CMS SOM App. A, Tag A-0703

Interpretive Guidelines §482.41(a)(2)

The hospital must have a system to provide emergency gas and water as needed to provide care

to inpatients and other persons who may come to the hospital in need of care. This includes

making arrangements with local utility companies and others for the provision of emergency

sources of water and gas. The hospital should consider nationally accepted references or

calculations made by qualified staff when determining the need for at least water and gas. For

example, one source for information on water is the Federal Emergency Management Agency

(FEMA).

Emergency gas includes fuels such as propane, natural gas, fuel oil, liquefied natural gas, as well

as any gases the hospital uses in the care of patients such as oxygen, nitrogen, nitrous oxide, etc.

The hospital should have a plan to protect these limited emergency supplies, and have a plan for

prioritizing their use until adequate supplies are available. The plan should also address the

event of a disruption in supply (e.g., disruption to the entire surrounding community).

Survey Procedures §482.41(a)(2)

• Review the system used by hospital staff to determine the hospital’s emergency needs for

gas and water. Verify that the system accounts for not only inpatients, but also staff and

other persons who come to the hospital in need of care during emergencies.

• Determine the source of emergency gas and water, both the quantity of these supplies

readily available at the hospital, and that are needed within a short time through

additional deliveries.

• Verify that arrangements have been made with utility companies and others for the

provision of emergency sources of critical utilities, such as water and gas.