Homecare and Hospice
Topic Collection
November 20, 2024
Topic Collection: Homecare and Hospice
Having agency, patient, and employee emergency preparedness plans in place is critical for home healthcare providers, hospice providers, and their clients. The scope of homecare is as broad as the nature of the needs (e.g., persons who need aid with activities of daily living, postsurgical patients, patients receiving home medications, and chronically ill patients who depend on oxygen, ventilators, or other power-dependent equipment). The majority of hospice patients are supported in the location they call home, however inpatient services are also available within free-standing buildings, hospitals, or long-term care or residential facilities.
Disasters, particularly pandemics, may overwhelm agencies with demand. The aftereffects of some disasters may make it difficult for providers to reach their clients, and clients may lose power or water (or both). The resources in this Topic Collection include reports, toolkits, and guidance specific to homecare and hospice for providers and patients. Materials addressing individuals with disabilities and others with access and functional needs may be found in the ASPR TRACIE Access and Functional Needs Topic Collection.
Each resource in this Topic Collection is placed into one or more of the following categories (click on the category name to be taken directly to that set of resources). Resources marked with an asterisk (*) appear in more than one category.
Must Reads
This document provides essential preparedness information for seniors and potentially those in home care situations regarding making a plan, getting a kit, and being informed during an emergency.
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This document is the product of a large national workgroup and includes tools and templates that can be customized and used by hospice and homecare providers in developing all hazards emergency preparedness plans.
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This rule establishes consistent emergency preparedness requirements for health care providers participating in Medicare and Medicaid, in order to increase patient safety during emergencies and establish improved response during natural and man-made disasters.
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The HHS emPOWER Map provides monthly de-identified totals of Medicare claims submitted for one or more of the fourteen types of life-maintaining or saving electricity-dependent durable medical and assistive equipment (DME) and certain implanted electricity-dependent cardiac devices, at the national, state, territory, county, and ZIP Code levels. Users have the ability to create unique aggregations by geography and export the data, as well as the ability to access historical HHS emPOWER Map datasets for further analysis. When combined with real-time severe weather and hazard maps, the HHS emPOWER Map gives communities the power to anticipate, plan for, and address the needs of this population prior to, during, and after an incident, emergency, or disaster.
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This handbook was written to help Michigan home care agencies develop and evaluate their emergency preparedness plans. Beginning in Chapter 3 it helps users define plan elements, assess their agency's level of preparedness (with the included checklist), develop a plan that addresses specific needs and populations, and test and evaluate the plan.
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This document provides a general overview of disaster response/ emergency preparedness specific to hospice care. It addresses requirements in the CMS Emergency Preparedness Requirements for Medicare and Medicaid Participating Providers and Suppliers specific to hospice providers.
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Education and Training
This webinar reviews the Centers for Medicare and Medicaid (CMS) Emergency Preparedness (EP) Rule requirements for home health and hospice.
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This slide presentation from Maryland provides a general overview of the elements of emergency operations plans for home care providers.
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This six-hour course can help nurses in various settings (e.g., homecare, long-term care facilities) prepare for emergencies.
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This PowerPoint presentation provides an overview of emergency preparedness topics specific to homecare and hospice facilities. Beginning on slide 23, the author includes a summary on exercises followed by a detailed exercise example using the scenario of a mass shooting event in Las Vegas, NV.
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The HHS emPOWER Program Web-Based Training is a free, publicly accessible course designed to help partners better understand the HHS emPOWER Program and integrate its tools into their emergency preparedness, mitigation, response, and recovery.
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General Resources
This article provides a general overview for seniors and caregivers about emergency preparedness. It includes a list of supplies and suggestions for ensuring equipment will be accessible and durable in the event of an emergency.
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This online document is a compilation of other resources that agencies may find useful to provide to their patients and their families prepare in advance for any type of emergency situation such as utility failures.
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This fact sheet provides information on preparing for emergencies for home care patients and their families, including knowing who to call; having contact information and medical/prescription information ready to take with you, if needed; and what to put into an emergency preparedness kit.
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Guidance
This ASPR TRACIE fact sheet provides information on the types of oxygen therapy and the types of oxygen supplies generally available. It also provides information on the typical sizes and length of use of various oxygen storage methods.
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This ASPR TRACIE tip sheet provides information on general durable medical equipment (DME) categories and focuses on electricity-dependent DME that may be affected by disasters and emergencies, including power failures. It also includes information to assist healthcare system preparedness stakeholders plan for populations who rely on DME.
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This document combines excerpts from the Final Rule and the recently released Interpretive Guidelines from CMS to provide a consolidated overview document of requirements for Home Health Agencies.
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This document combines excerpts from the Final Rule and the recently released Interpretive Guidelines from CMS to provide a consolidated overview document of requirements for Hospice providers.
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This handbook can help homecare providers develop emergency plans. It also features New York-specific state regulations and resources.
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This guide can help homecare agencies and programs in the State of New York (from certified home health agencies to "consumer directed personal assistance models") comply with state department of health regulations when developing their emergency preparedness plans. It lists critical elements of a plan and homecare-related challenges and how to overcome them. While a significant portion of the primer is specific to New York, it does contain a three-tier level of prioritized services that may be helpful for agencies across the country to use.
