Emergency Preparedness

​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​AHCA/NCAL provides information and resources to help members respond to an emergency in a timely, organized, and effective manner. ​​​


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Staying Warm Safely: Guidance on Space Heater Use in Long Term Care Communitieshttps://www.ahcancal.org/News-and-Communications/Blog/Pages/Staying-Warm-Safely-Guidance-on-Space-Heater-Use-in-Long-Term-Care-Communities-Term-Care-Communities-.aspxStaying Warm Safely: Guidance on Space Heater Use in Long Term Care Communities2/17/2026 5:00:00 AM<p>​<span style="font-size:11pt;">​This winter’s prolonge</span><span style="font-size:11pt;">d and widespread cold has pushed many providers to look more closely at how to keep residents and staff warm and comfortable. Space heaters may seem like a simple fix—especially during sudden temperature drops that strain a building’s heating system—but their use comes with important safety and compliance considerations. </span></p><div><br></div><div><span style="font-size:11pt;"><strong>Regulatory Requirements and Restrictions </strong></span></div><div><span style="font-size:11pt;">The <em>Life Safety Code®</em> places strict limitations on the use of space heaters in health care occupancies. They are <strong>prohibited</strong> unless: </span></div><div><ul><li><span style="font-size:11pt;">They are located <strong>only in nonsleeping staff areas</strong>, and </span></li><li><span style="font-size:11pt;">Their heating elements do <strong>not exceed 212°F</strong>. </span></li></ul></div><div><br></div><div><span style="font-size:11pt;">Because of these requirements, space heaters are rarely permitted in skilled nursing facilities. In a true heating emergency, the authority having jurisdiction (AHJ) may approve temporary use to prevent evacuation. These exceptions, however, vary by jurisdiction, remain time-limited, and require implementation of <strong>interim life safety measures.</strong></span></div><div><br></div><div><span style="font-size:11pt;">Requirements for assisted living and independent living settings are typically governed at the state level. Though they vary, these regulations are often less restrictive than those for skilled nursing. </span></div><div><br></div><div><span style="font-size:11pt;"><strong>Safe Use Practices When Space Heaters Are Allowed </strong></span></div><div><span style="font-size:11pt;">If your setting permits space heaters, follow these recommended best practices to minimize risk: </span></div><div><ul><li><span style="font-size:11pt;">Choose <strong>electric</strong>, portable heaters without open flames. Select units that use <strong>self-contained</strong> <strong>water or oil</strong> rather than exposed coils or heating wires.</span></li><li><span style="font-size:11pt;">Use only devices <strong>listed by recognized testing laboratories</strong> (UL, FM, etc.). </span></li><li><span style="font-size:11pt;">Ensure heaters include <strong>tip over protection and overheat protection</strong>.</span></li><li><span style="font-size:11pt;">Select models with <strong>thermostats and automatic shutoff features</strong>. </span></li><li><span style="font-size:11pt;">Place heaters on <strong>solid, flat floor surfaces</strong>—never on counters, tables, or carpets. </span></li><li><span style="font-size:11pt;">Plug heaters <strong>directly into a wall outlet</strong>. Do not use extension cords or surge protectors, and ensure the plug is grounded (three-pronged). </span></li><li><span style="font-size:11pt;"><strong>Turn off and unplug heaters</strong> when not in use. </span></li><li><span style="font-size:11pt;">Keep <strong>at least three feet of clearance</strong> between heaters and combustible materials. </span></li></ul></div><div><br></div><div><span style="font-size:11pt;"><strong>Safe Alternatives to Maintain Comfort </strong></span></div><div><span style="font-size:11pt;">Maintaining a warm environment isn’t just a comfort issue; it’s a regulatory requirement under <strong>F584</strong>. Space heaters are not the only option. Consider these safer, compliant alternatives: </span></div><div><ul><li><span style="font-size:11pt;"><strong>Electric blankets or heated mattress pads</strong>, when appropriate. </span></li><li><span style="font-size:11pt;"><strong>Layered