CMS released revised memo QSO-20-41-ALL to update guidance around use of the actual emergency exemption. In September 2019, the Medicare and Medicaid Programs; Regulatory Provisions To Promote Program Efficiency, Transparency, and Burden Reduction; Fire Safety Requirements for Certain Dialysis Facilities; Hospital and Critical Access Hospital (CAH) Changes To Promote Innovation, Flexibility, and Improvement in Patient Care Final Rule (84 FR 51732) revised emergency preparedness requirements for certified providers.

One revision was to allow for an actual emergency exemption from exercise requirements. Specifically, any provider that activated the emergency plan in response to an actual emergency, including both man-made and natural emergencies, would be exempt from completing the next required full-scale community-based or individual facility-based functional exercise. The rule stipulated that providers would still be required to complete the required exercise of choice, regardless of utilization of the actual emergency exemption.

In September 2020, CMS released memo QSO-20-41-ALL to confirm that the COVID-19 public health emergency would qualify as an actual emergency and providers who activated the emergency plan in response to the COVID-19 public health emergency could utilize the actual emergency exemption. CMS recently revised this memo on June 21, 2021 to clarify that providers that continue to operate under the emergency plan and have not returned to normal operations may utilize the actual emergency exemption, even if the exemption was used during the last exercise cycle.

More information on this update, including examples of how and when the actual emergency exemption can be utilized, are available in CMS memo QSO-20-41-ALL-REVISED.