Other names this process is called: Corporate contingency planning, disaster recovery planning, contingency planning, business resumption planning, business interruption planning, disaster preparedness
Business Continuity Disaster Recovery Are You Ready??
Standard Commercial Property Insurance policies cover fire and theft on premise. Various provisions restrict coverage in insurance policies. Read the entire policy carefully to determine your rights, duties and what is and is not covered.
HME providers’ equipment that is out in patients homes is not usually covered under a Standard Commercial Property policy unless an Equipment Off Premise endorsement is purchased. Equipment off premise provides limited protection for insured property while temporarily at a location not owned, leased or operated by the insured.
Depending on the area, some insurance companies include the endorsement within the property policy
Some companies will not write the endorsement in flood plains
Check with your agent!
Perils normally excluded from Standard Policies
Flood – 75% of disaster declarations result from natural phenomena in which flooding was a major component. If you are unsure, you can find out if you live/operate in a flood prone area from your state emergency management office or Red Cross chapter
Perils normally excluded from Standard Policies
Individuals and business owners can protect themselves from flood losses by purchasing flood insurance through the National Flood Insurance Program (there is normally a thirty day waiting period before a new policy becomes effective). Most commercial property policies exclude flood.
Penalties were applied to many HME providers affected by the disaster for “under-insuring”. Generally, most policies required the providers to purchase property coverage at 80% of “in-house” assets (inventory, furniture, fixtures, office equipment, etc).
Earthquake – Coverage for earthquake damage is excluded in most property insurance policies. If you are located in an earthquake-prone area, you’ll need a special insurance policy or commercial property earthquake endorsement
Wind/Hail – Coverage for wind and hail is typically excluded in the coastal regions. If coverage exists, usually a deductable applies; this will be explained in your policy wording.
In a follow up with HME providers, virtually 100% of them maintained patient lists, which included emergency contact, diagnosis, physician/contact information, HME equipment, settings and back-up equipment information.
However, less than half were up to date…many inaccuracies especially in current addresses were noted.
As you identify patients by diagnosis category, you need to assess what resources you need to have to provide ongoing support. Also, it is important where these resources are. Perhaps the most important is…
“This saved us because cell phones, answering services and pagers were done. I was able to reach the General Manager at his home. He was able to contact his employees to help us with liquid base units. In our case, our gas supplier did not have a generator and could not transfill. He did give us all of his liquid base units and “H” cylinders (used as backups). An “H” cylinder full lasts approximately 57 hours on 2 liters.”
Ensure that the backup supplier has a generator and will come to your aid in a crisis situation.
From another member: “ I happened to know a supplier in our area and he was ready if we needed him. It is very important to requote your business when your contract is up. You truly do make contacts and during a crisis this will separate the best from the average companies.”
“We had lights and phones within 1-2 minutes after the blackout. This saved us because our answering service could not handle our calls. We ended up spending the night to ensure our patients were taken care of.”
Even though your HME has a generator, it may not power your computer (e.g., surges, etc). Have a current hard-copy list of oxygen patients, and prioritize contacting those patients without backup oxygen cylinders.
From another member – “Most importantly, have someone in charge that can direct and keep people calm. It was truly a challenge when it was not long after 911 and without notice our communication to the world stopped. Someone needs to take control and have a calming affect until you really know what you are dealing with.”
Payroll continuity is key to continued loyalty of your employees, so make sure your planning addresses your on-going ability to pay employees. It helps them handle disaster-related problems at home and meet their personal financial obligations.
“ At the time we did not have a bonus structure in place for emergencies. Our employees rose to the occasion. I was extremely proud of them for going above and beyond. After the blackout, we instituted a bonus plan and paid employees a bonus. We had a luncheon meeting and presented all employees with the bonus. It went over so well. I really have to say it was one of the most moving moments for me. These people love and care for our patients. We even serviced patients that were not ours, just because we are who we are.”
One of your most valuable assets is your employees. In the event a disaster occurs, you need to protect yourself and your staff. You also have to consider the possible impact a disaster will have on your employees ability or desire to return to work.
Create and maintain an employee contact list with current address and phone numbers for each person on staff.
Create a “calling tree”. Use your employees contact list to fill out a calling tree. Maintain and keep this in an accessible location. Also make sure a copy is offsite. The person designated as “primary” on the tree should be the one responsible for the tree and for calls by fellow employees.
Have you considered the need for alternative forms of transportation for employees? Rental vehicles?
You need to be prepared if a disaster occurs and your employees don’t want to return to the area. You may need to consider issues such as alternative housing options and ways to replace the knowledge base lost if employees don’t return to work.
Store a hard copy of your vital information such as your employee data and payroll in a fire-proof box off-site. Some experts recommend at least 50 miles away. Make it a critical part of your routine to regularly back up your personnel and payroll files
More companies are using internet based back up companies who routinely back up critical information. Then the information is readily available from any internet ready source.
Planning is required so that when a disaster or emergency occurs, inquiries from the news media, patients, referral sources and staff can be handled effectively. It is easier to compose communications in advance, with time to think, than it is in the face of a crisis.
Identify a Spokesperson. Within the HME communication team, there should be an individual who is authorized to speak for the company. That person should be an effective communicator.
