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        "title": "Build emergency readiness around the RNHCI care model",
        "summary": "Use 42 CFR 403.748 - Emergency preparedness to review this narrow operational decision without extending the source beyond its stated scope.",
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        "reviewed_on": "2026-08-26",
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        "potentially_affected": "Teams, systems, services, or facilities within the stated scope of 42 CFR 403.748 - Emergency preparedness",
        "dse_recommendation": "Compare the observed state with the cited official source, document applicability and exceptions, and test any approved change with rollback safeguards.",
        "primary_source": {
            "name": "42 CFR 403.748 - Emergency preparedness",
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        "content_html": "<p>Use this document to resolve one bounded operational decision: Build emergency readiness around the RNHCI care model. Only the official source and traced locations below supply facts. Confirm applicability before acting.</p>\n<h2>Source fact:</h2>\n<p>The official <a href=\"https://www.ecfr.gov/current/title-42/section-403.748\" target=\"_blank\" rel=\"noopener noreferrer\">42 CFR 403.748 &#8211; Emergency preparedness</a> from Centers for Medicare &amp; Medicaid Services via eCFR supports the following bounded statements:</p>\n<ul>\n<li>Under 42 CFR 403, the rule requires that the RNHCI develop and maintain an emergency preparedness training and testing program that is based on the emergency plan set forth in paragraph (a) of this section, risk assessment at paragraph (a)(1) of this section, policies and procedures at paragraph (b) of this section, and the communication plan at paragraph (c) of this section. The research record locates this support at <strong>42 CFR 403.748(d) (eCFR anchor p-403.748(d))</strong>.</li>\n<li>Under 42 CFR 403, the rule requires that if the emergency preparedness policies and procedures are significantly updated, the RNHCI conduct training on the updated policies and procedures. The research record locates this support at <strong>42 CFR 403.748(d)(1)(v) (eCFR anchor p-403.748(d)(1)(v))</strong>.</li>\n</ul>\n<p>Only the traced statements above are asserted as source facts. Apply the review to essential functions, upstream providers, recovery sequences, alternate work paths, and tested recovery objectives after confirming that the source and deployed context match.</p>\n<h2>What the source does not establish</h2>\n<p>Provider-specific federal participation requirement; confirm current certification status, waivers, survey guidance, state law, and the complete section before applying it. A correct source interpretation can still be inapplicable to a particular design. Confirm identity, DNS, communications, facilities, suppliers, and the people authorized to invoke recovery, ownership, and change authority instead of treating documented behavior as a deployment guarantee.</p>\n<h2>Applicability questions</h2>\n<ul>\n<li>For source statement 1 at <strong>42 CFR 403.748(d) (eCFR anchor p-403.748(d))</strong>, which observable configuration, record, or test can confirm applicability here?</li>\n<li>For source statement 2 at <strong>42 CFR 403.748(d)(1)(v) (eCFR anchor p-403.748(d)(1)(v))</strong>, which observable configuration, record, or test can confirm applicability here?</li>\n<li>Which deployed instance of essential functions, upstream providers, recovery sequences, alternate work paths, and tested recovery objectives will be compared with the source, and why that instance?</li>\n<li>How will the review distinguish a source mismatch from a failure in identity, DNS, communications, facilities, suppliers, and the people authorized to invoke recovery?</li>\n<li>Who approves the conclusion, exception, test window, and rollback threshold?</li>\n</ul>\n<h2>DSE recommendation:</h2>\n<p>DSE recommends using the cited source as the evidence anchor for this decision. Begin by recording scope and current state before deciding whether a change is warranted. Record the source location, examined part of essential functions, upstream providers, recovery sequences, alternate work paths, and tested recovery objectives, observed and expected states, owner, and reason for deviation.</p>\n<p>Do not move from citation to production in one step. Pilot the decision where practical, observe agreed signals, retain a reversal point, and verify identity, DNS, communications, facilities, suppliers, and the people authorized to invoke recovery. Handle credentials, keys, recovery data, and personal information through approved secure channels.