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

Monkeypox
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.

Template for Facility After-Action Report / Improvement Plan

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.

Influenza / Infection Control / Vaccinations

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.

Latest News

Join This Free December 12 Webinar About Emergency Preparedness Decision-Making	https://www.ahcancal.org/News-and-Communications/Blog/Pages/Join-This-Free-December-12-Webinar-About-Emergency-Preparedness-Decision-Making.aspx	Join This Free December 12 Webinar About Emergency Preparedness Decision-Making	11/28/2023 5:00:00 AM	<p></p><div>HealthCap® is hosting a free webinar on Tuesday, December 12 at 2 p.m. EST titled <a href="https://riskmanagement.healthcapusa.com/products/emergency-response-evacuate-or-shelter-in-place" data-feathr-click-track="true" data-feathr-link-aids="["60b7cbf17788425491b2d083"]" target="_blank">Emergency Preparedness: Evacuate or Shelter in Place?</a> The webinar will discuss emergency response plans including the critical decision-making criteria for making timely and effective decisions when nursing homes and assisted living facilities are facing emergencies. </div><div><br></div><div><span style="font-size:11pt;">Communities are experiencing more hazardous events that may require decisions about evacuating or sheltering in place. These decisions are complex, often made under stressful circumstances, and can have life or death consequences. To prepare for these situations, nursing facilities and assisted living providers should assess their risks, devise a comprehensive evacuation plan, and test the plan. </span></div><div><br></div><div><span style="font-size:11pt;">The featured speaker is Jen Salter, MS, LNHA, CPHRM, who is Director of Operations at Century Care Management. The learning objectives for this webinar include: </span></div><div><br></div><div><ul><li><span style="font-size:11pt;">Improve your decision-making on sheltering in place or evacuating residents and staff <br><br></span></li><li><span style="font-size:11pt;">Compare criterial for risk assessment and guide response during sheltering or evacuations <br><br></span></li><li><span style="font-size:11pt;">Understand after-action reviews for improvement in future emergencies. </span></li></ul></div><div><br></div><div><span style="font-size:11pt;">Attendees will be awarded 1.0 ANCC contact hours and 1.00 NAB CEs for completing the webinar. Register for the free webinar <a href="https://riskmanagement.healthcapusa.com/products/emergency-response-evacuate-or-shelter-in-place" data-feathr-click-track="true" data-feathr-link-aids="["60b7cbf17788425491b2d083"]" target="_blank">here</a>. </span></div><div><br></div><div><span style="font-size:11pt;">AHCA/NCAL has embraced <a href="https://nam10.safelinks.protection.outlook.com/?url=http://www.healthcapusa.com/&data=04%7c01%7candrea.haupt%40chelsearhone.com%7ca06de39d68734186308f08d99e0475be%7c780a31273c7141dbbc3809e32ef3e62a%7c0%7c0%7c637714564287907466%7cUnknown%7cTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7c1000&sdata=4IpeRHUcTTtcM7ZIkOV%2BEt0L9dMuq%2BX/iuFPs3Y7ntg%3D&reserved=0" data-feathr-click-track="true" data-feathr-link-aids="["60b7cbf17788425491b2d083"]" target="_blank">HealthCap</a>® for more than a decade as a premier provider of liability insurance that is solely dedicated to serving senior care communities. HealthCap® clients have the fewest liability claims in the industry, and HealthCap® settles claims below the industry average. </span><span style="font-size:11pt;"></span></div><p></p>	HealthCap® is hosting a free webinar on Tuesday, December 12 at 2 p.m. EST titled Emergency Preparedness: Evacuate or Shelter in Place?
Utility Failures in Health Care Toolkit by ASPR	https://www.ahcancal.org/News-and-Communications/Blog/Pages/Utility-Failures-in-Health-Care-Toolkit-by-ASPR-.aspx	Utility Failures in Health Care Toolkit by ASPR	11/20/2023 5:00:00 AM	<p></p><div><strong>U</strong><strong>tility Failures in Health Care Toolkit by Administration for Strategic Preparedness and Response (ASPR)</strong><br><br></div><div>Utility failures are a major concern for health care and may cause substantial harm to patients, staff, and facilities. Threats include infrastructure damage due to natural disasters and other incidents, planned outages to relieve stress on services or prevent other hazards, and malicious acts such as physical and cyber sabotage. It is also important to note the cascading effects a failure of one utility may have on others; more than one utility may fail simultaneously or sequentially. <a href="https://files.asprtracie.hhs.gov/documents/utility-failures-in-health-care-toolkit-summary.pdf" data-feathr-click-track="true" data-feathr-link-aids="["60b7cbf17788425491b2d083"]" target="_blank">This suite of tip sheets</a> from Administration for Strategic Preparedness and Response (ASPR) can help health care facility managers and emergency planners identify issues to consider when planning for and responding to various types of utility failures. Access the related <a href="https://asprtracie.hhs.gov/technical-resources/resource/12050/utility-failures-in-health-care-toolkit" data-feathr-click-track="true" data-feathr-link-aids="["60b7cbf17788425491b2d083"]" target="_blank">Utility Failures Topic Collection </a>for additional resources. <br></div><p></p>
U.S. Antibiotic Awareness Week November 18-24	https://www.ahcancal.org/News-and-Communications/Blog/Pages/U-S--Antibiotic-Awareness-Week-November-18-24.aspx	U.S. Antibiotic Awareness Week November 18-24	11/14/2023 5:00:00 AM	<p></p><div>The <a href="https://www.cdc.gov/antibiotic-use/week/index.html" data-feathr-click-track="true" data-feathr-link-aids="["60b7cbf17788425491b2d083"]" target="_blank">U.S. Antibiotic Awareness Week (USAAW)</a> will take place next week, November 18-24. The purpose of USAAW is to raise awareness of the importance of appropriate antibiotic and antifungal use and the threat of antimicrobial resistance. </div><div><br></div><div>Long term care professionals can support USAWW by learning about the importance of appropriate antibiotic use. For example, did you know that: <br></div><div><br></div><div><ul><li>You can do harm by prescribing antibiotics when they are not needed. </li><li><span style="font-size:11pt;">Patients with asymptomatic bacteriuria should not be treated with antibiotics in most cases. </span></li><li><span style="font-size:11pt;">Antibiotics are only needed to treat certain infections caused by bacteria, not viruses like those that cause COVID-19. </span></li><li><span style="font-size:11pt;">Optimizing the use of diagnostic tests is critical for improving treatment of conditions like sepsis and stopping the spread of infections. </span></li><li><span style="font-size:11pt;">Always remember to prescribe the right antibiotic, at the right dose, for the right duration, and at the right time. </span></li><li><span style="font-size:11pt;">Reassess antibiotic therapy to stop or tailor treatment based on the patient/resident’s clinical condition and diagnostic test results as appropriate. </span></li><li><span style="font-size:11pt;">Use of the shortest effective duration of antibiotic therapy is a key antibiotic stewardship strategy. Optimizing duration of therapy, especially in care transitions, is an important target for improvement. </span></li></ul></div><div><br></div><div>For more information and ways to engage, see the <a href="https://www.cdc.gov/drugresistance/pdf/USAAW-2023-toolkit-508.pdf" data-feathr-click-track="true" data-feathr-link-aids="["60b7cbf17788425491b2d083"]" target="_blank">U.S. Antibiotic Awareness Week (USAAW) toolkit</a>. <br></div><p></p>	The U.S. Antibiotic Awareness Week will take place next week, November 18-24.
OCCHE Launches Program to Ensure Access to Financial Assistance	https://www.ahcancal.org/News-and-Communications/Blog/Pages/OCCHE-Launches-Program-to-Ensure-Access-to-Financial-Assistance-.aspx	OCCHE Launches Program to Ensure Access to Financial Assistance	11/14/2023 5:00:00 AM	<div>The Department of Health and Human Service’s Office of Climate Change and Health Equity (OCCHE) is launching a “catalytic program” in 2024 to support health care providers, especially safety net organizations, in taking advantage of the tax credits, grants and other supports made available by the historic Inflation Reduction Act (IRA). Investments and actions potentially facilitated by the IRA include energy efficient building improvements, transportation, on-site renewable energy generation, increased building resilience and increased community resilience. Details on the tax credits, grants and other supports can be found <a href="https://www.hhs.gov/climate-change-health-equity-environmental-justice/climate-change-health-equity/quickfinder-ira/index.html" data-feathr-click-track="true" data-feathr-link-aids="["60b7cbf17788425491b2d083"]" target="_blank">here</a>. </div><div><span style="font-size:11pt;"><br></span></div><div><span style="font-size:11pt;">More details on the initiative will be provided during a November 30th information session which you can <a href="https://www.zoomgov.com/webinar/register/WN_t9jLj5_eTNSY65uNNJq0AA#/registration" data-feathr-click-track="true" data-feathr-link-aids="["60b7cbf17788425491b2d083"]" target="_blank">sign up for here</a>. The session begins at 12pm EST. </span><span style="font-size:11pt;">Questions and feedback can be sent to: <a href="mailto:OCCHE@HHS.GOV" data-feathr-click-track="true" data-feathr-link-aids="["60b7cbf17788425491b2d083"]" target="_blank">OCCHE@HHS.GOV</a>. </span></div>

