Skilled Nursing Industry Shores Up Plans Before Emergency Prep Rule Hits

A storm has been brewing on the horizon for some time now. As a new emergency preparedness rule from the Centers for Medicare & Medicaid Services (CMS) approaches, skilled nursing providers are trying to make sure they’re protected from the flood of new regulations.

Under the rule, which was first introduced in 2013 and finalized last September, SNFs and a variety of other providers must meet four emergency preparedness standards by Nov. 15: Have an emergency plan with an all-hazards approach; develop policies and procedures based on the emergency plan; come up with a communication plan that complies with federal and state laws and loops in other area providers; and develop and maintain training programs and drills.

The rule is meant to preserve the health, safety and security needs of care providers, their employees and their patients during a sudden emergency like a hurricane, tornado or terrorist attack.


Providers prep for the storm

The Norcross, Ga.-based PruittHealth, the largest post-acute provider in the Southeast, has much of its emergency preparedness framework in place for when November rolls around.

“I feel good about being prepared to meet what CMS is requiring by November,” Natasha Brown, director of policy management at PruittHealth, tells Skilled Nursing News.


In recent months, the provider has trained its employees in a number of drills and exercises, Brown says. Possible disaster scenarios have included roof collapses, power outages that last over 24 hours, and Category 5 hurricanes.

The idea is to simulate something unexpected that would “stress the system” in the same way a real emergency would.

“Emergencies don’t always happen when you’re fully staffed during the daytime,” Brown says. “They very well may happen at midnight.”

One of the biggest challenges so far has been networking with other local providers, mostly due to time and personnel constraints.

“Having an administrator, a maintenance director or a nurse do that, it takes time away from the building where they’re needed,” Brown says.

Despite the occasional heartburn, PruittHealth is very supportive of the new rules, she adds.

Amedisys (Nasdaq: AMED), a home health care agency, is also well-prepared for the storm. With 434 care centers scattered throughout the U.S., the Baton Rouge, La.-based company has seen its fair share of disasters over the years.

Most notably, Amedisys tragically lost its founder and former CEO when he drowned during a devastating flood in Louisiana roughly one year ago.

Though the company already has an emergency preparedness plan that includes nearly all of the elements required by CMS, it hasn’t always looped in other health care providers.

“What’s new for us is the additional community mock drill,” Iris Rancatore, director of survey and accreditation at Amedisys, tells SNN.  “This will be an opportunity for our care centers to participate and collaborate with other Medicare providers such as hospitals, nursing homes, other home care companies, and hospices — with an emphasis placed on carrying out procedures necessary to protect patients and others in the community in which we serve.”

Some still struggling

Though many skilled nursing providers are prepared for the rule’s implementation, others may not be in the same boat, says Barbara B. Citarella, founder of RBC Limited, a health care-focused consulting firm based in Staatsburg, N.Y.

Citarella has presented webinars about the rule and has spoken with thousands of health care providers across the U.S.

“There are many agencies that may just have a policy about disaster preparedness that need a plan, need policies and procedures, that need education,” she says. “There are many that are realizing…that they don’t have until January.”

Still, it varies on a state-by-state basis. Health care companies in New York, North Carolina, New Mexico, and Maryland are generally more prepared because of those states’ regulations, for example.

The emergency prep rule could be more burdensome for skilled nursing and other long-term care providers due to the sheer amount of work related to the regulation. On the flip side, hospitals might be able to cope with the rule more easily due to better resources and organization.

“I think we have to see after the first go-around [when the rule takes effect]…what agencies are struggling with most,” Citarella says. “We will get guidance from CMS. I think they’ve been very good giving information.”

Written by Tim Regan

(Featured photo via Wikimedia Commons)

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