</p>\n<h2>Verification and evidence</h2>\n<p>A reviewer should be able to retrace the decision from <strong>42 CFR 403.748(d) (eCFR anchor p-403.748(d))</strong>; <strong>42 CFR 403.748(d)(1)(v) (eCFR anchor p-403.748(d)(1)(v))</strong> through business-impact records, dependency maps, exercise results, recovery timings, and open corrective actions. Record what was collected, where, when, by whom, and which system or role it represents.</p>\n<p>Preserve both successful and failed observations, along with approval and rollback evidence. Avoid uncontrolled production experiments. Assign an expiry or event-driven recheck so the conclusion is not treated as permanent.</p>\n<h2>Official references</h2>\n<ul>\n<li><a href=\"https://www.ecfr.gov/current/title-42/section-403.748\" target=\"_blank\" rel=\"noopener noreferrer\">42 CFR 403.748 &#8211; Emergency preparedness</a> — Centers for Medicare &amp; Medicaid Services via eCFR</li>\n</ul>",
        "content_text": "Use this document to resolve one bounded operational decision: Build emergency readiness around the RNHCI care model. Only the official source and traced locations below supply facts. Confirm applicability before acting.\nSource fact:\nThe official 42 CFR 403.748 – Emergency preparedness from Centers for Medicare & Medicaid Services via eCFR supports the following bounded statements:\n\nUnder 42 CFR 403, the rule requires that the RNHCI develop and maintain an emergency preparedness training and testing program that is based on the emergency plan set forth in paragraph (a) of this section, risk assessment at paragraph (a)(1) of this section, policies and procedures at paragraph (b) of this section, and the communication plan at paragraph (c) of this section. The research record locates this support at 42 CFR 403.748(d) (eCFR anchor p-403.748(d)).\nUnder 42 CFR 403, the rule requires that if the emergency preparedness policies and procedures are significantly updated, the RNHCI conduct training on the updated policies and procedures. The research record locates this support at 42 CFR 403.748(d)(1)(v) (eCFR anchor p-403.748(d)(1)(v)).\n\nOnly the traced statements above are asserted as source facts. Apply the review to essential functions, upstream providers, recovery sequences, alternate work paths, and tested recovery objectives after confirming that the source and deployed context match.\nWhat the source does not establish\nProvider-specific federal participation requirement; confirm current certification status, waivers, survey guidance, state law, and the complete section before applying it. A correct source interpretation can still be inapplicable to a particular design. Confirm identity, DNS, communications, facilities, suppliers, and the people authorized to invoke recovery, ownership, and change authority instead of treating documented behavior as a deployment guarantee.\nApplicability questions\n\nFor source statement 1 at 42 CFR 403.748(d) (eCFR anchor p-403.748(d)), which observable configuration, record, or test can confirm applicability here?\nFor source statement 2 at 42 CFR 403.748(d)(1)(v) (eCFR anchor p-403.748(d)(1)(v)), which observable configuration, record, or test can confirm applicability here?\nWhich deployed instance of essential functions, upstream providers, recovery sequences, alternate work paths, and tested recovery objectives will be compared with the source, and why that instance?\nHow will the review distinguish a source mismatch from a failure in identity, DNS, communications, facilities, suppliers, and the people authorized to invoke recovery?\nWho approves the conclusion, exception, test window, and rollback threshold?\n\nDSE recommendation:\nDSE recommends using the cited source as the evidence anchor for this decision. Begin by recording scope and current state before deciding whether a change is warranted. Record the source location, examined part of essential functions, upstream providers, recovery sequences, alternate work paths, and tested recovery objectives, observed and expected states, owner, and reason for deviation.\nDo not move from citation to production in one step. Pilot the decision where practical, observe agreed signals, retain a reversal point, and verify identity, DNS, communications, facilities, suppliers, and the people authorized to invoke recovery. Handle credentials, keys, recovery data, and personal information through approved secure channels.\nVerification and evidence\nA reviewer should be able to retrace the decision from 42 CFR 403.748(d) (eCFR anchor p-403.748(d)); 42 CFR 403.748(d)(1)(v) (eCFR anchor p-403.748(d)(1)(v)) through business-impact records, dependency maps, exercise results, recovery timings, and open corrective actions. Record what was collected, where, when, by whom, and which system or role it represents.\nPreserve both successful and failed observations, along with approval and rollback evidence. Avoid uncontrolled production experiments. Assign an expiry or event-driven recheck so the conclusion is not treated as permanent.\nOfficial references\n\n42 CFR 403.748 – Emergency preparedness — Centers for Medicare & Medicaid Services via eCFR",
