Continuation:
In this third article regarding the connection between the Occupational Safety and Health Administration (OSHA) and the Centers for Medicare & Medicaid Services (CMS) Life Safety and Emergency Preparedness (EP) Requirements, the focus will be on how OSHA’s regulations overlap with CMS’ EP requirements, found in 42 CFR 483.73 (Appendix Z).
It’s important to note that CMS’ EP requirements do NOT apply to assisted living, however any OSHA requirements do apply.
Emergency Preparedness-Overview:
- Emergency Preparedness: CMS established specific requirements for emergency preparedness in nursing communities that became effective in 2017. The CMS rule, commonly known as the Emergency Preparedness Rule, applies to various health care providers, including nursing communities. Emergency preparedness is typically surveyed by the state survey agency in conjunction with the Life Safety Code survey.
Key components of the CMS Emergency Preparedness Rule for nursing communities include, but are not limited to:
- Emergency Plan: Providers are required to develop and maintain an emergency plan that addresses potential emergencies specific to their geographic location. This plan should include strategies for addressing both natural and man-made disasters.
- Policies and Procedures: Nursing homes must have policies and procedures in place to implement the emergency plan. These should cover various aspects, including communication, patient tracking, and coordination with local emergency management agencies.
- Communication Plan: Nursing homes are required to establish a communication plan that ensures timely and effective communication during emergencies. This includes communication with staff, residents, families, and external entities.
- Training and Testing: Nursing home providers must conduct regular training for staff to ensure they are familiar with emergency procedures. Additionally, they are required to conduct regular testing and drills to assess the effectiveness of their emergency plans.
- Integrated Healthcare Systems: Nursing home communities are encouraged to coordinate their emergency plans with other health care providers and community resources to ensure a seamless response to emergencies.
- OSHA: OSHA does not have regulations or standards that specifically address emergency preparedness in long term care communities, including assisted living. However, OSHA does have general requirements that may indirectly relate to emergency preparedness and employee safety during emergencies, such as emergency evacuation procedures, personal protective equipment, infection control and respiratory protection.
Emergency Preparedness - Compare and Contrast of Key Compliance Items:
- Emergency Evacuation Plans:
- Emergency Preparedness: CMS mandates the development and implementation of comprehensive emergency evacuation plans that consider various potential emergencies, including fires and natural disasters. These plans outline procedures for the safe and orderly evacuation of residents, including the identification of evacuation routes and the assignment of responsibilities to staff members.
- OSHA: OSHA's Emergency Action Plan standard 1910.38 - Emergency action plans. | Occupational Safety and Health Administration (osha.gov) requires employers to develop and implement emergency action plans. These plans must include procedures for the evacuation of employees and, where applicable, residents during emergencies.
- Communication Systems:
- Emergency Preparedness: CMS emphasizes the importance of effective communication during emergencies. Communities are required to have communication systems in place to relay information to staff, residents, and, if necessary, external emergency response entities. This includes methods for notifying individuals about emergencies and providing clear instructions.
- OSHA: OSHA regulations also highlight the importance of communication during emergencies (29 CFR 1910.38). Emergency action plans must include procedures for reporting emergencies, including a method for employees to report emergencies or other dangerous situations.
- Training and Drills:
- Emergency Preparedness: CMS has specific requirements for training and drills to ensure that staff and residents are familiar with emergency procedures. This includes conducting evacuation drills, training on the use of emergency equipment, and educating individuals on their roles and responsibilities during emergencies.
- OSHA: OSHA's Emergency Action Plan standard emphasizes the need for employee training (29 CFR 1910.38). Employers, including long-term care centers, must ensure employees are familiar with the emergency action plan, including evacuation procedures, and conduct regular drills to evaluate its effectiveness.
Differences and Synergies:
The CMS rules and OSHA regulations overlap on certain aspects of emergency preparedness, yet each has distinct focuses. Both emphasize the importance of comprehensive emergency preparedness in health care settings, including long term care centers.
CMS rules, particularly the Emergency Preparedness Rule, require providers to develop and implement plans addressing various emergencies. This encompasses evacuation procedures, communication plans, and coordination with external entities.
OSHA, while not having specific regulations dedicated to health care emergency preparedness, mandates general emergency action plans for workplaces, emphasizing evacuation procedures and employee training.
Conclusion:
The CMS rules specifically address the safety and needs of health care recipients and their caregivers, ensuring continuity of care during emergencies, while OSHA's focus encompasses the safety of employees. Aligning with both sets of regulations ensures a universal approach to emergency preparedness, safeguarding the well-being of both health care recipients and staff in health care settings.