COVER STORY


gency preparedness efforts. ASCA rec- ommended that CMS accept written documentation of the ASC’s attempts to cooperate and collaborate with com- munity organizations, even if the com- munity organizations never respond. CMS agreed and now considers


ASCs to be in compliance with this requirement if the facility documents its efforts to contact pertinent emer- gency preparedness officials and, when applicable, participates in com- munity-based exercises. As part of a larger burden reduction


initiative in 2019, CMS removed the documentation requirement, although ASCs are still required to contact the emergency preparedness officials and offer to participate in community- based exercises.


be discharged when stable, even if that is past the 15- to 30-minute window.


Emergency Preparedness In September 2016, CMS released its final rule on Emergency Prepared- ness Requirements for Medicare and Medicaid Participating Providers and Suppliers. This final rule established national


emergency preparedness


requirements for Medicare providers and suppliers to plan for both natural and man-made disasters and coordi- nate with federal, state, tribal, regional and


local emergency preparedness


systems. ASCA submitted comments on the proposed rule based on ASCA member input and achieved several changes in the final rule. ASCA expressed concerns with proposed mandates to provide occu- pancy information and subsistence for


8 ASC FOCUS AUGUST 2021 | ascfocus.org


patients and staff, as these were not applicable to ASCs. CMS agreed and in the final rule, exempted ASCs from providing


occupancy information


since the term "occupancy" usually refers to an inpatient facility. ASCs also were exempted from the hospital requirement to have adequate subsis- tence on hand for patients and staff in case of emergency.


Emergency Plan: 42 CFR § 416.54 (a) The final rule required ASCs to develop an emergency plan based on risk assessment using an all-hazards approach and update their emergency plan annually. ASCA expressed con- cern about a provision in the proposed rule requiring that ASCs work with community emergency preparedness officials, as many communities do not want to include ASCs in their emer-


Policies and Procedures: 42 CFR § 416.54 (b) CMS proposed that ASCs develop arrangements with other ASCs and pro- viders to receive patients in the event of limitations on or the cessation of opera- tions to ensure the continuity of services to ASC patients. ASCA noted that in the case of an emergency, an ASC would cancel upcoming procedures for that day, stabilize any patients already in the facility and transfer patients to a higher level of care, if needed. The ASC would also ensure that all ASC staff and vol- unteers were accounted for and could either shelter in place or return home safely. CMS withdrew this entire pro- posed requirement and acknowledged that ASCs were highly specialized and transferring patients was not applicable.


Communication Plan: 42 CFR § 416.54 (c) ASCs are required to develop a com- munication plan, and as part of this communication plan, CMS proposed requiring ASCs to track staff and patients


expressed concern with the proposal to require ASCs to keep track of patients once they leave the facility. CMS agreed and withdrew this proposal.


after an emergency. ASCA


Page 1  |  Page 2  |  Page 3  |  Page 4  |  Page 5  |  Page 6  |  Page 7  |  Page 8  |  Page 9  |  Page 10  |  Page 11  |  Page 12  |  Page 13  |  Page 14  |  Page 15  |  Page 16  |  Page 17  |  Page 18  |  Page 19  |  Page 20  |  Page 21  |  Page 22  |  Page 23  |  Page 24  |  Page 25  |  Page 26  |  Page 27  |  Page 28  |  Page 29  |  Page 30