        "content_markdown": "Use this document to resolve one bounded operational decision: Build emergency readiness around the RNHCI care model. Only the official source and traced locations below supply facts. Confirm applicability before acting.\n\n## Source fact:\n\nThe official [42 CFR 403.748 – Emergency preparedness](https://www.ecfr.gov/current/title-42/section-403.748) from Centers for Medicare & Medicaid Services via eCFR supports the following bounded statements:\n\n- Under 42 CFR 403, the rule requires that the RNHCI develop and maintain an emergency preparedness training and testing program that is based on the emergency plan set forth in paragraph (a) of this section, risk assessment at paragraph (a)(1) of this section, policies and procedures at paragraph (b) of this section, and the communication plan at paragraph (c) of this section. The research record locates this support at 42 CFR 403.748(d) (eCFR anchor p-403.748(d)).\n\n- Under 42 CFR 403, the rule requires that if the emergency preparedness policies and procedures are significantly updated, the RNHCI conduct training on the updated policies and procedures. The research record locates this support at 42 CFR 403.748(d)(1)(v) (eCFR anchor p-403.748(d)(1)(v)).\n\nOnly the traced statements above are asserted as source facts. Apply the review to essential functions, upstream providers, recovery sequences, alternate work paths, and tested recovery objectives after confirming that the source and deployed context match.\n\n## What the source does not establish\n\nProvider-specific federal participation requirement; confirm current certification status, waivers, survey guidance, state law, and the complete section before applying it. A correct source interpretation can still be inapplicable to a particular design. Confirm identity, DNS, communications, facilities, suppliers, and the people authorized to invoke recovery, ownership, and change authority instead of treating documented behavior as a deployment guarantee.\n\n## Applicability questions\n\n- For source statement 1 at 42 CFR 403.748(d) (eCFR anchor p-403.748(d)), which observable configuration, record, or test can confirm applicability here?\n\n- For source statement 2 at 42 CFR 403.748(d)(1)(v) (eCFR anchor p-403.748(d)(1)(v)), which observable configuration, record, or test can confirm applicability here?\n\n- Which deployed instance of essential functions, upstream providers, recovery sequences, alternate work paths, and tested recovery objectives will be compared with the source, and why that instance?\n\n- How will the review distinguish a source mismatch from a failure in identity, DNS, communications, facilities, suppliers, and the people authorized to invoke recovery?\n\n- Who approves the conclusion, exception, test window, and rollback threshold?\n\n## DSE recommendation:\n\nDSE recommends using the cited source as the evidence anchor for this decision. Begin by recording scope and current state before deciding whether a change is warranted. Record the source location, examined part of essential functions, upstream providers, recovery sequences, alternate work paths, and tested recovery objectives, observed and expected states, owner, and reason for deviation.\n\nDo not move from citation to production in one step. Pilot the decision where practical, observe agreed signals, retain a reversal point, and verify identity, DNS, communications, facilities, suppliers, and the people authorized to invoke recovery. Handle credentials, keys, recovery data, and personal information through approved secure channels.\n\n## Verification and evidence\n\nA reviewer should be able to retrace the decision from 42 CFR 403.748(d) (eCFR anchor p-403.748(d)); 42 CFR 403.748(d)(1)(v) (eCFR anchor p-403.748(d)(1)(v)) through business-impact records, dependency maps, exercise results, recovery timings, and open corrective actions. Record what was collected, where, when, by whom, and which system or role it represents.\n\nPreserve both successful and failed observations, along with approval and rollback evidence. Avoid uncontrolled production experiments. Assign an expiry or event-driven recheck so the conclusion is not treated as permanent.\n\n## Official references\n\n- [42 CFR 403.748 – Emergency preparedness](https://www.ecfr.gov/current/title-42/section-403.748) — Centers for Medicare & Medicaid Services via eCFR"
