Federal law mandates that Medicare- and Medicaid-certified long term care ("LTC") facilities have "detailed written plans and procedures to meet all potential emergencies and disasters." Facilities are further required to "train employees in emergency procedures." State surveys assess compliance with these legal requirements.
A 2006 report by the Department of Health and Human Services Office of Inspector General ("OIG"), "Nursing Home Emergency Preparedness and Response During Recent Hurricanes," suggests that the following provisions (among others) be included in LTC facilities' emergency management plans:
· Community coordination: Formalize procedures for working with and submitting plans to local emergency response agencies.
· Decision to evacuate: Establish criteria and processes to determine whether to evacuate the building or to shelter in place, taking into account internal factors, as well as recommendations or instructions from local authorities.
· Evacuation procedures: Draft policies, procedures, specific roles and responsibilities, and contingency plans. Specify primary and secondary evacuation routes and estimated travel times.
· Food and water supply: Ensure that adequate stocks of food and potable water are available, if the decision is made to shelter in place.
· Host facility agreements: List procedures to serve as a host facility for other institutions and to ensure round-the-clock operations.
· Medical records: Take measures to protect resident records from fire or other disaster, and to ensure that necessary records follow residents during an evacuation.
· Re-entry strategy: Devise post-evacuation inspection procedures, determine who will authorize re-entry into the facility and decide how residents will be returned from the temporary host facility.
· Relocation agreements: Establish written agreements with similar facilities to take in your residents in case an evacuation is necessary.
· Resident needs: Compile and maintain an up-to-date, portable list of the medical needs of individual residents and the personal belongings that should accompany them if evacuation is necessary.
· Staffing plan: Make emergency assignments in advance and determine which staff members will accompany evacuated residents.
· Transport issues: Have emergency transportation contracts for residents arranged in advance, preferably with multiple vendors. Ensure that residents, while in transit, have access to necessary food, water and medications, and that drugs remain under a nurse's control.
The OIG report is available online at http://oig.hhs.gov/oei/reports/oei-06-06-00020.pdf
