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CMS Emergency preparedness final rule comes with penalties

With less than six months before implementation on the CMS Emergency Preparedness Final Rule, we’re hearing from many emergency planners that they are still grappling with what they need to do to meet the new criteria.  Despite growing urgency, many planners are waiting for the interpretive guidelines expected sometime “before summer.” Some even plan to wait until after November to see what CMS will do for penalties.  We don’t recommend that and here’s why.

Joint commission vs. CMS Emergency preparedness requirements

The first thing to understand is if The Joint Commission (TJC) certifies your organization, you will need to meet revised survey requirements.  The Joint Commission is updating their requirements to “meet or exceed” the CMS guidelines.  Other surveying bodies such as state agencies will have similar updates to their survey requirements. 

So, what is different? A lot has changed around communication plans including:

  • You must have a way to contact all staff, contractors, volunteers and other entities providing services during an emergency
  • Those individuals you contact must have a way to respond back to help coordinate coverage during an event – you must have primary and alternate means for communication with staff
  • You must evaluate options for before, during, and after an event as the situation changes and different communication channels are available

For more specifics, read our blog post on CMS Emergency Preparedness Communication Plans, 5 Things You Need To Know. 

Penalties for non-compliance

The other big change are the penalties for non-compliance.  In the past, a provider might lose accreditation by TJC for not meeting some of the emergency preparedness criteria.  With the revised rule, these regulations are part of CMS’ Conditions of Participation (CoP)/Conditions for Participation (CfC).  Failure to meet the Emergency Preparedness criteria is a condition-level deficiency and could result in a termination from the CMS program (following a 60-day remediation program).  This means the loss of funding for Medicare and Medicaid beneficiaries.  In addition, some providers could also face financial penalties:

  • NF/SNF Penalty – $1,000 – $10,000/instance or $50-$3,000/day if the failure resulted in patient harm
  • HHA Penalty – suspend payment for new admissions, 1-$10K per instance or $500-$8500 per day

According to J. Robert McKee, D.Sc.(c), MBA from Boston University’s Healthcare Emergency Management Master’s program, “no exceptions will be granted for the requirements of CMS, non-compliance will follow the same process of non-compliance as with any other Conditions of Participation and Conditions for Coverage.”

In addition, there are secondary financial issues which may crop up.  For instance, if you are cited and placed in remediation that could affect the facility’s liability insurance.  We urge you to consider the financial ramifications of delaying implementation until after the November deadline, you might find it’s not worth the risk. 

While this may seem punitive, it comes from lessons learned from recent tragedies — from Hurricane Katrina to the whooping cough outbreak in California to the Orlando Nightclub Shooting.  We’ve learned from gaps in preparedness and CMS is trying to ensure that people stay safe and hospitals stay open. If you’d like to learn more, we’d be happy to talk to you about how Everbridge can help you meet the communication requirements of the CMS Emergency Preparedness Rule.  You can request a demo here. 

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