Emergency Preparedness

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


What You Need to Know​​​ ​

In August 2022, the United States declared the ongoing monkeypox outbreak a public health emergency. Learn more about the disease and the warning​ signs you need to watch out for in LTC.​  

COVID-19 Updates​
​​Find the latest information on COVID-19 for long term care providers. This includes infection control practices, regulatory requirements and resources on COVID-19 vaccinations for long term care staff and residents. 

To meet Emergency Preparedness requirements, providers must be able to demonstrate their experience activating their emergency plans through written documentation. This is most commonly accomplished through ​an After-Action Report (AAR) and Improvement Plan. AHCA has developed a COVID-19 AAR Template that members can utilize to document their response and recovery efforts during the pandemic. 
Long term care facilities should prepare to manage potential flu outbreaks and double efforts to encourage residents and staff to take the influenza vaccine. Individuals 65 years or older are one of the high risk groups who can experience serious complications, even death, from influenza infection. Learn more on how to minimize the flu for residents.​ ​
Active Shooter Preparedness​
HealthCap® offers a free webinar that focuses on key aspects of active shooter events and what to do if your long term care community experiences a threat or real-life active shooter.




Falls Screening and Prevention in Assisted Living https://www.ahcancal.org/News-and-Communications/Blog/Pages/Falls-Screening-and-Prevention-in-Assisted-Living.aspxFalls Screening and Prevention in Assisted Living 3/13/2023 4:00:00 AM<p>​<span style="font-size:11pt;">Each year, there are over 37 million falls, 9 million resulting in injuries, 3 million in emergency department visits, 1 million in hospitalizations, and 36,000 deaths according to the Centers for Disease Control (CDC) Foundation.  Falls are often preventable if you know what to screen for and what the risk factors for falls include.  The CDC Foundation launched a toolkit that includes <a href="https://www.ncoa.org/age-well-planner/assessment/falls-free-checkup" data-feathr-click-track="true" data-feathr-link-aids="["60b7cbf17788425491b2d083"]" target="_blank">Falls Free Check-ups</a>.  The goal of the CDC’s <a href="https://www.cdc.gov/falls/" data-feathr-click-track="true" data-feathr-link-aids="["60b7cbf17788425491b2d083"]" target="_blank">toolkit and resources</a> is to prevent and protect older adults from sustaining falls and fall-related injuries by developing and implementing a risk factor prevention program.  You can learn more about the program and the CDC Foundation <a href="https://www.cdcfoundation.org/programs/falls" data-feathr-click-track="true" data-feathr-link-aids="["60b7cbf17788425491b2d083"]">here</a>.  </span></p><div><br></div><div>In addition, the CDC Foundation hosted a webinar on screening and prevention which highlighted the importance of using a screening program to identify potential warning indicators of high-risk residents.  The tools reviewed were developed by the CDC foundation to prevent and reduce older adult falls.  The webinar, titled Screening and Prevention: Tools for Reducing Older Adult Falls, can be found <a href="https://educate.ahcancal.org/products/screening-and-prevention-tools-for-reducing-older-adult-falls?Token=0793d72d-975f-4ae2-9537-514a82ffac31#tab-product_tab_overview" data-feathr-click-track="true" data-feathr-link-aids="["60b7cbf17788425491b2d083"]" target="_blank">here</a>.   <br></div><div><br></div><div>Links:  <br></div><div><br></div><div><ul><li>Webinar link - <a href="https://educate.ahcancal.org/products/screening-and-prevention-tools-for-reducing-older-adult-falls?Token=0793d72d-975f-4ae2-9537-514a82ffac31#tab-product_tab_overview" data-feathr-click-track="true" data-feathr-link-aids="["60b7cbf17788425491b2d083"]">AHCA Education: Screening and Prevention: Tools for Reducing Older Adult Falls (ahcancal.org) </a></li><li><span style="font-size:11pt;">CDC Foundation - <a href="https://www.cdcfoundation.org/programs/falls" data-feathr-click-track="true" data-feathr-link-aids="["60b7cbf17788425491b2d083"]">Preventing Older Adult Falls and Fall Injuries | CDC Foundation </a></span></li><li><span style="font-size:11pt;">CDC Older Adult Fall Prevention Page - <a href="https://www.cdc.gov/falls/" data-feathr-click-track="true" data-feathr-link-aids="["60b7cbf17788425491b2d083"]">Older Adult Falls | Fall Prevention | Injury Center | CDC </a></span></li><li><span style="font-size:11pt;">Falls Free CheckUp - <a href="https://www.ncoa.org/age-well-planner/assessment/falls-free-checkup" data-feathr-click-track="true" data-feathr-link-aids="["60b7cbf17788425491b2d083"]" target="_blank">NCOA's Falls Free CheckUp</a> </span><span style="font-size:11pt;">​</span></li></ul></div><p><span style="font-size:11pt;">​</span><br></p><p>​</p>Each year, there are over 37 million falls, 9 million resulting in injuries, 3 million in emergency department visits, 1 million in hospitalizations, and 36,000 deaths according to the Centers for Disease Control Foundation.
