Hurricane Irma Updates
All who have been affected by Hurricane Irma continue to be in our thoughts and prayers. We hope all continue to quickly and fully recover. As you know, the effects of Irma led Governor Deal to declare a state of emergency in all 159 counties across Georgia. As such, centers should have activated their emergency preparedness plans. GHCA has confirmed with HFRD Chief Simon that, if properly executed and documented, this natural disaster and the activation of emergency plans exempts centers from the requirement to participate in a full-scale exercise for one year following the onset of the disaster.
The effective date of the new emergency preparedness requirements is quickly approaching (eff. 11/15/2017). These requirements, in part, require centers to develop an emergency preparedness program that meet the standards specified within the requirement. The emergency preparedness program must describe a facility's comprehensive approach to meeting the health, safety, and security needs of their staff and patient population during an emergency or disaster situation.The program must also address how the facility would coordinate with other healthcare facilities, as well as the whole community during an emergency or disaster (natural, man-made, facility). A comprehensive approach to meeting the health and safety needs of a patient population should encompass the elements for emergency preparedness planning based on the “all hazards” definition and specific to the location of the facility. The emergency preparedness program must be reviewed annually.
On Friday, September 1, CMS released a memorandum to State Survey Agency Directors announcing that the Emergency Preparedness Training is now available. All surveyors are required to take the training prior to surveying the Emergency Preparedness requirements. Surveying for requirements begins November 15, 2017.
The online course is now available on the Surveyor Training Website On-Demand. Once in the course catalog for provider training, search "emergency" and the course information will appear. Providers will have continued (ongoing) access to the course, so they can review it anytime. We strongly encourage Administrators and Environmental and Safety Engineers and associates to view this training to assist with preparedness efforts.
Updated, 9/12, 5:00 p.m.
GHCA has received notification from DPH that the U.S. Army Corps of Engineers has offered to assist with electrical/power assessments at nursing centers throughout Georgia following Tropical Storm Irma. Over the next few days, you may see uniformed personnel around your center conducting these assessments.
Additionally, WPS Government Health Administrators, MAC for over 200 nursing centers in Georgia, is offering assistance with Medicare claims for WPS providers in the State who have been impacted by Hurricane Irma. Questions can be filtered through Aileen Sigler, Specialist – Outreach and Education. Aileen will connect you with the proper WPS personnel based on the nature of the inquiry. Aileen can be reached at Aileen.Sigler@wpsic.com or 1-402-995-0530.
Updated 9/13, 10:30 a.m.
As we continue to move through re-entry process for evacuating centers following Tropical Storm Irma, please log on to www.gha911.org and update your bed counts to let us know your center's status.
Updated 9/11 9:00 a.m.
Irma has been downgraded from a hurricane to a tropical storm, with winds of 70 mph, the National Hurricane Center said. The storm is expected to further weaken as it continues to move inland. The downgrade to tropical storm status does not mean that the threat is over, however. Authorities in Georgia are warning residents to seek secure shelter and mobilizing resources as Irma makes its way into the southeastern portion of the State this morning.
DPH has provided GHCA with a comprehensive list of tools and resources to assist providers. Click here to access.
Reminder: GHCA was notified by HFRD Chief Melanie Simon that survey activity will be suspended on Monday and Tuesday of this week.
Updated 9/10 6:00 p.m.
Acting on a recommendation from the state's Emergency Operations Command and ahead of heavy rains, strong wind and potential flooding from Hurricane Irma, Gov. Nathan Deal today expanded the emergency declaration to include an additional 65 counties. The state of emergency now includes all 159 counties in Georgia. State government will be closed Monday and Tuesday for all employees except essential personnel.
Hurricane Irma made landfall as a Category 4 storm in Florida Sunday morning in the Florida Keys, and has since been downgraded to a Category 2 storm. The time for Georgia to be most weather-aware is from Monday morning until Tuesday morning. Storm threats for Georgia include wind gusts up to 60 mph, heavy rain, and a possibility of down trees and power outages.
GHCA was notified by HFRD Chief Melanie Simon that survey activity will be suspended on Monday and Tuesday of this week.
Updated 9/9 5:00 p.m.
Following President Trump's emergency declarations for Georgia and South Carolina, Health and Human Services Secretary Tom Price, M.D., yesterday declared public health emergencies in Georgia and South Carolina as Hurricane Irma tracks toward the southeastern states. The declarations allow HHS' Centers for Medicare & Medicaid Services (CMS) to take action that gives beneficiaries and their healthcare providers and suppliers greater flexibility in meeting emergency health needs. Click here to read to full press release.
