day operations. The rule requires providers to develop their plans based on a comprehensive risk assessment strategy that addresses all-hazard disasters or emergency situations. Based on that risk assessment, the plan should consider how provisions and logistics for items such as food, water, medicine and other essential supplies will be managed for hospital and long term care facilities. For other providers such as clinics, home health care agencies and even community PACE programs, they will need to develop a plan that indicates how they will manage services when an emergency strikes.
Earlier this year, CMS ruled that hospitals, nursing homes, ambulatory surgical centers and related facilities need to show that their fire and life safety programs satisfy NFPA 99-2012 and NFPA 101-2012. The most recent rule adds in a specific component to integrate emergency planning across the spectrum of the health care delivery system. Both rules, combined, offer an enhanced level of protection and preparedness for the U.S. health care system.
The complete Emergency Preparedness Requirements for Medicare and Medicaid Participating Providers and Suppliers Final Rule can be found here. The NFPA CMS Resource page offers additional tools, products and educational materials related to these new rules, and will be updated with new content as information becomes available.