Don’t forget State Regulations in your CMS Compliance Plan

by Rick Christ
The very first words of the new CMS (Medicare) Emergency Preparedness requirements address state requirements, they are:
“The facility must comply with all applicable Federal, State, and local emergency preparedness requirements.”
Don’t overlook this very important element of planning, especially since state employees may be conducting your survey.
 
State regulations and even the definition of health care facilities vary greatly, and often reflect local conditions and local history. For example, New Jersey instituted significant new fire safety regulations for long-term care facilities in the 1980s, after a series of fatal fires in nursing homes brought the lack of standards to public attention. State regulations may not just come from the agency that provides licensing for your facility. It is likely that your state’s occupational health and safety agency has authority over issues that relate to your staff, while the health department may have primary regulatory power over what medical care is rendered to your residents or patients.
 
In Virginia, for example, the Department of Social Services licenses “Assisted Living Facilities” which fall under the CMS category of “Long-term Care” providers. They dedicate six pages of a 134-page document to “Emergency Preparedness.” It requires plans, policies, and procedures similar to those required by CMS, but adds some specifically required elements, such as “locating and shutting off utilities when necessary.” This detail could easily be overlooked during your CMS emergency planning, but if you fail to meet this requirement of the state plan, you are in violation of the CMS conditions of participation.
 
Those conditions of participation also require compliance with “local emergency preparedness requirements” so when you contact your local emergency manager (a CMS requirement) you should inquire about local regulations. Traditionally this would include health inspections and fire code enforcement, but of course, your municipality may go farther.
 
Here is an opportunity for us to promote the value of regional healthcare coalitions. Your coalition should be able to connect you with the emergency preparedness officials that have jurisdiction over your facility, and should also be aware of the regulations. (If you do not know how to contact your regional healthcare coalition, ask us.)
 
CMS has issued draft interpretive guidance, along with some elements that surveyors will begin looking for on November 16.
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Topics: CMS, Compliance, Medicaid, Medicare, Planning

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