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This article covers the use of home-based ambient assisted living technology and linkages with healthcare organizations to monitor medical emergencies.
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This document provides a general overview of disaster response/ emergency preparedness specific to hospice care. It addresses requirements in the CMS Emergency Preparedness Requirements for Medicare and Medicaid Participating Providers and Suppliers specific to hospice providers.
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The authors share results from a literature review they conducted on personal protective equipment usage and planning considerations for home health agencies.
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This webpage includes links to Texas-specific minimum requirements for written disaster plans for the following facilities: nursing homes, adult day care facilities, homecare agencies, and hospice providers. It also includes emergency plan components and can be tailored by other states.
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This handbook was designed to help home and hospice care agencies, staff, and patients develop their disaster plans. It provides an introduction to a variety of hazards for providers, discussion scenarios, forms, and templates.
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The first speaker provided an overview of emPOWER and highlighted new data, tools, and resources. Subsequent speakers (from Los Angeles County and the Virginia Department of Health) shared their experiences using the tool and how patients (including those with electrical dependent DME such as ventilators or oxygen concentrators could be contacted/assisted.
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This booklet can help those who use electrically-powered medical devices plan for and respond to power outages.
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The authors conducted 32 semi-structured interviews of Veterans Health Administration Home-Based Care Program staff to explore “ways in which policy and procedures support routine assessment of disaster preparedness for patients as well as patient education activities.” They found that assessments were incomplete and not standardized across practitioners; not all practitioners understood how to assign risk for their patients; and health and functional limitations are the primary contributors to patients’ lack of preparedness.
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The authors conducted a literature review that examined home healthcare disaster preparedness on three levels: organization, provider, and patient. The results highlighted gaps between best and promising tools and policies and adopted policies and differences in approaches to triage, evaluation, education, and classification between organizations.
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Homecare and MERS/Pandemic Influenza
Staff who are coordinating homecare and isolation or quarantine of people who are being evaluated for or are confirmed to have MERS-CoV infection can use this guidance to assess the suitability of the home care setting and provide guidance to the patient and household members.
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The authors present the findings from a pandemic preparedness survey administered to home health agencies after the 2009 H1N1 pandemic. Gaps listed included surge capacity, availability of personal protective equipment, and lack of drill participation.
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This guide can help people create a plan for and recognize the signs of influenza and care for themselves or others sick with the virus. It is available in several languages.
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Legal/Regulatory
This rule establishes consistent emergency preparedness requirements for health care providers participating in Medicare and Medicaid, in order to increase patient safety during emergencies and establish improved response during natural and man-made disasters.
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This resource provides the Joint Commission’s revised emergency management standards for home care agencies, which were implemented to align with the Centers for Medicare and Medicaid Services (CMS) Emergency Preparedness (EP) Rule requirements.
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Lessons Learned
This blog post describes a palliative care physician’s experience and role working in the hospital setting during Hurricane Irma. She found that her clinical skills, as well as experience helping people make difficult medical decisions under stressful conditions, were valuable to the care of patients throughout the hospital.
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ASPR TRACIE interviewed Sheryl Pierce to learn more about the changing role of homecare and hospice agencies in community resilience.
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This article shares lessons earned by home care providers following their experiences during the 2017 hurricane season. Topics discussed include communication and coordination; patient triage and mapping; and ways organizations provided support to non-clients in need.
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This article includes lessons learned for caring for patients and staff during hurricanes and wildfires. Lessons pertaining to preparedness, response, and recovery are discussed.
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This study was conducted to provide lessons learned from the experience of a small, rural hospice care organization to an actual crisis that required evacuation of the facility. A process improvement framework using the emergency response certification guidelines was used to provide details of the incident, analyze the effectiveness of disaster planning and response in response to an actual crisis, and discuss the post-event review, lessons learned, and process improvement.
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This article reviews lessons learned from the New York State home care community’s response to Hurricane Sandy in 2012.
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The authors present the findings from a pandemic preparedness survey administered to home health agencies after the 2009 H1N1 pandemic. Gaps listed included surge capacity, availability of personal protective equipment, and lack of drill participation.
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The authors reviewed 41 home health emergency plans, identified ten domains, and suggest that planners use the information as an assessment tool for evaluating their own plans.
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The first speaker provided an overview of emPOWER and highlighted new data, tools, and resources. Subsequent speakers (from Los Angeles County and the Virginia Department of Health) shared their experiences using the tool and how patients (including those with electrical dependent DME such as ventilators or oxygen concentrators could be contacted/assisted.
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The authors conducted a literature review that examined home healthcare disaster preparedness on three levels: organization, provider, and patient. The results highlighted gaps between best and promising tools and policies and adopted policies and differences in approaches to triage, evaluation, education, and classification between organizations.
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Plans, Tools, and Templates
This emergency power planning checklist is for people who use electricity and battery dependent assistive technology and medical devices, including: breathing machines (respirators, ventilators); power wheelchairs and scooters; and oxygen, suction or home dialysis equipment.
