State Survey Agency Guidance

Emergency Preparedness for Every Emergency 

The State Survey Agency (SA) and local emergency response entities should collaborate and develop effective and integrated emergency management policies and procedures, considering such factors such as:

• Local city/county/parish responsibilities
• Mass evacuation procedures, including inter-state issues
• Identification of special need populations

 Recommendations for effective SA emergency planning activities include: 

• Fostering and building relationships with Federal, Tribal, State, Regional, and local emergency agencies to ensure the SA is included in emergency planning efforts, for a collaborative, integrated and seamless response.
• Clarifying which activities will be performed at a Tribal, State, local, or coordinated level, and determining the essential functions the SA will conduct during an emergency.
• Ensuring up-to-date personal contact information for one or more key staff members is provided to the CMS Regional Office as well as other Federal, Tribal, State and local emergency partners.
• Ensuring SA staff are trained and knowledgeable regarding the State's emergency plan and regular drills and exercises are held.
• Establishing the capability to track the status of health care providers affected by the disruptive event, and provide CMS with an electronic report.
• Encouraging health care providers collaborate with their local emergency management agency when developing an emergency plan. 

To ensure effective State and Federal survey and certification coordination during an emergency, CMS has established the following SA emergency preparedness requirements:

• SA Continuity of Operations (COOP):  The SA maintains a coordinated, emergency Continuity of Operations Plan (COOP), updated at least annually, which is submitted to the CMS RO.  The COOP addresses:
  • Essential S&C business functions, including:
    • Provision of prompt responses to complaints regarding patients/residents who are in immediate jeopardy.
    • Provision of monitoring and enforcement of health care providers.  Even in widespread or significant disasters where reduced S&C activities may occur, key activities (such as complaint investigations) will still need to occur in order to ensure the health and safety of patients and residents.
    • Conducting timely surveys or re-surveys in the aftermath of a disaster.
  • Identification of strategies to ensure maintenance and protection of S&C critical data.
  • A program of COOP exercises, conducted at least annually by designated staff to ensure State, Regional, Tribal and Federal responsiveness, coordination, effectiveness, and mutual support.
• Effective Communication & Coordination with CMS
  • Point of Contact: An S&C emergency point of contact (and back-up) is available 24 hours per day and 7 days per week to the CMS RO when the State declares a widespread disaster.  The contact:
    • Coordinated State S&C activities with CMS,
    • Addresses questions and concerns regarding S&C essential functions,
    • Provide status reports, and 
    • Ensures effective communication of federal S&C policy to local constituencies (see details below).

These functions may be fulfilled be a person within the State Incident Command System (ICS) who has been clearly assigned to communicate with CMS and provide data for S&C functions.

• • Policy Communications: The SA maintains capability for prompt dissemination of CMS policy and procedures to surveyors, providers, and affected stakeholders.  During a disaster, the capability is operative 24/7.  The SA capability includes back-up communication strategies, such as websites and hot lines, and emergency capability that enable functional communication during energy blackouts.  A designated person is available for responding to health care providers' questions and concerns related to federal survey and certification.  These functions may be performed by a person within the State ICS, who has been clearly assigned to perform these functions.
  • Information and Provider Status Reports: The SA or the State ICS maintains system capability and operational protocols to provide the CMS RO with (a) State policy actions (such as a Governor's emergency declarations or waiver of licensure requirements) and (b) an electronic provider tracking report, upon request, regarding the current status of all health care providers affected by a disaster.  See the Downloads section below for the data elements which must be included in the status report:
    • An Agency Affected Provider Status Report template has been developed in MS Word and Excel as a tool to assist SAs to submit information to their Regional Offices regarding health care providers that have been affected by a disruptive event.

In addition, based on the input and recommendations of the S&C Emergency Preparedness Stakeholder Communication Forum, and their partners, an emergency preparedness checklist has been developed as recommended tool to assist SAs with their planning and response efforts.

Click on the links in the Downloads section below to access these helpful tools for State Survey Agencies.