Home Health & Hospice Week

Recent hurricanes emphasize why EP changes matter.

Some actual regulatory relief might be forthcoming from Medicare’s recent proposed rule that aims to cut providers’ red tape.

The home care- and hospice-specific proposals included in the rule are largely expected to provide insignificant relief (see Eli’s HCW, Vol. XXVII, Nos. 34 and 36). But the more general provisions attempting to lighten providers’ workload regarding emergency preparedness may actually make an appreciable difference for providers.

In the rule the Centers for Medicare & Medicaid Services published in the Sept. 20 Federal Register, CMS proposes eliminating or lightening a number of emergency preparedness requirements.

Foremost among the changes is the requirement to ease up on the annual training for an EP plan. For “outpatient providers,” which include home health agencies and hospices, “we propose to revise the requirement such that only one testing exercise is required annually,” CMS notes in the rule. That’s down from two exercises per year, notes the National Association for Home Care & Hospice.

Why? “We believe that conducting two testing exercises per year is overly burdensome as [outpatient] providers do not provide the same level of acuity or inpatient services for their patients,” CMS says in the rule.

Requirements for the type of exercise will also ease under the proposal, as CMS expands the options. The annual exercise “may be either one community-based full-scale exercise, if available, or an individual facility-based functional exercise,” CMS continues. “Every other year and in the opposite years, these providers may chose the testing exercise of their choice which may include a community-based full-scale exercise, if available, a facility-based functional exercise, a drill, or a tabletop exercise or workshop that includes a group discussion led by a facilitator.”

In the fact sheet, CMS emphasizes that “we continually assess our Emergency Preparedness policies to ensure that facilities maintain access to services during emergencies, provide safety for patients, safeguard human resources, maintain business continuity and protect physical resources. This proposed rule will continue to ensure that these expectation are met. At the same time we are proposing to reduce the complexity of the requirements to ensure that providers are spending more time and resources on actual patient care.”

The proposed changes “will allow facilities to modernize their testing to use innovative methods such as desktop drills and simulations,” CMS adds in the fact sheet.

CMS also proposes a number of other EP changes (see story, this page).

Different: Inpatient hospices would have to abide by the training requirements for providers of inpatient services. CMS would still require them to have two training exercises per year — one full scale community exercise, and one “done through various innovative methods such as simulations, desk top exercises, workshops or other methods,” according to the fact sheet.

NAHC expects the proposed EP changes “to genuinely reduce regulatory burdens for both home health and hospice,” cheers the trade group’s Theresa Forster. However, NAHC is examining the proposals carefully and soliciting input to make sure they “maintain an appropriate balance between the burden reduction and sufficient safeguards,” Forster tells Eli.

The importance of EP safeguards has been highlighted recently by hurricanes Michael and Florence.

Note: The rule, including instructions for commenting by Nov. 19, is at www.gpo.gov/fdsys/pkg/FR-2018-09-20/pdf/2018-19599.pdf.