Capitol Correspondence - 04.12.21

CMS Updates Appendix Z Guidance

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The Centers for Medicare and Medicaid Services issued a QSO memo related to Appendix Z, Emergency Preparedness Regulation guidance. The updated guidance applies to the Medicaid Intermediate Care Facilities (ICF) program and did the following:

  • Expanded surveyor guidance to ensure Life Safety Code and health surveyors communicate/collaborate surrounding potential deficiencies for alternate source energy.
  • Added new definitions for testing exercises.
  • Clarified expectations surrounding documentation of the emergency program.
  • Added additional guidance/considerations for Emerging Infectious Diseases (EIDs) planning stages, including personal protective equipment (PPE).
  • Added additional guidance on risk assessment considerations, including EIDs.
  • Included planning considerations for surge and staffing.
  • Expanded guidance for surge planning- to include recommendations for natural disaster surge planning and EID surge planning.
  • Included recommendations during PHE’s for facilities to confer with the CDC and other public health agencies, which may issue event-specific guidance and recommendations to healthcare workers.
  • Clarified existing guidance surrounding the use of portable generators and maintaining temperature controls.
  • Expanded guidance and added clarifications related to alternate care sites and 1135 Waivers.
  • Expanded guidance and best practices related to reporting of facility needs, the facility’s ability to provide assistance, and occupancy reporting.
  • Revised guidance related to training and testing programs and how and when to implement the different drills and exercises.
  • Provided clarifications related to testing exercise exemptions when a provider/supplier experiences an actual emergency event.