Emergency Preparedness

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



 

 

 

Preparing For and Managing Extreme Heat This Summerhttps://www.ahcancal.org/News-and-Communications/Blog/Pages/Preparing-For-and-Managing-Extreme-Heat-This-Summer-.aspxPreparing For and Managing Extreme Heat This Summer6/9/2026 4:00:00 AM<p>​​As temperatures rise during the summer months, long term care providers should be prepared to protect residents from the risks associated with extreme heat. Older adults are particularly vulnerable to heat-related illnesses due to chronic medical conditions, medications, decreased mobility, and a reduced ability to regulate body temperature. Even short-term exposure to high temperatures can place residents at serious risk if providers are not prepared. </p><div><span style="font-size:14.6667px;"><br></span></div><div><span style="font-size:14.6667px;">To adequately prepare for a hot summer, maintenance staff should complete preventive maintenance and seasonal inspections of HVAC systems to reduce the likelihood of unexpected failures during peak season demands.  Facility leadership should review and update emergency preparedness plans that address heat emergencies and prolonged air conditioning outages.  This includes items such as: </span></div><div><ul><li>Verifying vendor relationships for HVAC repair, </li><li>Gathering, testing, and servicing portable cooling equipment and fans, </li><li>Topping off emergency generator fuel supplies, </li><li>Verifying alternate care locations and evacuation agreements. </li></ul></div><div><span style="font-size:14.6667px;"><br></span></div><div><span style="font-size:14.6667px;">Keeping residents cool and hydrated during periods of elevated temperatures is critical.  Staff should closely monitor indoor temperatures throughout the facility, with a specific focus on resident sleeping rooms and areas where there is known to be limited air flow.  Consider the following tips for managing temperatures and keeping residents comfortable: </span></div><div><ul><li>Provide cold water, refresh frequently, and encourage hydration, to drink more than usual as residents should not wait until they are thirsty to drink.  </li><ul><li><em>Note: For those residents on fluid restrictions, check with their doctor how much they should drink in hot weather. </em></li></ul><li>Keep blinds, curtains, and drapes closed in areas of the building that receive direct sunlight. </li><li>Encourage loose, lightweight clothing and provide breathable bedding. </li><li>Turn off lights as well as other heat-producing appliances whenever possible. </li><li>Limit outdoor activities and strenuous activities. </li><li>Move residents to cooler areas of the building. </li><li>Conduct additional observation rounds. </li><li>Set up fans and other cooling equipment around the building, if available. Use fans only if indoor temperatures are less than 90ºF. Above 90ºF, a fan can increase body temperature. </li><li>Consider serving a non-cooking menu. </li></ul></div><div><span style="font-size:14.6667px;"><br></span></div><div><span style="font-size:14.6667px;">Additional tips and information are available on the Centers for Disease Prevention and Control’s (CDC) <a href="https://www.cdc.gov/climate-health/php/resources/protect-yourself-from-the-dangers-of-extreme-heat.html" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">website</a>. </span></div><div><span style="font-size:14.6667px;"><br></span></div><div><span style="font-size:14.6667px;">As part of your annual Emergency Preparedness Program (EPP) review and update, ensure that high heat / loss of air conditioning scenarios are fully addressed. A comprehensive plan should include: </span></div><div><ul><li>Strategies for maintaining a comfortable, safe environment. </li><li>Contact lists for HVAC vendors and emergency repair services. </li><li>Details of HVAC service agreements and backup options. </li><li>Contingency plans for evacuation, which may be necessary if air conditioning systems are down for an extended period. </li></ul></div><div><span style="font-size:14.6667px;"><br></span></div><div><span style="font-size:11pt;">Preparing for extreme heat before temperatures rise can help protect residents, support staff, and reduce operational disruptions.  </span></div><div><span style="font-size:14.6667px;"><br></span></div><div><span style="font-size:11pt;">Visit the </span><a href="https://ahca/NCAL%20website." data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank" style="font-size:11pt;">AHCA/NCAL website</a><span style="font-size:11pt;"> for additional emergency preparedness tools, resources, and guidance.</span></div><p>​</p>As temperatures rise during the summer months, long term care providers should be prepared to protect residents from the risks associated with extreme heat.
What Long Term Care Leaders Should Know About the CDC Hantavirus Alerthttps://www.ahcancal.org/News-and-Communications/Blog/Pages/What-Long-Term-Care-Leaders-Should-Know-About-the-CDC-Hantavirus-Alert-.aspxWhat Long Term Care Leaders Should Know About the CDC Hantavirus Alert5/26/2026 4:00:00 AM<p>​<span style="font-size:11pt;">The recent Centers for Disease Control and Prevention (CDC) <a href="mailto:https://www.cdc.gov/han/php/notices/han00528.html?ACSTrackingID=DM155339&ACSTrackingLabel=HAN%20529%20-%20Health%20Advisory%20(for%20COCA%20partners)&deliveryName=DM155339" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">Health Alert Network update</a> regarding hantavirus has understandably raised questions across healthcare settings, including long term care.  While headlines involving outbreaks and respiratory illness can quickly generate concern, context matters when assessing the actual level of risk and operational impact for providers and residents.  </span></p><div><span style="font-size:11pt;"><br></span></div><div><span style="font-size:11pt;">At this time, the CDC continues to emphasize that the overall risk to the American public remains very low. The current concern is tied to a travel-associated Andes virus outbreak connected to a cruise ship exposure event; not widespread U.S. transmission. </span></div><div> </div><div>Importantly, the Andes strain differs from the hantaviruses more commonly seen in the United States. Historically, most U.S. cases have occurred in western states such as New Mexico, Arizona, Colorado, and Utah and are typically associated with exposure to infected deer mice in rural environments.   <br></div><div> </div><div>For long term care providers, this is not currently a situation requiring operational changes or heightened respiratory precautions. Instead, it serves as a reminder to: </div><div> <br></div><div><ul><li><span style="font-size:11pt;">Reinforce environmental safety and rodent control practices, </span></li><li><span style="font-size:11pt;">Maintain clinical awareness for severe respiratory illness with relevant travel exposure,  </span></li><li><span style="font-size:11pt;">And continue communicating clearly and calmly with staff and families. </span></li></ul></div><div><br></div><div>Another important takeaway is how rapidly public health and laboratory systems mobilized in this response. Following the outbreak, researchers developed a <a href="mailto:https://www.cdc.gov/han/php/notices/han00529.html?ACSTrackingID=DM155339&ACSTrackingLabel=HAN%20529%20-%20Health%20Advisory%20(for%20COCA%20partners)&deliveryName=DM155339" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">PCR test</a> for the Andes virus within days; a reflection of how much infectious disease preparedness and response infrastructure has evolved since COVID-19. </div><div><br></div><div>Long term care organizations have significantly strengthened infection prevention, surveillance, and emergency preparedness capabilities over the past several years. Events like this reinforce the importance of maintaining strong public health partnerships, clinical awareness, and responding thoughtfully as new information emerges. Facilities should partner closely with Medical Directors and an infection prevention leader to interpret evolving public health guidance.    </div><div><br></div><div>Any questions may be directed to <a href="mailto:regulatory@ahca.org" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">regulatory@ahca.org. </a><br></div><p>​</p>​The recent CDC Health Alert Network update regarding hantavirus has understandably raised questions across healthcare settings, including long term care. 
Maintenance Director Training Course on ahcancalEDhttps://www.ahcancal.org/News-and-Communications/Blog/Pages/Maintenance-Director-Training-Course-on-ahcancalED.aspxMaintenance Director Training Course on ahcancalED4/14/2026 4:00:00 AM<p><span style="font-size:11pt;">The Emergency Preparedness & Life Safety Committee is excited to announce another live session to introduce more providers to the </span><a href="https://educate.ahcancal.org/products/maintenance-director-training" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank" style="font-size:11pt;">Maintenance Director Training Course</a><span style="font-size:11pt;">, now available on ahcancalED. This 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><span style="font-size:11pt;">The Maintenance Director 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></li><li><span style="font-size:11pt;">Portable P</span><span style="font-size:11pt;">atient-Care Related Electrical Equipment (PCREE) Testing </span></li><li><span style="font-size:11pt;">Kitchen Fire Safety and 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><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>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 <strong>April 22 at 12PM ET.</strong> 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, $65 for nonmembers.</em><br></div><p>​</p>The Emergency Preparedness & Life Safety Committee is excited to announce another live session to introduce more providers to the Maintenance Director Training Course, now available on ahcancalED.
New Therapeutics Reporting Options Now Available in NHSNhttps://www.ahcancal.org/News-and-Communications/Blog/Pages/New-Therapeutics-Reporting-Options-Now-Available-in-NHSN-.aspxNew Therapeutics Reporting Options Now Available in NHSN4/14/2026 4:00:00 AM<p><span style="font-size:11pt;">Beginning March 30, 2026, facilities may optionally report weekly data on therapeutics administered to residents for COVID-19, influenza, and RSV using the NHSN Respiratory Pathogens and Vaccination (RPV) Module.  </span></p><div><strong style="font-size:11pt;"><em>Reporting for the therapeutics data fields is optional.</em></strong><span style="font-size:11pt;"> More information is available in the following resources:  </span></div><div><br></div><div><ul><li><a href="https://t.emailupdates.cdc.gov/r/?id=h9be65054%2c1f2ca05b%2c1f2cddee&e=QUNTVHJhY2tpbmdJRD1VU0NEQ18yMTM3LURNMTU0MTQzJkFDU1RyYWNraW5nTGFiZWw9TmV3JTIwVGhlcmFwZXV0aWNzJTIwUmVwb3J0aW5nJTIwT3B0aW9ucyUyMEF2YWlsYWJsZSUyMGluJTIwTkhTTg&s=rscTUVcJF6-D8DNxMBl-zwFaBoRqx83v-H0YZDqP1fk" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">LTCF Respiratory Pathogens and Vaccination Module CDC Webpage</a>. This site includes revised forms, instructions, FAQs, .CSV file templates, and file layout documents <br><br></li><li><span style="font-size:11pt;"><a href="https://t.emailupdates.cdc.gov/r/?id=h9be65054%2c1f2ca05b%2c1f2cddef&e=QUNTVHJhY2tpbmdJRD1VU0NEQ18yMTM3LURNMTU0MTQzJkFDU1RyYWNraW5nTGFiZWw9TmV3JTIwVGhlcmFwZXV0aWNzJTIwUmVwb3J0aW5nJTIwT3B0aW9ucyUyMEF2YWlsYWJsZSUyMGluJTIwTkhTTg&s=UPAUo6ZdMMxuTM48DwBTnusieCnJ02bHQyEhuc_d9BY" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">Weekly