By aiding first responders in their efforts and providing care for disaster victims, medical centers play a vital role in the success of emergency response.  All agencies, including medical institutions, must examine how they act before, during and after an emergency to improve their end-to-end disaster preparedness.

Medical centers lack emergency preparedness
Not all medical facilities are required to have emergency plans. The chaos following Hurricane Katrina surfaced significant equipment problems for medical service providers and suppliers that interfered with patient care. Overcrowding at emergency departments also revealed recruitment and retention issues for mental health staffing. Lives could have been saved had New Orleans' hospitals and their extended networks employed competent planning and execution.

After seeing how cities struggled with disasters, the Centers for Medicare & Medicaid Services (CMS) proposed a rule change that would revamp disaster preparation for medical centers as part of a widespread movement toward end-to-end response. Providers would be required to plan for natural and man-made disasters, ensuring they can meet the medical needs of patients and staff—as well as area residents and new clients—in the event of an emergency. 

Medical centers also need to maintain safe temperatures for patients and equipment, and test backup generators with greater frequency. Lighting, fire safety systems and waste disposal must continue to operate effectively during a disaster. Under the rule, CMS would demand that facilities such as hospitals, nursing homes, clinics and home health agencies develop a plan to keep utilities running.

Preparing for anything may drain resources
The shift to more comprehensive emergency preparedness is not without its disadvantages. From nursing homes to hospital chains, more than 68,000 institutions would be forced to change their ways. While the adjustments would improve care in the event of a disaster, the requirements could cost an estimated $225 million to complete in the first year, according to The New York Times

"It's a big step," Susan C. Waltman, an executive vice president of the Greater New York Hospital Association, told The New York Times. "It will be a resource-intensive process for many providers." 

To incentivize adoption of end-to-end disaster strategies, the federal standards are tied to participation in Medicare and Medicaid programs. The resources offered by these programs, however, may not be enough to offset the costs of compliance. That could leave some centers scrambling to find funding for basic operations. If that quality of standard care falls, the quality of emergency response will likely decline as well.

Currently, health care facilities must abide by different local, state and federal rules. The changes proposed by CMS would make it easier to comply with those regulations by providing clear guidelines for preparedness. Although the initial cost may be greater for medical institutions, the long-term effects of such a move would offset these expenses by streamlining emergency response and improving the safety of patients. 

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