Affordable Infection Prevention Basics Training for Your Staffhttps://www.ahcancal.org/News-and-Communications/Blog/Pages/Affordable-Infection-Prevention-Basics-Training-for-Your-Staff.aspxAffordable Infection Prevention Basics Training for Your Staff2/8/2023 5:00:00 AM<p><span style="font-size:11pt;"><em style="color:#555555;font-size:14.6667px;background-color:#ffffff;">​ahcancalED</em>​ offers a 50-minute training on the basics of effective infection prevention and control suitable for all levels of staff members in skilled nursing, assisted living, and ID/DD facilities. </span><br></p><div><br></div><div><a href="https://educate.ahcancal.org/BasicsofIPPostCOVID" data-feathr-click-track="true" data-feathr-link-aids="["60b7cbf17788425491b2d083"]"><strong>Basics of Infection Prevention & Control in the Post-COVID-19 World </strong></a><strong> </strong></div><div><br></div><div><ul><li>​Describes what COVID-19 is, how it spreads and who is most at risk </li><li>Identifies the signs and symptoms of COVID-19 and other variants </li><li>Explains staff members’ roles in reporting suspicions of respiratory illnesses </li><li>Discusses key considerations for “return to work”  </li><li>Reviews the universal basics of essential infection prevention and control practices </li><li>Addresses common PPE and handwashing errors </li></ul></div><div><br></div><div>This course is a vital tool in a comprehensive infection prevention and control program. No CEs are offered with this course.  </div><div><br></div><div><ul><li>​Individual Course Fees: $25 for AHCA/NCAL members and $65 for non-members. </li><li>AHCA/NCAL Member Only One-Year Facility Subscription Fee: $500 <em>(Facilities will use one individual's login to access the material throughout the year that may viewed individually or in small groups as part of staff in-service trainings.)    </em></li></ul></div><div><br></div><div>Individuals will need to login to <em>ahcancalED</em> with their AHCA/NCAL usernames and passwords to <a href="https://educate.ahcancal.org/BasicsofIPPostCOVID" data-feathr-click-track="true" target="_blank" data-feathr-link-aids="["60b7cbf17788425491b2d083"]">register</a>. For assistance obtaining usernames and passwords, members should e-mail <a href="mailto:educate@ahca.org" data-feathr-click-track="true" data-feathr-link-aids="["60b7cbf17788425491b2d083"]">educate@ahca.org</a> with their name and facility contact information.<br></div>According to the U.S. Administration for Strategic Preparedness and Response, age currently is the leading risk factor for COVID hospitalizations and deaths.
PHE Unwinding — Returning to Medicaid Eligibility Redeterminationhttps://www.ahcancal.org/News-and-Communications/Blog/Pages/PHE-Unwinding-Returning-to-Medicaid-Eligibility-Redetermination.aspxPHE Unwinding — Returning to Medicaid Eligibility Redetermination2/7/2023 5:00:00 AM<p>The Consolidated Appropriations Act of 2023 laid out timelines for states to return to regular Medicaid redeterminations, which were paused during the COVID-19 Public Health Emergency. For providers, this means your state will begin redetermining all residents covered by Medicaid in February, March or April 2023, and your buildings will begin receiving Redetermination Notices all together depending upon your state’s start date.​<br><br>Additional information is available in this <a href="/Survey-Regulatory-Legal/Emergency-Preparedness/Documents/COVID19/Returning-to-Medicaid-Eligibility-Redetermination.pdf" data-feathr-click-track="true" data-feathr-link-aids="["60b7cbf17788425491b2d083"]">AHCA/NCAL memo</a>.​</p>The Consolidated Appropriations Act of 2023 laid out timelines for states to return to regular Medicaid redeterminations, which were paused during the COVID-19 PHE.
Emergency Management Programs in Long Term Care – Planning for When Bad Days Happenhttps://www.ahcancal.org/News-and-Communications/Blog/Pages/Emergency-Management-Programs-in-Long-Term-Care-–-Planning-for-When-Bad-Days-Happen.aspxEmergency Management Programs in Long Term Care – Planning for When Bad Days Happen1/31/2023 5:00:00 AM<p></p><p>Power grid failure, severe weather impact, hazardous materials release, another pandemic - Oh My!!! Bad days happen in our society and specifically within the realm of long term care (LTC) and assisted living (AL) facilities. Take an incident that recently occurred at an assisted living community, for example. A sprinkler pipe burst, flooding their clinical areas and mechanical room. Fortunately, they had a comprehensive emergency management program and operations plan, making them better prepared for the event they experienced. </p><p><strong>Emergency Management Programs in Healthcare</strong></p><p>Many consider healthcare facilities the light on the hill during the darkest hours due to their planning, resources, and ability to continue to care for their residents in the face of adversity. Staff, residents, families, and the community all look to healthcare facilities to be ready to provide for the residents. </p><p> How can facilities plan for the next adverse event? The Centers for Medicare & Medicaid Services (CMS), as well as other accrediting bodies, all require some facet of risk stratification and planning.  