More than a quarter of state investigators lack proper emergency response skills, a new federal report shows. Partnering with other institutions and skilled nursing facilities could be a solution to prepare nursing homes for disasters, researchers say.
The study by the Inspectors' Office said 26% of state research agencies also said surveyors' expertise in emergency preparedness is challenged, but they also said they have recruiting and maintaining surveyors who already have experience in emergency preparation.
This is probably a natural side effect of professional-level background not a requirement for employment, leaving agencies to train and nurture employees, the report says.
This approach has not come without difficulty.
“The agency has focused on the challenges of developing specific expertise in multiple regulatory areas. One agency said it is unrealistic to expect surveyors to have expertise in all regulatory areas covered in the research process — emergency preparation, safety of life due to fire, staffing, etc. The report added that 42% of government agencies said they had low staffing levels.
Respondents to the survey, released Friday, were welcomed by 52 state research agencies contracted by the Centers for Medicare and Medicaid Services, overseeing compliance with 26 emergency response requirements for nursing homes.
But the investigator believes that the majority of responsibility doesn't rest solely on the surveyors. Two-thirds of respondents (67%) cited the lack of clear direction in emergency response guidelines from CMS as another obstacle.
“The state investigators explained that the lack of detailed instructions in Appendix Z has some negative consequences,” the report said. “These reported negative outcomes include discrepancies between surveyors: a lack of orientation to assess the quality or content of information, and a lack of clarity regarding the thresholds to determine whether nursing homes are complying with or lacking emergency preparedness requirements.”
I'm doing it together
Active information exchange – Training tips, resource introductions, and joint review of preparatory plans – 34% of agencies say that emergency preparation and recovery between research agencies and emergency preparation partners will be improved.
Some SNFs across the country have already implemented such collaborations in collaboration with state public health agencies and others to help develop and establish emergency response plans.
In Michigan, for example, the Nursing Home Quality Coalition before the advancement last year received a $500,000 grant from the Michigan Health Fund Fund last year. We hope that this training will promote industry-wide partnerships.
“The goal is to educate and prepare nursing homes (at the time) to share that experience with other nursing homes, public health agencies and local public health agencies,” coalition chair Alice Bonner told McKnight's Long-Term Care News last month. “We're building a network that increases emergency preparedness across the state.”
OIG made two recommendations that the CMS agreed to implement.
As part of the investigation process, we will provide instructions to the surveyors on how to assess the contents of nursing home emergency response documents. We will publish guidance encouraging state research agencies to collaborate and share information.
