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CMS issues updates to EMTALA regs, IC guidelines

Emergency Management Alert, December 11, 2007

CMS has been busy updating items relating to emergency management:

• On December 7 it issued revisions to the EMTALA regulation at 42 CFR 489.24(a)(2) concerning non-applicability of EMTALA sanctions during public health emergencies declared by the Secretary of Health and Human Services (HHS) pursuant to amendments to Section 1135(b). It has clarified the scope of the waiver; the regulation now specifies that it applies to "both inappropriate transfers and redirection or relocation of individuals for a medical screening examination pursuant to an appropriate state emergency preparedness plan or state pandemic preparedness plan by a hospital located in an emergency area." A time frame of 72 hours for the duration of the waiver has been added, consistent with the statute.
  
  
• A "Special Challenges" section covering MDROs, communicable disease outbreaks, ambulatory care issues, bioterrorism, and pan-flu was included in updates to CMS' Interpretive Guidelines for 42 CFR 482.42, Hospital Condition of Participation: Infection Control. They underline CMS' recommendation of an all-hazards approach stressing tight intra-agency support among medical facilities and local, state, and federal agencies. "The duration of a pandemic may present special challenges for staffing, supplies, resupply, etc. Hospitals should work with local, state, and federal public health agencies to identify likely communicable disease threats and develop appropriate preparedness and response strategies."
  
  The IC update, announced November 21, was effective immediately. Revisions were driven by "changing infectious disease threats, as well as new mechanisms to confront these threats," which were needed to "better reflect current conditions within hospitals as well as contemporary infection control standards of practice," said CMS. 
  
  The guidelines discuss the applicable requirements for the infection control CoP and related standards, as well as the survey procedures to be used to determine compliance.  They also contain discussion and examples of practices that hospitals are encouraged to adopt, but that are not necessarily required by the regulation.
  
  Click here for the IC information.

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