Consequently, emergency management programs are implemented to assess and mitigate risks where possible and provide a process for continuous planning and preparation for incident response and recovery. From risk assessments involving local community partners to training and exercising of staff, emergency management can encompass a significant amount of time and resources.</p><p><strong>Incorporating an All-Hazards Approach</strong></p><p>Creating an emergency management program that incorporates all-hazards planning, in addition to hazard-specific planning, is paramount to helping guide the facility's response. A foundation of a good emergency management program is an all-hazards approach. This is an integrated approach to emergency preparedness planning that considers the full spectrum of emergencies and disasters. It requires prior thought, frequent assessment, planning, and continual revision and updates and should incorporate broad approaches applicable within multiple types of incidents (e.g., building lockdown). This is unlike event-specific plans which are more detailed in their guidance to address known risks, including electronic health record system failure, loss of fire protection systems, and more. </p><p><strong>Implementing Successful Emergency Response Plans</strong></p><p>Just writing a plan is not enough if they are never adopted or utilized. The above-mentioned facility was able to respond and recover successfully because they actively implemented robust emergency management plans, which guided them in establishing their command center, managing internal flooding and power loss, and evacuating the building. Additionally, emergency management plans, including their full building evacuation plan (FBE), provided the leadership team and staff with pre-established tools for success, including job action sheets, resident preparation guides, and floor plans that identified stairwells for resident evacuation and for staff and first responders to travel up. </p><p>The facility's staff and residents were also trained, tested, and ready to respond. While the continual training of staff on the implementation of the plans and processes can be a challenge, it is essential for a successful response and recovery. Drills, exercises, and other approaches not only help to prepare staff and validate training but also identify additional gaps.  </p><p>Have you taken all the steps to assess the risks of, mitigate, plan for, respond to, and recover from your next bad day? If not, the AHCA's <a href="https://ahcapublications.org/products/emergency-preparedness-program?_pos=1&_sid=085f0fe1c&_ss=r" data-feathr-click-track="true" data-feathr-link-aids="["60b7cbf17788425491b2d083"]" target="_blank">Emergency Preparedness Program Best Practice Guidebook</a> can assist in developing and optimizing your customized Emergency Management Program and plans, including tools for success to help face your next adverse event. This AHCA <a href="https://educate.ahcancal.org/products/developing-and-maintaining-a-comprehensive-emergency-preparedness-program#tab-product_tab_overview" data-feathr-click-track="true" data-feathr-link-aids="["60b7cbf17788425491b2d083"]">webinar</a> will also provide overview of the critical components of a comprehensive EPP, outlines various updated requirements, explores new high profile risks, and reviews best practices learned from real events.<br></p><p><em>​This article was written by </em><span style="text-align:justify;font-size:11pt;"><em>Bobby Baker, Jensen Hughes Healthcare + Emergency Management Service Line Leader; </em></span><span style="text-align:justify;font-size:11pt;"><em>Jim Garrow, ​Jensen Hughes Senior Emergency Management Consultant​.</em></span></p><p><br></p>

 Featured Video

 Top Resources

 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:
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. ​​



 ‭(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. 

AHCA/NCAL's Active Shooter Resources
External 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 Incident Command 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.​

 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)

 State Resources


 Winter Weather

The Centers for Disease Control and Prevention published a comprehensive winter weather health and safety site. Owners and administrators can take tips to prepare for extreme cold conditions and winter storms.​

 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.