Birth of a New CoP for Medicare Hospice, Part 1

After three years of waiting, the final rule for Medicare and Medicaid Programs; Emergency Preparedness Requirements for Medicare and Medicaid Participating Providers and Suppliers (CMS-3178-F) was finally posted in the Federal Register on September 16, 2016.

The Centers for Medicare and Medicaid Services undertook the architecture of specific emergency preparedness regulations to establish national emergency preparedness requirements for Medicare and Medicaid participating providers and suppliers to ensure that they adequately plan for both natural and man-made disasters, and coordinate with federal, state, tribal, regional, and local emergency preparedness systems.  CMS also wanted to ensure that providers were adequately prepared to meet the needs of patients and families during disasters and emergency situations.  Disasters can disrupt the environment of health care and change the demand for health care services. Regulatory requirements make it necessary that health care providers and suppliers integrate emergency management into their daily operation and culture.

Prior to the posting of the final rule, the federal hospice Conditions of Participation (CoPs) at § 418.110 (c) only included hospice inpatient facilities to have a written disaster preparedness plan that is periodically rehearsed with hospice employees, with procedures to be followed in the event of an internal or external disaster, and procedures for the care of casualties (patients and staff) arising from such disasters.  This final rule has emergency preparedness requirements for both homecare and inpatient hospice providers. Hopefully, most hospice providers have some type of emergency or disaster plan in place right now that contains most of the components in this new CoP which will make the implementation less onerous. Whether your hospice is enhancing your current plan or starting from scratch, including your assessment of your current compliance and development of a plan to become compliant is a must for either a hospice compliance program or quality assessment performance improvement (QAPI) program.

The CoP for hospice providers contains four main standards that specify requirements for the hospice to develop an emergency plan, specific policies and procedures for emergency preparedness, a communication plan, and a program for preparedness training and testing that is based on the emergency plan. The good news for hospice providers is that the implementation date for this new CoP is November 16, 2017.

Next up for discussion (in Part 2) are the hospice emergency preparedness plan and policies/ procedures.

Jennifer Kennedy, MA, BSN, RN, CHC
NHPCO Senior Director, Regulatory & Quality