Hospitals Must Adopt Disaster Management Standards by November 2017

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By James Swann

Sept. 8 — Hospitals and other providers will have to meet four best-practice standards for handling natural and man-made disasters, including developing a comprehensive emergency plan and instituting employee training programs, according to a federal final rule released Sept. 8.

Medicare and Medicaid providers and suppliers also will have to develop and implement policies and procedures and establish a communications plan to coordinate patient care with state and local health departments.

The final rule (RIN:0938-AO91) was necessary because existing disaster management plans don't go far enough in ensuring the safety of patients and staff in case of disaster, especially in light of events such as 2012's Hurricane Sandy and 2014's Ebola outbreak, the Centers for Medicare & Medicaid Services said.

Greg Crist, a senior vice president with the American Health Care Association, told Bloomberg BNA the implementation date for the final rule is Nov. 15, 2017, and is an indication the CMS recognizes the challenges that some providers may have to develop the systems and processes that the rule requires.

Crist said the AHCA had just begun to review the final rule and couldn't respond to the potential burdens or impacts it might have on nursing homes. AHCA represents about 12,000 not-for-profit and for-profit nursing homes across the country.

Hospital Flexibility

The final rule will be published in the Sept. 16 Federal Register. It is intended to protect the health-care system by establishing consistent ground rules for handling any disaster situations.

In addition to the best-practice standards, the final rule gives hospitals some flexibility with the installation of new generators, and doesn't require the relocation of existing generators. Additionally, the final rule didn't include additional generator testing, as was originally proposed. The CMS said there was no evidence that extra testing would improve a facility's ability to handle a disaster.

“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 suppliers is to protect the health and safety of their patients,” CMS Deputy Administrator and Chief Medical Officer Patrick Conway said in a Sept. 8 statement.

The CMS proposed the rule in late 2013 and noted that some of the deaths that resulted from Hurricane Katrina could have been avoided if emergency preparedness measures had been in place for Medicare and Medicaid providers and suppliers (246 HCDR, 12/23/13).

Ashley Thompson, a senior vice president with the American Hospital Association, told Bloomberg BNA the association was pleased that the CMS “has taken a commonsense approach to ensuring patients continue to be cared for in times of disaster.”

Best Practices

All Medicare and Medicaid providers and suppliers will be required to carry out risk assessments that cover all natural and man-made disasters likely to occur in their regions. Risk assessments will cover situations such as equipment and power failures, loss of communications due to cyberattacks and the destruction of the facility itself.

Once the risk assessment has been done, providers and suppliers will then be responsible for crafting policies and procedures to implement an emergency response plan, as well as training employees on the plan. Training will be required on annual basis, in addition to periodic emergency drills.

All providers and suppliers will also be required to develop a communications plan to ensure patient care coordination at the facility level, with other health-care providers and with state and local health-care agencies. Patients often have to be moved in a disaster situation, and the final rule stressed the importance of ensuring continuity of care where ever the patient goes.

To contact the reporter on this story: James Swann in Washington at

To contact the editor responsible for this story: Kendra Casey Plank at

For More Information

The CMS final rule is at

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