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Effective November 15, 2017, 17 specific supplier and provider types are impacted by the new Centers for Medicare and Medicaid Services (CMS) Emergency Preparedness Rule. The new rule establishes national emergency preparedness requirements to ensure that natural and manmade disasters can be adequately planned for and coordinated with a variety of emergency preparedness systems, including federal, state, tribal, regional, and local systems.

Are you among the provider and supplier types affected by the rule? Read on to learn more about the different agencies that will be held responsible for adopting these standards in the near future.

Inpatient Providers

Hospitals— According to CMS, a hospital is an institution that primarily engages in offering inpatient therapeutic and diagnostic services as well as rehabilitation services, all under the supervision of licensed physicians.

Hospices— A hospice is, per CMS guidelines, a facility that’s primarily focused on caring for individuals that have been certified terminally ill per the CMS guidelines. In addition to the physical needs of a terminally ill patient, a hospice meets the emotional, psychosocial, and spiritual needs of the patient and their family per a previously created plan of care.

Critical Access Hospitals (CAHs)— CMS rules dictate that CAHs must be located in a state with an established State Medicare Rural Hospital Flexibility Program and be designated by the state as a CAH. Additionally, a CAH must be located in a rural part of the state that’s more than 35 miles from the closest hospital or be located further than 15 miles in an area with potentially treacherous driving conditions, such as a mountainous terrain. There can’t be more than 25 beds, and the average length of stay must be 96 hours or less for acute inpatient care, and the facility must be available for emergency care 24/7.

Long Term Care (LTC)— This umbrella term includes nursing and skilled nursing facilities. A skilled nursing facility that operate within LTC facilities engages in offering skilled care for residents who require it as well as rehab services for disabled, injured, or ill patients. A nursing facility offers health-related care and services to patients who require additional assistance beyond room and board.

Immediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID)— This particular facility operates as an optional Medicaid benefit which funds institutions with 4 or more beds for people with intellectual disabilities, offering active treatment while they reside within.

Psychiatric Residential Treatment Facilities (PRTFs)— Per CMS, a PRTF is a non-hospital facility that has a provider agreement with a state Medicaid Agency to offer Medicaid-eligible people under 21 inpatient services.

Transplant Centers— A transplant center is required to operate within a hospital that has a current Medicare provider agreement. It can offer transplants of particular types of organs, including:

  • Lung
  • Heart
  • Lung/Heart
  • Liver
  • Intestine
  • Kidney
  • Pancreas

Religious Nonmedical Health Care Institutions (RNHCIs) (Inpatient)– A RNHCI is a tax-exempted religious organization that offers nursing and services that are not medical to any beneficiary that opts for a religious healing method. No medical services are provided, on the basis of the religious belief that it’s unnecessary.

Outpatient Providers

Ambulatory Surgical Centers (ASCs)— This encompasses any entity that offers surgical services to patients who don’t require hospitalization post-surgery; the anticipated length of the services rendered wouldn’t be more than 24 hours after admittance.

Clinics, Rehabilitation Agencies, and Public Health Agencies as Providers of Outpatient Physical Therapy and Speech-Language Pathology Services (Outpatient)— These organizations are defined as:

  • Rehabilitation Agency— Any organization that offers a multidisciplinary program to improve the physical function of disabled, handicapped individuals by coordinating specialized rehabilitation personnel.
  • Clinic—  Any place that’s created to facilitate outpatient physicians’ services, particularly if the services are offered by groups of three or more physicians practicing as a group and there’s a licensed physician available in the facility during all hours of operation to offer medical services to patients.
  • Public Health Agency— An organization created by the state or local government for the specific purpose of maintaining the general populace’s health and well-being through environmental health services, preventative medical care, and therapeutic care.

Comprehensive Outpatient Rehabilitation Facilities (CORFs)—  A CORF offers coordinated outpatient care including diagnostic, restorative, and therapeutic services at one location to facilitate the rehabilitation of sick, injured, or disabled people. This includes occupational therapy, speech-language pathology, and physical therapy services that can be offered at an off-site locale.


Community Mental Health Centers (CMHC)— Any outpatient facility that offers partial hospitalization services to a Medicare beneficiary for mental health services can be classified as a CMHC.


End-Stage Renal Disease (ESRD) Facilities— ESRD facilities are a freestanding dialysis center that offers maintenance dialysis to ESRD patients on an outpatient basis, up to and including home-based dialysis services. It can be hospital based or independent.


Home Health Agencies (HHAs)— An organization that offers skilled nursing and other therapeutic services to their patients is considered a HHA per CMS. The policies of an HHA are established by an agency-associated group of professionals that includes at least one physician and at least one registered professional nurse to govern the services provided.


Hospice (Outpatient)— Services offered to terminally ill patients in their home, including physical, spiritual, emotional, and psychosocial services, are under the auspices of outpatient hospice.


Organ Procurement Organizations (OPOs)— OPOs are responsible for increasing the ranks of registered organ donors in the US as well as coordinating the organ donation process, ensuring that the donated organs are recovered and matched to the proper party. It offers the opportunity to volunteer and raise awareness for organ donation registration.


Programs of All-Inclusive Care for the Elderly (PACE)— PACE offers a variety of integrated and preventative care as well as acute and long-term care services to help manage the needs of the fragile elderly populace. It enables senior citizens to live in the community and have their health care needs met safely.


Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs)—  Per CMS, an RHC meets health care requirements in a rural setting, with the exception of rehabilitation or mental diseases. A FQHC offers service to an otherwise underserved area or populace using a sliding fee scale. It provides comprehensive services with a perpetual assurance program that’s overseen by a governing board of directors.


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