The storm remains on track with models indicating it will move into Georgia Monday. Newer storm models show it has shifted even more westward, aiming at Florida's gulf coast. The current track still shows north Georgia at a higher risk for gusty winds, heavy rain and the possibility for tornadoes and the storm striking metro Atlanta late Monday and early afternoon.
Updated 9/8 5:00 p.m.
Following a recommendation from Georgia Emergency Management and Homeland Security Agency (GEMA/HS) officials ahead of Hurricane Irma's imminent landfall, Gov. Nathan Deal today expanded the state of emergency to include a total of 94 counties. In light of the storm's forecasted track shifting west, which will bring hurricane force winds, rain and potential flooding, 64 additional counties are now under the emergency declaration. Mandatory evacuations for coastal areas east of I-95 and all of Chatham County remain in place and contraflow on I-16 will begin at 8 a.m. Saturday.
A state of emergency now exists in the following 94 counties: Appling, Atkinson, Bacon, Baker, Baldwin, Ben Hill, Berrien, Bibb, Bleckley, Brantley, Brooks, Bryan, Bulloch, Burke, Calhoun, Camden, Candler, Charlton, Chatham, Chattahoochee, Clay, Clinch, Coffee, Colquitt, Cook, Crawford, Crisp, Decatur, Dodge, Dooly, Dougherty, Early, Echols, Effingham, Emanuel, Evans, Glynn, Grady, Harris, Houston, Irwin, Jeff Davis, Jefferson, Jenkins, Johnson, Jones, Lamar, Lanier, Laurens, Lee, Liberty, Long, Lowndes, Macon, Marion, McIntosh, Meriwether, Miller, Mitchell, Monroe, Montgomery, Muscogee, Peach, Pierce, Pike, Pulaski, Quitman, Randolph, Schley, Screven, Seminole, Stewart, Sumter, Talbot, Tattnall, Taylor, Telfair, Terrell, Thomas, Tift, Toombs, Treutlen, Troup, Turner, Twiggs, Upson, Ware, Washington, Wayne, Webster, Wheeler, Wilcox, Wilkinson and Worth Counties.
Read the executive order here. Click here to read the full press release.
Also today, President Donald Trump declared a federal state of emergency in Georgia ahead of the storm. The declaration unlocks special federal resources to be sent to Georgia, including extra money, debris removal and protective measures aimed at supplementing the state's efforts.
The latest track for the storm shows it moving into Georgia Monday afternoon, further west than previous tracks. The current track shows the storm entering Georgia as a possible Category 1 storm in the southeast portion of the State. The current track also puts north Georgia at a higher risk for gusty winds, heavy rain and the possibility for tornadoes and shows the storm getting closer to metro Atlanta.
GHCA is currently seeking guidance on any requirements related to MDS completion for evacuees as well as guidance related to payment for individuals who may evacuate to a skilled nursing center but are not evacuating from a skilled nursing center. We will provide updates as we have them.
Updated 9/7 at 4:15 p.m.
Ahead of Hurricane Irma, Gov. Nathan Deal has expanded his emergency declaration to include 24 additional counties, with a total of 30 counties now included in a state of emergency. Deal also issued a mandatory evacuation order for all areas east of I-95, all of Chatham County and some areas west of I-95 that could be impacted by potential storm surge from Hurricane Irma. The executive order also authorized up to 5,000 Georgia National Guard members to be on state active duty to support Hurricane Irma response and recovery. The state of emergency prohibits price gouging for all goods and services related to the storm. Additionally, the executive order states that contraflow on I-16 will begin at 8 a.m. on Saturday, September 9. Click here to read the full press release.
The 30 counties under a state of emergency are: Appling, Atkinson, Bacon, Brantley, Bryan, Bulloch, Burke, Camden, Candler, Charlton, Chatham, Clinch, Coffee, Echols, Effingham, Emanuel, Evans, Glynn, Jenkins, Jeff Davis, Liberty, Long, McIntosh, Pierce, Screven, Tattnall, Toombs, Treutlen, Wayne and Ware Counties.
A map of mandatory evacuation areas and a list of local emergency management authorities can be found here. Gov. Deal and the State Operation Command Team will hold a news conference Friday morning at 10 a.m. to provide updates on storm preparations. A livestream of the conference will be available here.
Tools & Resources
Continuously Update Bed Counts on GHA911
It is imperative that you log on to GHA911 to update your bed counts at your earliest convenience. It is important that DPH and GEMA have accurate information to work with for emergency placement of evacuating residents. Please update your census information in GHA911 if you have not already done so and continue to update as bed availability changes.
If you are unable to access GHA911, please email your bed availability to Alexandra Benoit, Vulnerable Populations Coordinator of the Division of Health Protection and Emergency Preparedness & Response at the Georgia Department of Public Health via email at firstname.lastname@example.org.
