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 Providers ‘Applaud’ Flexibility Of Proposed Emergency Rules, But Hope For Slow Phase-In

Providers “appreciate and applaud” the flexibility of proposed federal rules on emergency preparedness, but hope that regulators will make a careful estimate of costs and burdens and phase in the new rules gradually, the American Health Care Association/National Center for Assisted Living (AHCA/NCAL) says in newly public comments.

Authorities at the Centers for Medicare & Medicaid Services (CMS) have proposed a series of new regulations requiring health care companies—including long term and post-acute care providers—to come up with worst-case-scenario plans for their patients, residents, and workers.

In comments on the rulemaking, AHCA/NCAL Director of Quality, Peggy Connorton, says her member companies are impressed that federal regulators have offered proposed rules that are “detailed yet in most instances allow for flexibility.”

“We appreciate and applaud that flexibility—it is essential to appropriate implementation, which will vary based on the patients/residents and location of the provider,” Connorton says.

For all that, providers are relatively new to some of the emergency systems already in place, and could probably use a carefully lit glide path before being required to take off, Connorton says.

“We strongly recommend that implementation begin with the hospitals, enabling CMS to test implementation processes and determine which approaches work best,” she says, adding that long term and post-acute care providers ought to be given a four-year phase-in of any new rules.

“Some states require providers to have a more advanced and comprehensive approach to emergency preparedness, although this is certainly not the case in all states,” Connorton says. “As such, it is important to allow adequate time for long term care providers to fully understand and then implement the provisions included in this is proposed rule.”

That’s especially true where rules might require cooperative efforts among providers and disaster relief officials, Connorton says.

It’s generally understood that disasters take an inordinate toll on the frail, elderly. But most providers know—if even most public health officials don’t always know—that sometimes the best option for seniors and the frail is to shelter in place.

Nearly three-quarters of those who died after Hurricane Katrina were 60 years or older; nearly half of the New Yorkers who died after Superstorm Sandy were at least 65 or older.

After Sandy, the Obama administration proposed the new rules and expanded them to cover 17 different kinds of providers or suppliers. Under the proposal, providers or suppliers would have to meet preparedness guidelines in order to receive Medicare or Medicaid dollars. The administration says it wants to “ensure that these providers and suppliers are adequately prepared to meet the needs of patients, residents, clients, and participants during disaster and emergency situations.”

Bill Myers is Provider’s senior editor. E-mail him at wmyers@providermagazine.com. Follow him on Twitter, @ProviderMyers.

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