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Health groups told to improve disaster plans

NEW YORK — Federal officials are proposing sweeping requirements for US health care facilities — from large hospitals to small group homes for the mentally disabled — intended to ensure their readiness to care for patients during disasters.

Describing emergency preparedness as an “urgent public health issue,” the proposal by the Department of Health and Human Services offers regulations aimed at preventing the severe disruptions to health care that followed Hurricane Katrina and Hurricane Sandy. More than 68,000 institutions would be affected, including large hospital chains, “mom and pop” nursing homes, home health agencies, rural health clinics, organ transplant procurement organizations, outpatient surgery sites, psychiatric hospitals for youths, and kidney dialysis centers.

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The proposed rule, issued in December and open for comment until later this month, has met resistance from industry officials who question the first-year price tag of $225 million. Some complained that the costs could be “draconian.”

The American Hospital Association said in a member advisory that federal officials “may have significantly underestimated the burden and cost associated with complying with this rule.”

The regulations would require hospitals, nursing facilities, and group homes to have plans to maintain emergency lighting, fire safety systems, and sewage and waste disposal during power losses, and to keep temperatures at a safe level for patients. Those inpatient facilities would also be expected to track displaced patients, provide care at alternate sites, and handle volunteers.

Transplant centers would need to identify alternate hospitals for patients awaiting organs — a challenge because centers maintain different transplant criteria.

Home health care agencies would be required to help patients create personalized disaster plans. Hospices and others caring for frail, homebound patients would need procedures to help rescuers locate them. And health care employees would have to conduct disaster drills, while administrators might have to coordinate drills and response plans with local business competitors.

“It’s a big step,” said Susan C. Waltman, an executive vice president of the Greater New York Hospital Association, which is urging substantive changes. “It will be a resource-intensive process for many providers.”

Others said they were already struggling with Medicare and Medicaid reimbursement cuts and regulatory changes related to health reform.

One of the most contested of the requirements calls for hospitals and nursing homes to test backup generators for extended periods at least yearly, rather than once every three years, as is currently recommended.

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