CMS Emergency Preparedness Myths & Realities

As nursing home horrors continue to unfold in Texas and Florida, and people ask, “How can this happen (again)?” the answers, even among well-informed emergency management professionals, reflect the confusion that exists in the field. We’ll try to sort fact from fantasy here.
 
Question. Is the infamous “floating grandmas” photo real?
Answer. We haven’t been able to validate the photo, but the story of the helicopter evacuation of up to 20 residents from the not-well-named “La Belle Vita” nursing home has been confirmed by the Galveston County Office of Emergency Management.
 
Q. Will CMS really start enforcing its Emergency Preparedness rules on November 16?
A. So they said recently. While they have relaxed many administrative rules for areas in declared disasters after Harvey and Irma, they certainly have not relaxed any patient safety standards. There is NO announcement of a delay in the due date.
 
Myth. (the other extreme) Medicare shut down the Hollywood Hills, Florida nursing home where 8 patients died.
Reality. Medicare doesn’t “shut down” facilities – they just sever their contract with the facility, meaning no more reimbursement. Yes, that will likely bankrupt the facility, but a more likely scenario has the state and local authorities acting more quickly, some of whom do have “shut-down” authority. In Florida, the state agency that licenses long-term care facilities did just that. The Florida Agency for Health Care Administration investigated promptly and issued a “moratorium” on the facility accepting residents after the entire facility was evacuated. Remember, states administer Medicare and Medicaid and enforce Medicare/Medicaid rules.
 
M. Medicare rules will require the evacuation of long-term care facilities in the face of a major hurricane.
R. Nope. The new Medicare Emergency Preparedness conditions merely require that an evacuation plan is in place, including transportation, mutual aid agreements with other facilities, and systems to ensure that patient data and medical needs like prescriptions are available in a disaster, whether patients or residents shelter in place or evacuate. The decision to evacuate is always local, made between the facility administration and local authorities.
 
Q. Where can we buy a preparedness plan that will make us compliant with the new Medicare rules?
A. You can’t. While CMS offers guidance on the plan’s structure and contents, the facility itself must:
  1. Assess the community and facility risks from its perspective;
  2. Develop an Emergency Operations Plan, and policies and procedures based on those risks;
  3. Develop an Emergency Communications Plan;
  4. Train staff and volunteers on the procedures and policies;
  5. Conduct or participate in exercises that accurately test those plans, policies, and procedures.
Got more questions? Ask the experts. If we can’t find an answer for you, we’ll connect you with the people who can.
Categories: CMS Compliance | Healthcare
Topics: CMS, Compliance, LTC

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