Top Resources

NEW! Emergency Preparedness Checklist
Emergency Preparedness Guide for Assisted Living
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.
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.
ASPR TRACIE Long Term Care Requirements CMS Emergency Preparedness Final Rule
The Centers for Medicare & Medicaid Services (CMS) issued the Emergency Preparedness Requirements for Medicare and Medicaid Participating Providers and Suppliers Final Rule to establish consistent emergency preparedness requirements for healthcare providers participating in Medicare and Medicaid, increase patient safety during emergencies, and establish a more coordinated response to natural and human-caused disasters. The U.S. Department of Health and Human Services Office of the Assistant Secretary for Preparedness and Response (ASPR) worked closely with CMS in the development of the rule.

Important 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:

ASPR TRACIE Hazard Vulnerability/Risk Assessment

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.

HVA Worksheets
HVA Instructions (How to use the worksheets and how to approach the assessment)

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 memorandum 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

Incorporating Active Shooter Incident Planning into Health Care Facility Emergency Operations Plans
This report was prepared by staff from the U.S. Department of Health and Human Services, Office of the Assistant Secretary for Preparedness and Response, Division of Health System Policy, and Division of Tactical Programs, in collaboration with staff from the Federal Emergency Management Agency and the Federal Bureau of Investigation.
Active Shooter Poster
Department of Homeland Security: Active Shooter Preparedness

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.

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)

State Resources

Arizona

Disaster Ready Main Page

California

Michigan

Michigan State LTC Disaster Planning Resources

New Jersey

New York

Emergency Preparedness

Wisconsin

CMS Preparedness Rule Tool Kit by Wisconsin Department of Health
The Wisconsin Department of Health Services has created toolkits to assist providers affected by the new rule. This toolkits gives facilities that fall under the new rule an overview of the requirements for their provider type, as well as some sample templates in a workbook that can be used in their planning efforts.

Winter Weather

Winter Weather Health and Safety

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.