Respiratory Pathogen and Vaccination Summary for Residents of Long Term Care Facilities (57.218)</a>  <br><br></span></li><li><span style="font-size:11pt;"><a href="https://t.emailupdates.cdc.gov/r/?id=h9be65054%2c1f2ca05b%2c1f2cddf0&e=QUNTVHJhY2tpbmdJRD1VU0NEQ18yMTM3LURNMTU0MTQzJkFDU1RyYWNraW5nTGFiZWw9TmV3JTIwVGhlcmFwZXV0aWNzJTIwUmVwb3J0aW5nJTIwT3B0aW9ucyUyMEF2YWlsYWJsZSUyMGluJTIwTkhTTg&s=GTUg3C_SSGq7JePaE0ukHD9NpRSYOkdqxl94kklAV7E" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">RPV Residents Table of Instructions</a>  <br><br></span></li><li><span style="font-size:11pt;"><a href="https://t.emailupdates.cdc.gov/r/?id=h9be65054%2c1f2ca05b%2c1f2cddf1&e=QUNTVHJhY2tpbmdJRD1VU0NEQ18yMTM3LURNMTU0MTQzJkFDU1RyYWNraW5nTGFiZWw9TmV3JTIwVGhlcmFwZXV0aWNzJTIwUmVwb3J0aW5nJTIwT3B0aW9ucyUyMEF2YWlsYWJsZSUyMGluJTIwTkhTTg&s=xoPCDfOqZqcs4vRGQxm0XuG87OsahS6S2wtNHibJPwI" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">2026 Respiratory Pathogens & Vaccination Protocol </a> <br><br></span></li><li><span style="font-size:11pt;"><a href="https://t.emailupdates.cdc.gov/r/?id=h9be65054%2c1f2ca05b%2c1f2cddf2&e=QUNTVHJhY2tpbmdJRD1VU0NEQ18yMTM3LURNMTU0MTQzJkFDU1RyYWNraW5nTGFiZWw9TmV3JTIwVGhlcmFwZXV0aWNzJTIwUmVwb3J0aW5nJTIwT3B0aW9ucyUyMEF2YWlsYWJsZSUyMGluJTIwTkhTTg&s=MDjytwhJg4Kxqa7pLoPV57QKXd0svLPkuVt61NraKOg" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">RPV Module Residents Group and Facility CSV File Layout </a> <br><br></span></li></ul></div><a href="https://t.emailupdates.cdc.gov/r/?id=h9be65054%2c1f2ca05b%2c1f2cddf3&e=QUNTVHJhY2tpbmdJRD1VU0NEQ18yMTM3LURNMTU0MTQzJkFDU1RyYWNraW5nTGFiZWw9TmV3JTIwVGhlcmFwZXV0aWNzJTIwUmVwb3J0aW5nJTIwT3B0aW9ucyUyMEF2YWlsYWJsZSUyMGluJTIwTkhTTg&s=z8DZdEmMReRd6W9Uwu4awLdivvJ4JGB0_5OVWIZ1dlk" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank"><div><ul><li><span style="font-size:11pt;">RPV Module Resident Summary Guidance Document </span></li></ul></div></a><div><br></div><div><span style="font-size:11pt;">The NHSN team will host two training sessions in late April 2026 to review RPV Module updates including new therapeutics reporting capabilities. Registration links and additional information will be sent closer to the event. </span></div><div><br></div><div><span style="font-size:11pt;">Please submit questions to the NHSN Help Desk via <a href="https://t.emailupdates.cdc.gov/r/?id=h9be65054%2c1f2ca05b%2c1f2cddf4&e=QUNTVHJhY2tpbmdJRD1VU0NEQ18yMTM3LURNMTU0MTQzJkFDU1RyYWNraW5nTGFiZWw9TmV3JTIwVGhlcmFwZXV0aWNzJTIwUmVwb3J0aW5nJTIwT3B0aW9ucyUyMEF2YWlsYWJsZSUyMGluJTIwTkhTTg&s=CvXcb1oL7yhvEO7CyV_4aPXmeIFTzPcXioxFhGw6nMk" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">NHSN-ServiceNow</a> with the subject line “Therapeutics Reporting”. If you are unable to access NHSN-ServiceNow, please <a href="mailto:nhsn@cdc.gov?subject=Therapeutics%20Reporting" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">submit a question</a> to the NHSN Help Desk via email at <a href="mailto:nhsn@cdc.gov" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">nhsn@cdc.gov</a> with the same subject line. You may also submit questions to <a href="mailto:regulatory@ahca.org" data-feathr-click-track="true" data-feathr-link-aids="60b7cbf17788425491b2d083" target="_blank">regulatory@ahca.org​</a>.</span><span style="font-size:11pt;">​</span></div><p>​<br></p>Beginning March 30, 2026, facilities may optionally report weekly data on therapeutics administered to residents for COVID-19, influenza, and RSV using the NHSN RPV Module.

 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:
​​
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

 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)


 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.