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                "description": "Use 42 CFR 403.748 - Emergency preparedness to review this narrow operational decision without extending the source beyond its stated scope.",
                "abstract": "Use 42 CFR 403.748 - Emergency preparedness to review this narrow operational decision without extending the source beyond its stated scope.",
                "articleBody": "Use this document to resolve one bounded operational decision: Build emergency readiness around the RNHCI care model. Only the official source and traced locations below supply facts. Confirm applicability before acting.\nSource fact:\nThe official 42 CFR 403.748 – Emergency preparedness from Centers for Medicare & Medicaid Services via eCFR supports the following bounded statements:\n\nUnder 42 CFR 403, the rule requires that the RNHCI develop and maintain an emergency preparedness training and testing program that is based on the emergency plan set forth in paragraph (a) of this section, risk assessment at paragraph (a)(1) of this section, policies and procedures at paragraph (b) of this section, and the communication plan at paragraph (c) of this section. The research record locates this support at 42 CFR 403.748(d) (eCFR anchor p-403.748(d)).\nUnder 42 CFR 403, the rule requires that if the emergency preparedness policies and procedures are significantly updated, the RNHCI conduct training on the updated policies and procedures. The research record locates this support at 42 CFR 403.748(d)(1)(v) (eCFR anchor p-403.748(d)(1)(v)).\n\nOnly the traced statements above are asserted as source facts. Apply the review to essential functions, upstream providers, recovery sequences, alternate work paths, and tested recovery objectives after confirming that the source and deployed context match.\nWhat the source does not establish\nProvider-specific federal participation requirement; confirm current certification status, waivers, survey guidance, state law, and the complete section before applying it. A correct source interpretation can still be inapplicable to a particular design. Confirm identity, DNS, communications, facilities, suppliers, and the people authorized to invoke recovery, ownership, and change authority instead of treating documented behavior as a deployment guarantee.\nApplicability questions\n\nFor source statement 1 at 42 CFR 403.748(d) (eCFR anchor p-403.748(d)), which observable configuration, record, or test can confirm applicability here?\nFor source statement 2 at 42 CFR 403.748(d)(1)(v) (eCFR anchor p-403.748(d)(1)(v)), which observable configuration, record, or test can confirm applicability here?\nWhich deployed instance of essential functions, upstream providers, recovery sequences, alternate work paths, and tested recovery objectives will be compared with the source, and why that instance?\nHow will the review distinguish a source mismatch from a failure in identity, DNS, communications, facilities, suppliers, and the people authorized to invoke recovery?\nWho approves the conclusion, exception, test window, and rollback threshold?\n\nDSE recommendation:\nDSE recommends using the cited source as the evidence anchor for this decision. Begin by recording scope and current state before deciding whether a change is warranted. Record the source location, examined part of essential functions, upstream providers, recovery sequences, alternate work paths, and tested recovery objectives, observed and expected states, owner, and reason for deviation.\nDo not move from citation to production in one step. Pilot the decision where practical, observe agreed signals, retain a reversal point, and verify identity, DNS, communications, facilities, suppliers, and the people authorized to invoke recovery. Handle credentials, keys, recovery data, and personal information through approved secure channels.\nVerification and evidence\nA reviewer should be able to retrace the decision from 42 CFR 403.748(d) (eCFR anchor p-403.748(d)); 42 CFR 403.748(d)(1)(v) (eCFR anchor p-403.748(d)(1)(v)) through business-impact records, dependency maps, exercise results, recovery timings, and open corrective actions. Record what was collected, where, when, by whom, and which system or role it represents.\nPreserve both successful and failed observations, along with approval and rollback evidence. Avoid uncontrolled production experiments. Assign an expiry or event-driven recheck so the conclusion is not treated as permanent.\nOfficial references\n\n42 CFR 403.748 – Emergency preparedness — Centers for Medicare & Medicaid Services via eCFR",
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