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CMS Should Take Additional Actions To Help Hospitals Prepare for a Future Emerging Infectious Disease Outbreak

Issued on  | Posted on  | Report number: A-02-22-01019

Why OIG Did This Audit

  • Hospitals that cannot control the spread of emerging infectious diseases within their facilities risk spreading diseases to patients, staff, and the community. This is the second OIG audit of CMS controls related to hospital preparedness for emerging infectious diseases.
  • Our prior audit assessed the design and implementation of CMS controls. This audit assessed the operating effectiveness of CMS controls related to emerging infectious disease outbreaks.

What OIG Found

Although CMS took significant actions to help hospitals prepare for a future emerging infectious disease outbreak, we identified gaps in CMS controls that could negatively affect hospital preparedness during a future event with a scope and duration similar to COVID-19. Specifically:

  • CMS did not ensure that surveyors were trained to cover key planning areas for an emerging infectious disease outbreak.
  • CMS did not ensure that hospital emergency preparedness plans met the needs of all at-risk patient populations.
  • CMS’s guidance did not address the mental health of hospital frontline staff as part of hospital emergency preparedness planning

What OIG Recommends

We made five recommendations to CMS, including that it collaborate with its emergency preparedness partners to expand surveyor training, require that hospital accreditation organization standards and survey processes cover the needs of people from all at-risk patient populations, and encourage hospitals to take into consideration the mental health of hospital frontline staff as part of emergency preparedness planning. The full recommendations appear in the report.

CMS concurred with all five recommendations, with some limitations, and described actions it plans to take in response to our recommendations.

25-A-02-086.01 to CMS - Open Unimplemented
Update expected on 01/24/2026
We recommend that the Centers for Medicare & Medicaid Services collaborate with its emergency preparedness partners to expand SSA surveyor training to include key planning areas related to emerging infectious diseases consistent with CMS interpretive guidelines.

25-A-02-086.02 to CMS - Open Unimplemented
Update expected on 01/24/2026
We recommend that the Centers for Medicare & Medicaid Services require AO surveyor training to include key planning areas related to emerging infectious diseases comparable to those included for SSA surveyors.

25-A-02-086.03 to CMS - Open Unimplemented
Update expected on 01/24/2026
We recommend that the Centers for Medicare & Medicaid Services, as part of CMS's accreditation review process, require AOs' hospital emergency preparedness standards to include addressing the needs of individuals from all at-risk patient populations.

25-A-02-086.04 to CMS - Open Unimplemented
Update expected on 01/24/2026
We recommend that the Centers for Medicare & Medicaid Services require that AOs' hospital survey processes include verifying that hospital emergency plans address the needs of all at-risk patient populations.

25-A-02-086.05 to CMS - Open Unimplemented
Update expected on 01/24/2026
We recommend that the Centers for Medicare & Medicaid Services encourage hospitals to take into consideration the mental health of hospital frontline staff as part of emergency preparedness planning.

View in Recommendation Tracker