Emergency Preparedness Requirements for Medicare and Medicaid Participating Providers and Suppliers 

On September 16, 2016, the Emergency Preparedness Requirements for Medicare and Medicaid Participating Providers and Suppliers (Emergency Preparedness Rule) final rule was published in the Federal Register. Health care providers and suppliers affected by the rule were required comply and implement all regulations by November 15, 2017. In the referenced document, CMS is updating Appendix Z of the SOM to reflect changes to add emerging infectious diseases to the definition of all-hazards approach, new Home Health Agency (HHA) citations and clarifications under alternate source power and emergency standby systems. 


CMS just released revisions to Appendix Z for Emergency Preparedness. Note, these are not changing any requirements, but just adding some clarifications. Changes are highlighted in red italics.  

CMS sent a memo to state survey agency directors regarding an update to Appendix Z of the State Operations Manual (SOM) to add emerging infectious diseases to the definition of all-hazards approach.  In the memo, CMS also responds to questions about alternate source power and emergency standby systems under the Emergency Preparedness Final Rule:  

Additionally, since the release of the Interpretive Guidelines for Emergency Preparedness in 2017, stakeholders and providers have asked for additional clarifications related to portable/mobile generators. CMS has added guidance under Tag E0015- Alternate Source Power as well as clarifications under Tag E0042- Emergency Standby Power Systems. Facilities should use the most appropriate energy source or electrical system based on their review of their individual facility’s all-hazards risks assessment and as required by existing regulations or state requirements. Regardless of the alternate sources of energy a facility chooses to utilize, it must be in accordance with local and state laws, manufacturer requirements, as well as applicable Life Safety Code (LSC) requirements. 

If a facility risk assessment determines the best way to maintain temperatures, emergency lighting, fire detection and extinguishing systems and sewage and waste disposal would be through the use of a portable and mobile generator, rather than a permanent generator, then the LSC provisions such as generator testing, maintenance, etc. outlined under the National Fire Protection Association (NFPA) guidelines requirements would not be applicable, except for NFPA 70 – National Electrical Code. However, the revisions, as the provisions under emergency preparedness themselves, do not take away existing requirements under LSC, physical environment or any other Conditions of Participation that a provider type is subject to (for example to maintain safe and comfortable temperatures). 

The memo is available here.