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This document provides essential preparedness information for seniors and potentially those in home care situations regarding making a plan, getting a kit, and being informed during an emergency.
Login to favorite or comment on the article
This slide presentation from Maryland provides a general overview of the elements of emergency operations plans for home care providers.
Login to favorite or comment on the article
This document is the product of a large national workgroup and includes tools and templates that can be customized and used by hospice and homecare providers in developing all hazards emergency preparedness plans.
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This handbook can help homecare providers develop emergency plans. It also features New York-specific state regulations and resources.
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This online document is a compilation of other resources that agencies may find useful to provide to their patients and their families prepare in advance for any type of emergency situation such as utility failures.
Login to favorite or comment on the article
The HHS emPOWER Map provides monthly de-identified totals of Medicare claims submitted for one or more of the fourteen types of life-maintaining or saving electricity-dependent durable medical and assistive equipment (DME) and certain implanted electricity-dependent cardiac devices, at the national, state, territory, county, and ZIP Code levels. Users have the ability to create unique aggregations by geography and export the data, as well as the ability to access historical HHS emPOWER Map datasets for further analysis. When combined with real-time severe weather and hazard maps, the HHS emPOWER Map gives communities the power to anticipate, plan for, and address the needs of this population prior to, during, and after an incident, emergency, or disaster.
Login to favorite or comment on the article
This fact sheet provides information on preparing for emergencies for home care patients and their families, including knowing who to call; having contact information and medical/prescription information ready to take with you, if needed; and what to put into an emergency preparedness kit.
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This webpage includes a link to an Emergency Preparedness Resource Guide for Home Care Providers, which includes sections on emergency planning and business continuity planning. There are also links to fillable forms that support the Emergency Preparedness Resource Guide.
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This handbook was written to help Michigan home care agencies develop and evaluate their emergency preparedness plans. Beginning in Chapter 3 it helps users define plan elements, assess their agency's level of preparedness (with the included checklist), develop a plan that addresses specific needs and populations, and test and evaluate the plan.
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This website provides comprehensive downloadable emergency operations templates that can be customized and used by home health and hospice providers.
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This checklist was created to ensure that clients receiving home care and case management services in Montgomery County (MD) develop an emergency plan and stock a 72 hour (or longer) supply of nine essential items (e.g., water, food, hygiene items, and clothes). The checklist can be replicated by others, and can also be added to a client's chart.
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This checklist can help home care and hospice staff analyze workplace hazards and carry out safety protocols (e.g., standard and COVID-19 infection prevention, respiratory protection, cleaning and disinfection).
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This tool can help home health, hospice and other agencies assist their patients/clients in developing an appropriate emergency evacuation plan by enabling staff to maintain an information record of summary medical information and specific patient needs during an emergency.
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Though it includes Louisiana-specific information, this template can be adapted by home health agencies in other states to develop emergency operations plans. It is an update of the content in the 2015 Louisiana Model Home Health/Hospice Emergency Plan and includes information relevant to compliance with the Centers for Medicare and Medicaid Services (CMS) Emergency Preparedness (EP) Rule.
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This handbook was designed to help home and hospice care agencies, staff, and patients develop their disaster plans. It provides an introduction to a variety of hazards for providers, discussion scenarios, forms, and templates.
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This document provides clear, concise emergency plan guidance for hospice and homecare providers in Virginia (but it can be used by those in other states responsible for developing a plan).
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This business continuity template may be referenced and adapted by other home care agencies developing their own plans.
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This webpage includes links to toolkits and other resources designed to help certain types of healthcare facilities better understand the Centers for Medicare & Medicaid Services (CMS) Emergency Preparedness Rule. There is both a PDF (toolkit) and Word version (workbook) for each facility type, and the relevant CMS rules for each facility type are included. Each toolkit includes sample templates and planning worksheets that can help facilities develop compliant plans, policies, and procedures.
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Plans, Tools, and Templates: Hospice
This resource includes information on preparing for a hurricane, as well as a blank “Hurricane Plan” that individuals may fill in with their specific preparedness plan.
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This checklist can help home care and hospice staff analyze workplace hazards and carry out safety protocols (e.g., standard and COVID-19 infection prevention, respiratory protection, cleaning and disinfection).
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This tool can help home health, hospice and other agencies assist their patients/clients in developing an appropriate emergency evacuation plan by enabling staff to maintain an information record of summary medical information and specific patient needs during an emergency.
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This handbook was designed to help home and hospice care agencies, staff, and patients develop their disaster plans. It provides an introduction to a variety of hazards for providers, discussion scenarios, forms, and templates.
Login to favorite or comment on the article
This webpage includes links to toolkits and other resources designed to help certain types of healthcare facilities better understand the Centers for Medicare & Medicaid Services (CMS) Emergency Preparedness Rule. There is both a PDF (toolkit) and Word version (workbook) for each facility type, and the relevant CMS rules for each facility type are included. Each toolkit includes sample templates and planning worksheets that can help facilities develop compliant plans, policies, and procedures.
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Agencies and Organizations
Administration for Strategic Preparedness and Response.
HHS emPOWER Map.
U.S. Department of Health and Human Services.
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