This federal emergency preparedness regulation requires covered facilities to include in their emergency plans a documented process for cooperation and collaboration with local, tribal, regional, state, and federal emergency preparedness officials to maintain an integrated disaster response. Facilities must engage with local healthcare systems, health departments, and emergency management agencies, and are encouraged to participate in healthcare coalitions. ESRD (dialysis) facilities have an additional requirement to contact their local emergency preparedness agency at least annually to confirm awareness of the facility's needs. This regulation applies across a wide range of Medicare/Medicaid-certified facility types and is not specific to behavioral health, IDD, ABA, or foster care settings.
View official sourceE-0009 (Rev. 204, Issued: 04-16-21; Effective: 04-16-21, Implementation: 04-16-21) §403.748(a)(4), §416.54(a)(4), §418.113(a)(4), §441.184(a)(4), §460.84(a)(4), §482.15(a)(4), §483.73(a)(4), §483.475(a)(4), §484.102(a)(4), §485.68(a)(4), §485.625(a)(4), §485.727(a)(5), §485.920(a)(4), §486.360(a)(4), §491.12(a)(4), §494.62(a)(4) [(a) Emergency Plan. The [facility] must develop and maintain an emergency preparedness plan that must be reviewed, and updated at least every 2 years [annually for LTC facilities]. The plan must do the following:] (4) Include a process for cooperation and collaboration with local, tribal, regional, State, and Federal emergency preparedness officials' efforts to maintain an integrated response during a disaster or emergency situation. * * [For ESRD facilities only at §494.62(a)(4)]: (4) Include a process for cooperation and collaboration with local, tribal, regional, State, and Federal emergency preparedness officials' efforts to maintain an integrated response during a disaster or emergency situation. The dialysis facility must contact the local emergency preparedness agency at least annually to confirm that the agency is aware of the dialysis facility’s needs in the event of an emergency. Interpretive Guidelines applies to: §403.748(a)(4), §416.54(a)(4), §418.113(a)(4), §441.184(a)(4), §460.84(a)(4), §482.15(a)(4), §483.73(a)(4), §483.475(a)(4), §484.102(a)(4), §485.68(a)(4), §485.625(a)(4), §485.727(a)(5), §485.920(a)(4), §486.360(a)(4), §491.12(a)(4), §494.62(a)(4). NOTE: This does not apply to Transplant Programs. Cooperation and Collaboration While the responsibility for ensuring a coordinated disaster preparedness response lies upon the state and local emergency planning authorities, the facility must have a process to engage in collaborative planning for an integrated emergency response. The facility must include this integrated response process in its emergency plan. Facilities are encouraged to participate in a healthcare coalition as it may provide assistance in planning and addressing broader community needs that may also be supported by local health department and emergency management resources. While every detail of the cooperation and collaboration process is not required to be documented in writing, it is expected that the facility has documented sufficient details to support verification of the process. When deciding on ways to meet public health emergency needs in their community, facilities are expected to engage and coordinate with their local healthcare systems (including any emergency-related Alternate Care Sites), and their local and state health departments, and federal agency staff and also encouraged to engage with their healthcare coalitions, as applicable. Facility awareness of the state’s emergency preparedness programs and pandemic plan ensures coordination occurs with the community. Coordination and communications between facilities and their public health emergency officials is instrumental in ensuring a collaborative environment during a disaster. Coordination should be pre-planned and facility management should know the state and local emergency contacts (further defined within a facilities communication plan). We also note that under state licensure or their accreditation requirements, facilities may still be required to document their collaboration with local, tribal, regional, State, and Federal emergency preparedness officials. We recommend facilities contact their State Survey Agency (SA) and/or accrediting organizations (AO) to determine if any additional requirements exist. Additional Requirement for ESRD For ESRD facilities, §494.120(c)(2) of the ESRD Conditions for Coverage on Special Purpose Dialysis Facilities describes the requirements for ESRD facilities that are set up in an emergency (i.e., an emergency circumstance facility) which are issued a unique CMS Certification Number (CCN). ESRD facilities must incorporate these specific provisions into the coordination requirements under this standard. NOTE: This standard to the emergency preparedness plan must be reviewed and updated annually for LTC facilities only. Survey Procedures • Interview facility leadership and ask them to describe their process for ensuring cooperation and collaboration with local, tribal, regional, State, and Federal emergency preparedness officials' efforts to ensure an integrated response during a disaster or emergency situation. • For ESRD facilities, ask facility leadership to describe their process for contacting the local public health and emergency management agency public official at least to confirm that the agency is aware of the ESRD facility’s needs in the event of an emergency and know how to contact the agencies in the event of an emergency.