clothing</strong>, such as sweaters, sweatshirts, socks, and slippers. </span></li><li><span style="font-size:11pt;"><strong>Warm beverages and snacks</strong> to help maintain core body temperature. </span></li><li><span style="font-size:11pt;"><strong>Repositioning residents</strong> away from drafty windows and doors. </span></li><li><span style="font-size:11pt;">Creating activity or seating areas in parts of the building that naturally retain heat. </span></li></ul></div><div><br></div><div><span style="font-size:11pt;"><strong>Incorporating Heat Loss into Emergency Planning</strong> </span></div><div><span style="font-size:11pt;">As you annually update your <strong>Hazard Vulnerability Assessment (HVA)</strong>, ensure that heat loss scenarios are fully addressed. A comprehensive plan should include: </span></div><div><ul><li><span style="font-size:11pt;">Strategies for preserving a warm, safe environment </span></li><li><span style="font-size:11pt;">Contact lists for heating vendors and emergency repair services </span></li><li><span style="font-size:11pt;">Details of service agreements and backup options </span></li><li><span style="font-size:11pt;">Contingency plans for <strong>evacuation</strong>, which may be necessary if heating systems will be down for an extended period during extreme cold </span></li></ul></div><div><br></div><div><strong style="font-size:11pt;">Additional Resources</strong><span style="font-size:11pt;"> </span></div><div><span style="font-size:11pt;">For more tools to support preparedness, compliance, and safety, visit the </span><a href="/Survey-Regulatory-Legal/Emergency-Preparedness/Pages/default.aspx" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank" style="font-size:11pt;"><strong>AHCA/NCAL website​</strong></a><span style="font-size:11pt;"><strong>.</strong></span></div><p>​<br><br><br></p>This winter’s prolonged and widespread cold has pushed many providers to look more closely at how to keep residents and staff warm and comfortable.
Maintenance Director Training Expanded in ahcancalEDhttps://www.ahcancal.org/News-and-Communications/Blog/Pages/Maintenance-Director-Training-Expanded-in-ahcancalED.aspxMaintenance Director Training Expanded in ahcancalED2/17/2026 5:00:00 AM<p></p><div>The Emergency Preparedness & Life Safety Committee is excited to announce the expansion of the <a href="https://educate.ahcancal.org/products/maintenance-director-training" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">Maintenance Director Training Course</a>, available on ahcancalED. This new resource is designed to support long term care facility managers and maintenance directors in building compliant environmental programs that meet regulatory standards.  </div><div><br></div><div><span style="font-size:11pt;">The Maintenance Di</span><span style="font-size:11pt;">rector Training Course is structured into four focused modules, each addressing critical areas of facility safety and compliance:  </span></div><div><br></div><div><ol><li>Maintenance Director Overview  </li><li><span style="font-size:11pt;">Fire and Smoke Door Inspection  </span></li><li><span style="font-size:11pt;">Generator Inspection, Testing, and Maintenance  </span><span style="font-size:11pt;">​</span></li><li>Portable Patient Care Related Electrical Equipment (PCREE) Testing  </li><li><span style="font-size:11pt;">Kitchen Fire Safety & Compliance  </span></li><li><span style="font-size:11pt;">Oxygen Cylinder Storage  </span></li><li><span style="font-size:11pt;">Sprinkler System Inspection, Testing, and Maintenance  </span></li></ol></div><div><span style="font-size:11pt;"></span></div><div><br></div><div><span style="font-size:11pt;">Each module includes educational videos, downloadable PowerPoint presentations, and handouts to support learning and implementation.   </span></div><div><br></div><div>Whether you’re looking to train new staff or reinforce existing protocols, this course offers flexible learning options. Modules can be completed individually or as a full series, allowing facilities to tailor the experience to their specific needs.  </div><div><br></div><div>Upon successful completion, participants will receive a certificate that can be used to demonstrate competency in fire and smoke door inspections, fulfilling annual requirements under NFPA 80 and NFPA 105, as part of the 2012 Life Safety Code®. <br></div><p>​</p>The Emergency Preparedness & Life Safety Committee is excited to announce the expansion of the Maintenance Director Training Course, available on ahcancalED.
