Skilled Nursing Facility

Is your SNF prepared for an emergency?

With the recent earthquakes in Puerto Rico, and wildfires in California, it’s as important as ever for SNFs to brush up on their emergency preparedness plan. CMS’ emergency preparedness (EP) final rule, was enacted November 16, 2016. Appendix Z of the State Operations Manual provides interpretive guidance to the final rule that provides insight on how facilities will be surveyed.

The rule states that whether evacuating or sheltering in place, facilities must be able to supply food, water, medical materials, and pharmaceuticals to staff and residents. Additionally, facilities need alternative sources of energy to maintain temperatures, lighting, fire prevention systems (to detect, alarm, and extinguish), and waste disposal. The EP final rule also stresses the importance of having a tracking system in place for both staff and residents during an emergency. It’s essential to be aware not only of the location of each resident, but staff as well in case an employee is suddenly needed elsewhere.

CMS states in the core EP rule elements that there are four components SNFs should evaluate when creating an EP plan:

  • Risk assessment and emergency planning
    • Geographic hazards (hurricanes, earthquakes, tornados, etc.)
    • Care-related emergencies
    • Power and equipment failures
    • Communication interruptions, including cyberattacks
    • Loss of all or portion of facility
    • Loss of all or portion of supplies
    • Annual review and update of plan
  • Communication plan
    • Compliance with federal and state laws
    • Communication systems to contact necessary staff
    • Coordination across facility, with healthcare providers, and with state and local public health departments and emergency management agencies
  • Policy procedures
    • Compliance with federal and state laws
  • Training and testing
    • Compliance with federal and state laws
    • Annual maintenance and update

CMS has released an informative checklist to prepare for an emergency. Following are some key points to consider when drafting an EP plan:

  • Location of emergency exits
  • Alarm system instructions, and modifications for hearing and visually impaired residents
  • How to keep track of residents during an evacuation
  • How medical charts will be transferred
  • How families will be notified
  • Where residents will evacuate to
  • How medicines and supplied will be protected and transferred
  • How residents and family members can be of assistance
  • How able-bodied residents can be incorporated into the EP plan