Anticipate and prepare universal talking points. You need to make sure the facts presented to the public are accurate and positive. Be proactive and prepared for a crisis. Hold a Communication Team meeting and identify possible crises that can occur. Think in advance about “canned” responses to different situations.
In this electronic-age, you rely more than ever on your computers to supply you with the information you need. Chances are every piece of data you might ever rely on to make an important decision has been reduced to a digital format and resides somewhere on a computer hard drive.
Improved functionality and productivity are the benefits of technology, however on the flipside, one wrong click, one nasty virus, one untimely power surge, one unhappy employee or one natural disaster and that data can be gone forever!
Having hard copies of data important to your company is crucial to recovery. Data is located in many places throughout your business, even if you are “computerized”. Use the Data Backup Worksheet to help you identify what data you need and determine if it’s backed up and where. Then use the Risk Assessment worksheet. These two worksheets will help you determine where your data backups need to reside for the greatest level of protection for your business.
You need to make sure that your backup process is working before you need it. A simple way to test the effectiveness of your backup procedures is to create a test file that is backed up during your normal backup process. Delete this file from your computer and attempt a restore from your backup media. We suggest doing this at least twice a year.
As you are well aware, certain documents are extremely important to an HME business, including patient medical records and CMN’s. In the planning process you must consider how you would deal with the potential loss of these important documents. Consider the purchase of scanning capabilities to “image” patient CMN’s and other papers that are crucial to your business.
Contact Information. Make sure a list of all contact information for utilities, contractors, building maintenance, any company that is involved in physical building is kept offsite.
Included in this list will be all account numbers, any contractual information or any other pertinent information. Make sure you also have a telephone list for all employees that would be involved with fire, police and emergency personnel.
Setup Building Safe Area. Identify safe areas in building if disaster occurs during business hours.
Identify these areas with appropriate signage, e.g., Tornado Shelter
In case of fire, designate an area outside the building where employees should meet. If building is unavailable, have predetermined location for personnel to meet after a disaster. Have two alternates, just in case disaster is wide spread.
Office Equipment Inventory. Keep an inventory of all office equipment, copiers, office machines, desks, chairs, fixtures, etc, and whether you own or lease.
You should explore rental options to replace damaged equipment during the time it is being repaired or replaced and request written estimates of rental, set-up, shipping costs and delivery times. This is particularly important if you rely on equipment that is highly specialized or difficult to replace. Be sure to add the rental companies you have contacted to your Suppliers/Vendors form.
Transportation Needs. Don’t forget your cars/delivery vans. Plan to protect them, but also have alternate plans to meet your essential transportation needs.
Essential Equipment List. After a disaster a building might not be entered for more than a few minutes. Have predetermined list of critical items (if salvageable) that you would need to retrieve. Items such as computers, computer disks, certain paper files and work in progress.
Determining how your patients, referral sources and employees reach you during an incident is critical. Whether it is by voice, email, fax or snail mail, you need to pre-plan how you will be contacted!
Consider alternative forms of communications. Should your phone system not be working, it is necessary to keep in touch with your employees and patients. In anticipation of a break in all phone service, including cell phones, some alternatives would be simple two-way radios, satellite phones and pagers that send signals to each other.
Recovery Location. As you think about your voice communication needs at your recovery location, determine whether you will need speakerphones, voice mail capacity or the ability to record conversations. Also decide if you will need conference calling capability in order to have conference calls with employees, key contacts and/or patients to assess disaster damage and to make recovery decisions.
If your fax machine is directly connected to a telephone line, you should be able to plug a plain telephone into the connection the fax uses and make phone calls. This is because the local phone company has extensive back up power.
Consider purchasing back-up “Plain Old Telephone” sets(very inexpensive!)
Importance Communications Records (Keep Offsite) & To Do..
Local phone service-get “Customer Service Record”, all contact information, discuss emergency options
Answering service-get contact information; ask what services they offer
It is essential that senior leadership of the HME organization sponsors and takes responsibility for creating, maintaining, testing and implementing these steps. This will insure that management and staff at all levels understand that preparedness is a critical top management priority.
“The fact of the matter is, when it comes to pandemics, we are overdue and we are under-prepared,” warned U.S. Health and Human Services Secretary Mike Leavitt at a forum at the National Press Club in Washington D.C.
HHS’s Home Health Care Services Pandemic Influenza Planning Checklist is now available!
Please download, review and complete this document carefully!
Establish policies to be implemented during a pandemic:
Establish policies for employee compensation and sick-leave absences unique to a pandemic (e.g. non-punitive, liberal leave), including policies on when a previously ill person is no longer infectious and can return to work after illness.
Establish policies for flexible worksite (e.g. telecommuting) and flexible work hours (e.g. staggered shifts).
Establish policies for preventing influenza spread at the worksite e.g., promoting respiratory hygiene/cough etiquette, and prompt exclusion of people with influenza systems.
Establish policies for employees who have been exposed to pandemic influenza, are suspected to be ill or become ill at the worksite (e.g. infection control response, immediate mandatory sick leave).
Establish policies for restricting travel to affected geographic areas, evacuating employees working in or near an affected area when an outbreak begins, and guidance for employees returning from affected areas (refer to CDC travel recommendations).
Set up authorities, triggers and procedures for activating and terminating the company’s response plan, altering business operations (e.g. shutting down operations in affected areas), and transferring business knowledge to key employees.