New Laundry Fire Safety Toolhttps://www.ahcancal.org/News-and-Communications/Blog/Pages/New-Laundry-Fire-Safety-Tool.aspxNew Laundry Fire Safety Tool1/20/2026 5:00:00 AM<p>​<span style="font-size:11pt;">Laundry fires are one of the more common fire situations in healthcare settings, especially in long term care. Organizations are continually using and laundering linens, clothing, and cleaning items such as mop heads, rags, and towels. Factors such as chemical use, dryer heat, and lint build-up can significantly increase the potential for fires in laundry locations. Prevention is the most effective mechanism to reduce the potential for a laundry related fire.   </span></p><div><span style="font-size:11pt;">AHCANCAL recently published a tool for prevention guidelines, best practices and a template laundry safety checklist for both skilled nursing and assisted living providers, found </span><a href="/Survey-Regulatory-Legal/Emergency-Preparedness/MemberOnlyDocs/Laundry%20Fire%20Safety%20Tool%20AHCANCAL%202026.docx" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank" style="font-size:11pt;">here</a><span style="font-size:11pt;">.  </span></div><div><br></div><div>Questions can be sent to <a href="mailto:emergencyprep@ahca.org" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">emergencyprep@ahca.org​</a>.  <br></div><div>    <br></div><p>​</p>Laundry fires are one of the more common fire situations in healthcare settings, especially in long term care.
New Maintenance Director Training Course Launches on ahcancalEdhttps://www.ahcancal.org/News-and-Communications/Blog/Pages/New-Maintenance-Director-Training-Course-Launches-on-ahcancalEd-.aspxNew Maintenance Director Training Course Launches on ahcancalEd9/29/2025 4:00:00 AM<p>​<span style="font-size:11pt;">The Emergency Preparedness & Life Safety Committee is excited to announce the launch of the <a href="https://educate.ahcancal.org/products/maintenance-director-training" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">Maintenance Director Training Course</a>, now available on ahcancalED. This new resource is designed to support long term care facility managers and maintenance directors in building compliant environmental programs that meet regulatory standards. </span></p><div><br></div><div>The Maintenance Director Training Course is structured into four focused modules, each addressing critical areas of facility safety and compliance: <br></div><div><br></div><div><ol><li>Maintenance Director Overview </li><li><span style="font-size:11pt;">Fire and Smoke Door Inspection </span></li><li><span style="font-size:11pt;">Generator Inspection, Testing, and Maintenance </span></li><li><span style="font-size:11pt;">Portable Patient-Care Related Electrical Equipment (PCREE) Testing </span></li></ol></div><div><br></div><div><span style="font-size:11pt;">Each module includes educational videos, downloadable PowerPoint presentations, and handouts to support learning and implementation.  </span></div><div><br></div><div>Whether you’re looking to train new staff or reinforce existing protocols, this course offers flexible learning options. Modules can be completed individually or as a full series, allowing facilities to tailor the experience to their specific needs. </div><div><br></div><div>Upon successful completion, participants will receive a certificate that can be used to demonstrate competency in fire and smoke door inspections, fulfilling annual requirements under NFPA 80 and NFPA 105, as part of the 2012 Life Safety Code®. </div><div><br></div><div>To kick off the launch, AHCA/NCAL members are invited to a <a href="https://educate.ahcancal.org/products/maintenance-director-training" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">live webinar</a> on October 1 at 1PM EST. Attendees will get an overview of the training program and be able to participate in a live Q&A session with life safety experts. <em>Registration is free for AHCA/NCAL members. </em><br></div><p>​</p>The Emergency Preparedness & Life Safety Committee is excited to announce the launch of the Maintenance Director Training Course, now available on ahcancalED.

