Nurs­ing homes and hospice providers face loom­ing emer­gency pre­pared­ness dead­line

Modern Healthcare - - NEWS - By Steven Ross John­son

Af­ter Hur­ri­cane Ka­t­rina in 2005, Amedisys de­cided it needed to up­grade its dis­as­ter plan. The na­tional home health­care and hospice provider be­gan con­duct­ing risk anal­y­sis and fac­tor­ing in po­ten­tial lo­cal haz­ards to de­velop a plan to en­sure staff and res­i­dents at its U.S. fa­cil­i­ties could weather nat­u­ral dis­as­ters. From this came sev­eral changes: greater co­or­di­na­tion with first re­spon­ders, reg­u­lar drills and closer col­lab­o­ra­tion with other Medi­care providers.

The plan, which sent dis­as­ter re­sponse teams to check in on pa­tients at home and bring them food, wa­ter and clean­ing sup­plies, was im­ple­mented dur­ing last year’s floods in Louisiana. It helped keep Amedisys staff and res­i­dents safe.

But now Amedisys and other providers like it are be­ing asked to step up their ef­forts. Many of the na­tion’s health­care providers are fac­ing a dead­line to im­ple­ment new fed­eral re­quire­ments that stan­dard­ize how they han­dle nat­u­ral dis­as­ters and ter­ror­ists’ threats.

In Septem­ber, the CMS fi­nal­ized a rule re­quir­ing 17 types of health­care providers to set new poli­cies that re­sult in bet­ter co­or­di­na­tion with emer­gency per­son­nel and fre­quent tests and adap­ta­tions of emer­gency plans.

While most ex­perts sup­port the reg­u­la­tions, oth­ers worry that many fa­cil­i­ties, es­pe­cially small and ru­ral ones, will fall short of meet­ing the re­quire­ments. That could mean providers would be dropped by Medi­care and Med­i­caid.

“I do not see how all fa­cil­ity types can and will be in com­pli­ance by Nov. 15,” said Denise Braun, se­nior man­ager for health­care so­lu­tions at Evans Inc., which is ad­vis­ing health­care or­ga­ni­za­tions on their emer­gency pre­pared­ness plans.

For some fa­cil­i­ties, it means widescale changes. Be­cause the CMS didn’t of­fer much clear di­rec­tion in the re­quire­ments, many stake­hold­ers may be non­com­pli­ant, said Jocelyn Mont­gomery, di­rec­tor of clin­i­cal af­fairs at the Cal­i­for­nia As­so­ci­a­tion of Health Fa­cil­i­ties. The CMS in Oc­to­ber said it would pub­lish its guid­ance on the rule by this spring. But that hasn’t ar­rived yet.

“The beauty of writ­ing the reg­u­la­tions so that they can be in­ter­preted a num­ber of ways is that they let providers be able to work that out for their unique sit­u­a­tion,” Mont­gomery said.

Ex­perts be­lieve providers who al­ready meet the Stan­dards of Care for Dis­as­ter Pre­pared­ness and Re­sponse set by the Joint Com­mis­sion should be well-po­si­tioned to meet the new CMS reg­u­la­tions. “I think hos­pi­tals them­selves feel like they’re in bet­ter shape in terms of com­ing into com­pli­ance be­cause of that leg up,” said Nancy Foster, vice pres­i­dent of qual­ity and pa­tient safety for the Amer­i­can Hos­pi­tal As­so­ci­a­tion. Long-term care and hospice fa­cil­i­ties, as well as am­bu­la­tory sur­gi­cal sites, home health agen­cies and dial­y­sis cen­ters, would face “a much heav­ier lift,” she said.

“They are the ones that are ab­so­lutely in a up­hill bat­tle to be in com­pli­ance,” said Scott Aron­son, a prin­ci­pal with Rus­sell Phillips

and As­so­ci­ates, a lead­ing health­care emer­gency man­age­ment con­sul­tancy.

The CMS es­ti­mates the to­tal cost for providers to ad­here to the rule would be more than $370 mil­lion an­nu­ally.

The prepa­ra­tion re­quires in­put from lo­cal public health de­part­ments, acute­care hos­pi­tals, and po­lice and fire de­part­ments. By Nov. 15, nurs­ing homes must con­duct a multi-ju­ris­dic­tional dis­as­ter ex­er­cise that in­cludes drills with mul­ti­ple emer­gency re­sponse agen­cies.

“For some hospice providers that’s go­ing to be a chal­lenge in form­ing those re­la­tion­ships,” said Jen­nifer Kennedy, se­nior reg­u­la­tory and qual­ity di­rec­tor for the Na­tional Hospice and Pal­lia­tive Care Or­ga­ni­za­tion.

Fa­cil­i­ties lo­cated in states with fre­quent earth­quakes or vi­o­lent storms are al­ready man­dated to have emer­gency plans in place that call for co­or­di­na­tion with first re­spon­ders. Most other long-term care providers have fo­cused on be­ing self-suf­fi­cient.

Mont­gomery also won­ders whether emer­gency re­sponse agen­cies could even help or co­or­di­nate with long-term care fa­cil­i­ties given their num­ber. The U.S. has more than four times as many nurs­ing homes as hos­pi­tals.

Calls to sev­eral emer­gency re­sponse agen­cies were not re­turned.

Mont­gomery adds that some fa­cil­i­ties are wait­ing for the CMS’ guid­ance to start craft­ing plans. Other providers hope the agency will ex­tend its dead­line.

But the CMS said one year of prepa­ra­tion was more than enough. “Some thought Medi­care was not go­ing to take this too se­ri­ously,” Braun said. “I think that’s a dan­ger­ous at­ti­tude to take.”

Newspapers in English

Newspapers from USA

© PressReader. All rights reserved.