Big Changes for Medicare Home Care Provider’s Emergency Preparedness Under CMS Final Rule

The Centers for Medicare & Medicaid Services (CMS) finalized a rule to establish consistent emergency preparedness requirements for health care providers participating in Medicare and Medicaid, increase patient safety during emergencies, and establish a more coordinated response to natural and man-made disasters.

These new requirements will require certain participating providers and suppliers to plan for disasters and coordinate with federal, state tribal, regional, and local emergency preparedness systems to ensure that facilities are adequately prepared to meet the needs of their patients during disasters and emergency situations.

The final rule also includes a number of local and national resources related to emergency preparedness, including helpful reports, toolkits, and samples. Additionally, health care providers and suppliers can choose to participate in their local healthcare coalitions, which provide an opportunity to share resources and expertise in developing an emergency plan and also can provide support during an emergency.


In order to assist agencies to understand the final regulations, we are conducting a live webcast on January 10th at 1PM Eastern. This session (Item #608) will be recorded and will be available for repeat viewing for one-full year to anyone that orders the webcast, even those unable to attend the live program. There will be an opportunity to ask questions about:

  • Risk Assessments
  • COOP planning
  • Healthcare Coalition Partnerships
  • Drills
  • exercises, and much more.

To register for the webcast Item #608: NH Only: Final Disaster Preparedness Regulations, click on the green box above. After clicking on the “Add” button, then go to “Click Here When Done.” On the next screen enter your NH state code in the “State Code” box (not the Discount box) . Hit update cart and then check out by paying with a credit card or the pay by mail option. The fee for this presentation is $99.00, and allows for a full year’s access.

Make a Plan: A Comprehensive guide is also available to all of our members. Order Today.

The Foundation for Home Health has partnered with Barbara Citarella of RBC Limited to develop a comprehensive Emergency Preparedness Manual for Home Health Agencies and Hospices to comply with the CMS Emergency Preparedness Regulations.

Table of Contents:

  1.  Home Care & Hospice’s Role in Emergency Disaster
  2.  Emergency Disaster Planning
  3.  Sample Emergency Preparedness Plan
  4.  Patient Tools
  5.  Infection Control & Prevention
  6.  Biological, Chemical Agents/Radiological Emergencies
  7.  Pandemic Influenza
  8.  NIMS/ICS
  9.  Addendum A:  Hazard Vulnerability Analysis
  10.  Addendum B:  COOP Plan Template
  11.  Addendum C:  Acronyms

The Manual is compiled into a binder that includes a number of model documents.  This purchase also includes a CD with customization forms and templates.


“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,” said CMS Deputy Administrator and Chief Medical Officer Patrick Conway, M.D., MSc. “Preparation, planning, and one comprehensive approach for emergency preparedness is key. One life lost is one too many.”
“As people with medical needs are cared for in increasingly diverse settings, disaster preparedness is not only a responsibility of hospitals, but of many other providers and suppliers of healthcare services. Whether it’s trauma care or long-term nursing care or a home health service, patients’ needs for health care don’t stop when disasters strike; in fact their needs often increase in the immediate aftermath of a disaster,” said Dr. Nicole Lurie, HHS assistant secretary for preparedness and response. “All parts of the healthcare system must be able to keep providing care through a disaster, both to save lives and to ensure that people can continue to function in their usual setting. Disasters tend to stress the entire health care system, and that’s not good for anyone.”
After reviewing the current Medicare emergency preparedness regulations for both providers and suppliers, CMS found that regulatory requirements were not comprehensive enough to address the complexities of emergency preparedness. For example, the requirements did not address the need for: (1) communication to coordinate with other systems of care within cities or states; (2) contingency planning; and (3) training of personnel. CMS proposed policies to address these gaps in the proposed rule, which was open to stakeholder comments.
After careful consideration of stakeholder comments on the proposed rule, this final rule requires Medicare and Medicaid participating providers and suppliers to meet the following four common and well known industry best practice standards.
1. Emergency plan: Based on a risk assessment, develop an emergency plan using an all-hazards approach focusing on capacities and capabilities that are critical to preparedness for a full spectrum of emergencies or disasters specific to the location of a provider or supplier.
2. Policies and procedures: Develop and implement policies and procedures based on the plan and risk assessment. The National Association of Home Care has also put together a free guide for agencies to use as a template for their own policy development.
3. Communication plan: Develop and maintain a communication plan that complies with both Federal and State law. Patient care must be well-coordinated within the facility, across health care providers, and with State and local public health departments and emergency systems.
4. Training and testing program: Develop and maintain training and testing programs, including initial and annual trainings, and conduct drills and exercises or participate in an actual incident that tests the plan.
These standards are adjusted to reflect the characteristics of each type of provider and supplier. For example:

  • Outpatient providers and suppliers such as Ambulatory Surgical Centers and End-Stage Renal Disease Facilities will not be required to have policies and procedures for provision of subsistence needs.
  • Hospitals, Critical Access Hospitals, and Long Term Care facilities will be required to install and maintain emergency and standby power systems based on their emergency plan.

In response to comments, CMS made changes in several areas of the final rule, including removing the requirement for additional hours of generator testing, flexibility to choose the type of exercise a facility conducts for its second annual testing requirement, and allowing a separately certified facility within a healthcare system to take part in the system’s unified emergency preparedness program.

These regulations are effective 60 days after publication in the Federal Register. Health care providers and suppliers affected by this rule must comply and implement all regulations one year after the effective date.

For more information please see a blog by Dr. Lurie, HHS assistant secretary for preparedness and response, and the CMS Survey & Certification – Emergency Preparedness webpage.

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