CMS issued QSO-20-41-ALL on September 28 to provide guidance on the specific testing exercises required under the emergency preparedness regulations in light of the coronavirus public health emergency (PHE). During or after an actual emergency, the regulations allow for an exemption to the testing requirements based on real world actions taken by providers and suppliers.

The memo provides guidance for surveyors and providers on meeting the testing requirements in light of many of the response activities associated with the COVID-19 PHE.

On Friday, March 13, 2020, the President Trump declared a national emergency due to COVID-19 and subsequently many providers and suppliers have activated their emergency plans in order to address surge and coordinate response activities. Facilities that activate their emergency plans are exempt from the next required full-scale community-based or individual, facility-based functional exercise. Facilities must be able to demonstrate, through written documentation, that they activated their program due to the emergency.

CMS requires facilities to conduct an exercise of choice annually for inpatient providers, which include long term care facilities. For the “exercise of choice,” facilities must conduct one of the testing exercises below:

• another full-scale exercise;
• individual-facility-based functional exercise;
• mock disaster drill; or
• a tabletop exercise or workshop.

As a reminder, all providers and suppliers must continue to analyze their facility’s response to and maintain documentation of all drills, tabletop exercises, and activation of their emergency plan. This would include documentation showing any revisions to the  facility’s emergency plan as a result of the after action review process.