 Top Resources

 Assisted Living Resources
​The Emergency Preparedness Guide for Assisted Living is a comprehensive resource that will assist members with developing emergency operations plan and includes the planning process. The guide includes templates and numerous resources for members to utilize.

 

Assisted Living Incident Command System (ALICS)

The Incident Command System (ICS) is one component of the National Incident Management System or (NIMS). The Assisted Living IncidentCommand System or “ALICS” is a simplified ICS and through its use, long-term care providers can become part of this standardized system of efficient response. ICS was modified by two consultants for assisted living and reviewed by AALNA board members and then reviewed by the NCAL Workgroup of the AHCA/NCAL Emergency Preparedness Committee.

ALICS offers long-term care providers a flexible framework for command and control that is based on the standardized system of ICS. It does this through a system that is designed to:
  • Manage all emergency, routine, or planned events, of any size or type, by establishing a clear chain of command and a process for communication, decision‐making and delegation.
  • Allow personnel from different agencies or departments to be integrated into a common structure that can effectively address issues and delegate responsibilities.
  • Provide needed logistical and administrative support to operational personnel.​

 Planning Ahead
​In order to effectively handle disasters and emergencies, it is important for centers to plan ahead and prepare in advance. Long term and post-acute care centers can use a targeted approach to addressing vulnerabilities and hazards to help them best respond to and recover from events. This site seeks to assist centers in creating a plan to address its greatest risks:
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Hazard Vulnerability Assessment
The Hazard Vulnerability Assessment (HVA) is a tool designed to assist centers in evaluating vulnerability to specific hazards. The tool uses various categories, such as probability of experiencing a hazard, human impact, property and business impact and response, to create a numeric value based on various hazards.

 Incident Command System
The Incident Command System is part of the emergency management system in many levels (federal, state, and local). Every significant incident or event, whether large or small, and whether it is even defined as an emergency, requires certain management functions to be performed.

The Nursing Home Incident Command System (NHICS) and Assisted Living Incident Command System (ALICS) outline a management framework that empowers long-term care staff to improve the effectiveness and efficiency of their incident response -- no matter what shift, or what day of the week the event occurs. ​​

Resources

 ‭(Hidden)‬ CMS Emergency Preparedness Rule
The Emergency Preparedness Final Rule was released on Friday, September 16, 2016. AHCA, along with guest speakers, will hold a webinar series event​ this year on the new emergency preparedness final rule impacting Skilled Nursing Facilities (SNF), Nursing Facilities (NF) and Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID). This final rule is not applicable to Assisted Living Providers. 

Providers will need to be in compliance by November 15th 2017. The webinar series will include, special guest speakers, an overview of the key new requirements, a list of tools to assess if you are prepared for the rule, steps to take now to prepare.

On Friday, September 1st, CMS released a memorand​um 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 15th, 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.

Members are strongly encouraged to review and complete the training as it includes quizzes and exercises to check understanding. The training states to surveyors that the requirements do not prescribe or mandate specific technology or tools nor detailed requirements for how facilities should write emergency plans. The training includes the questions surveyors will ask and how documentation will be reviewed and checked. Links to resources and glossary terms are also included.​

​Emergency Resources

In addition to planning for natural disasters, staff and facilities must be prepared for other emergencies, such as pandemics, influenza, active shooters and more. All emergency situations must be handled swiftly, diligently and with the utmost care for staff and patients.

 Active Shooter
​While many emergencies are caused by natural disasters and are, staff and facilities should also be prepared for other types of emergencies. One emergency for which facilities should have plans in place is an active shooter.
Please note: The policies below are models only and should be modified and tailored to meet the needs of individual communities. 

External Resources

 Pandemic and Influenza

For more information on specific conditions, prevention, and treatment, please visit the Clinical Practice website.

Pandemic and Influenza Resources

 Shelter In Place
​​Shelter In Place: Planning Resource Guide for Nursing Homes

For the purposes of this resource guide, shelter in place (SIP) is defined as: A protective action strategy taken to maintain resident care in the facility and to limit the movement of residents, staff and visitors in order to protect people and property from a hazard.

Shelter In Place Guidebook (PDF)

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 In Case of An Emergency
AHCA/NCAL regularly publishes and distributes informative documents for members regarding emergency preparedness, response, and recovery.

During public health emergencies, CMS will post updates on waivers on their Emergency Response and Recovery page. Members should check this page for updates during an event.

 QUESTIONS?

Contact:​
EmergencyPrep@ahca.org​

 CMS CONTACTS
For general Emergency Preparedness or Life Safety Code inquiries: 
 
For waiver/FSES requests: 
(non-Deemed Providers Only)


 Emergency Preparedness Operational Resources
​The Emergency Preparedness Program Best Practice Guidebook for Long Term Care  Available to Buy Today!​
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Assisted Living Emergency Preparedness and Procedure Manual
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