Maintain Contact with Your Local EMA
If you have coordinated evacuation proceedings with another center, please notify your EMA of the plan. This will enable GEMA and the SOC to remain abreast of current status in all of the regions. Also, any request for resources, including supplies or staff, should be directed to the EMA. Directing requests to any other source will slow the response time.
Medicaid Billing Information for Evacuating and Receiving Nursing Centers
GHCA reached out to DCH for the most updated Medicaid billing procedures for centers in the event of an evacuation and received the following guidance:
- No discharges and admissions are necessary as long as the patients are away from the evacuating centers no more than thirty (30) days.
- The evacuating center will be able to bill for their patients up to thirty (30) days.
- Click here for an authorization letter that, once signed by DCH, will be the evacuating center's authorization to bill. Signed letters should be emailed to Wylean Thomas (WThomas1@dch.ga.gov) along with both centers' information (the evacuating and receiving) and a list of the evacuated residents. Wylean will sign the letter and send copies to both centers as well as those cc'd on the document. This letter should be retained in the recipient's file at the facility for auditing purposes.
- Following the weather event, the evacuating and receiving centers should complete and submit the reimbursement collection information spreadsheet to Wylean via email.
Ahead of the storm, the Georgia Board of Nursing voted to implement Policy 1.14 asserting that practical nurses and registered nurses who hold unencumbered licenses in other states may work in established healthcare systems in Georgia, including public health, during an emergency or disaster if:
- The supervision of the out of state nurse is provided by a registered professional nurse with a current, unencumbered Georgia license; and
- The healthcare/public health system verifies the current licensure of each out of state nurse and provide names and license number of each out of state nurse to the Georgia Board of Nursing within fifteen (15) days of initial credentialing verification through www.nursys.com or the board of nursing under which the nurse is licensed.
Inquiries Regarding Dialysis Patient Placement
For inquiries concerning dialysis patient placement, please refer to the End Stage Renal Disease (ESRD) Network for assistance with placing patients.
End Stage Renal Disease Network
Main Phone: 919-463-4500
Toll-Free Patient Line: (800) 524-7139
Shannon Wright Executive Director Cell Phone: (516) 697-4330
Anna Bennett, Education Coordinator Cell Phone: (917) 826-7495
In addition to contacting the ESRD Network for help with placing dialysis patients, there are three large dialysis corporations (LDOs) that treat the majority of dialysis patients (Davita, Fresinius and DCI). If you have a patient who is unable to get in contact with their dialysis unit – or if they need dialysis and they know the NAME of the corporation that runs their dialysis clinic, you can also contact the dialysis corporation hotline:
DaVita Emergency Hotline: 1-800-400-8331
DCI Emergency Hotline: 1-866-424-1990
Fresenius Emergency Hotline: 1-800-626-1297
Additional Dialysis providers with a presence in Georgia:
U.S. Renal Care: 1-866-671-8772
American Renal Associates: 1-888-880-6867
Free XFinity WiFi Hotspots for Irma
To help residents and emergency personnel stay connected if Hurricane Irma makes its anticipated landfall in Georgia, Comcast is opening nearly 10,000 Xfinity WiFi hotspots throughout impacted areas to anyone who needs them, including non-Xfinity customers, for free.
Comcast has opened up all WiFi hotspots in Savannah and surrounding communities, as well as in Augusta and Brunswick. For a map of the Xfinity WiFi hotspots, which are located both indoors and outdoors in places such as shopping districts, parks, and businesses, residents can visit www.Xfinity.com/wifi. Once in range of a hotspot, they may select the “xfinitywifi” network name in the list of available hotspots and then launch a browser.
Xfinity internet customers can sign in with their usernames and passwords, and they will be automatically connected to Xfinity WiFi hotspots in the future. Non-Xfinity internet subscribers should visit the “Not an Xfinity Internet Customer” section on the sign-in page to get started. Non-customers will be able to renew their complimentary sessions every two hours through September 15, 2017.
Remember that any requests for resources should be directed to your local EMA. Directing requests to any other source will slow the response time. If there is an emergency at your facility, please contact your local Coalition Facilitator (previously referred to as your Health Care Liaison) once you have contacted your local EMA. Your Coalition Facilitator is your direct point of contact to your local Healthcare Coalition.
In preparation for Hurricane Irma's potential impact, centers should also do the following:
- Confirm Southern Link connectivity
- Ensure emergency vehicles and equipment are fueled
- Review disaster supply and augment as indicated
- Participate in any drills and respond to any requests from your Regional Coalition or Council Coordinators in a timely manner
GHCA VP for Quality Advancement & Regulatory Affairs