CMS Releases Memo Reiterating Emergency Prep Guidance

Regulation | September 30, 2020 | by Jodi Eyigor

CMS has released a memo to reiterate and clarify guidance related to the emergency preparedness rule finalized in September 2019.

In September 2019, CMS finalized a rule revising emergency preparedness requirements for all providers. Guidance on that rule was released in December 2019 and you can find the LeadingAge analysis of this rule and guidance here. On September 28, 2020, CMS released this memo reiterating the guidance on this rule; specifically, the exemption clause related to actual disasters.

In the final rule, CMS revised requirements around testing of the emergency plan to allow providers an exemption from the next required full-scale, community-based or individual, facility-based functional exercise if the provider had to activate their emergency plan in response to an actual natural or man-made disaster. CMS has clarified in this memo that the COVID-19 public health emergency declared in March 2020 qualifies as an actual disaster. Providers will be exempt from their next functional exercise if they can demonstrate through written documentation that the emergency plan was activated in response to COVID-19.

Recall that inpatient providers including nursing homes, inpatient hospice, and intermediate care facilities for individuals with intellectual disabilities (ICF/IIDs) are required to conduct 2 training exercises per year: one full-scale or functional exercise and one exercise of choice. Regardless of whether the inpatient provider qualifies for the exemption clause for the full-scale or functional exercise, the provider must complete the required exercise of choice. This may include a mock disaster drill, table-top exercise, or workshop.

Outpatient providers, including Programs for the All-Inclusive Care for the Elderly (PACE) and home health agencies, are required to conduct only 1 annual test of the emergency plan, alternating each year between full-scale or functional exercises and exercises of choice. An outpatient provider that qualifies for the exemption clause would be exempt from the next required full-scale or functional exercise, but must continue to conduct the exercise of choice according to schedule.

More information on this exemption clause, including example scenarios, is included in the memo and accompanying Surveyor Worksheet. The Surveyor Worksheet also details the steps a surveyor must take to determine use of the exemption clause. Of note, a provider must be able to describe the exemption in addition to providing written documentation of activation of the emergency response plan.