Meeting compliance under Medicare and Medicaid emergency preparedness Final Rule requirements.

Nursing home residents experience death and injury at a disproportionately higher rate than other populations during and after a disaster. This paper addresses the complex chronic conditions of vulnerable residents that will become even more challenging due to compounding effects from continued disasters and rapid population aging. In 2016, the Centers for Medicare and Medicaid Services (CMS) established national emergency preparedness requirements for long-term care (LTC) and skilled nursing (SN) facilities. The problems facing nursing facilities created by an increasing population to serve, present a challenge to meeting the highest level of requirements and responsibilities for healthcare preparedness. This paper argues that nursing facility personnel are required to participate in an unfamiliar culture of operational processes, using terminology foreign to their profession, in an environment requiring planning and decision-making skills using organisational concepts they most likely have never experienced. Furthermore, unlike hospitals, LTC and SN facility staff have not had extensive access to standardised training to meet the current requirements. The paper concludes that this environment adversely affects emergency managers and unnecessarily increases their planning and operational burden.