CMS Updates Appendix Z Guidance

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.