Emergency situations occur every day – some are the result of natural disasters such as winter storms, flooding or extreme heat; others are the result of man-made situations. However, with preplanning and emergency preparedness, not all emergencies need end in a disaster. While everyone should have some form of disaster plan, it is essential that healthcare providers - especially long-term care facilities - have established emergency plans.
Emergency Plans Required - State and federal regulations both require that nursing facilities have a written emergency plan to be followed in the event of fire, tornado, or other emergency. [481 IAC 58.28(2)] Further, in-service shall be provided to ensure that all employees are knowledgeable of the emergency plan. The Interpretive Guidelines contained in the State Operations Manual (SOM) suggest that a facility tailor its disaster plan to its geographic location and the type of residents its serves. The purpose of a “staff drill” is to test the efficiency, knowledge, and response of institutional personnel in the event of an emergency.
Emergency Power and Water Supplies - In addition to having an emergency plan, federal regulations require that all facilities have an emergency electrical power system and a procedure to ensure that water is available to essential areas when there is a loss of normal water supply.
Reporting Requirements - State regulations require that the Director of the Department of Inspections and Appeals (DIA) be notified when damage to the facility which impairs its ability to function is caused by fire or natural or other disaster. Notification must occur within 24 hours of the event.
Facility Evacuations - The Department must also be notified if, due to an emergency situation, residents need to be evacuated from a facility. DIA may temporarily waive occupancy limits for a facility accepting evacuated residents, provided the accepting facility has sufficient staff and supplies to accommodate the additional residents. If a facility finds it necessary to relocate its residents, it is the facility’s responsibility to make sure all records, medications, basic needs and associated materials are transported to the accepting facility.
Emergency Planning - Planning for emergencies ensures that the emergency services, local authorities and other organizations better communicate and coordinate their efforts, improving the management at the scene, in the emergency operations center, and the post-disaster recovery process. There are many useful guides and disaster preparedness planning tools available from the Homeland Security and Emergency Management Department (HSEMD) website.
County Emergency Management Coordinators - A key player in any successful emergency plan is the County Emergency Management Coordinator. Your local coordinator is an excellent source of information about emergency planning disaster preparedness. Often, the local coordinator can assist a facility is lining up emergency provisions in the event that a disaster does strike.
Additional Internet Resources - A number of state and federal agencies have web sites devoted to emergency planning and disaster preparedness. Among those sites are:
Federal Agencies and Organizations
American Red Cross
Centers for Disease Control and Prevention (CDC)
Centers for Medicare & Medicaid Services (CMS)
Federal Emergency Management Agency (FEMA)
Food and Drug Administration (FDA)
Iowa Department of Public Health (IDPH)
Iowa Homeland Security and Emergency Management (HSEMD)
State Fire Marshal’s Office
Industry Associations and Organizations
Iowa Health Care Association
Fact Sheets - Fact sheets are available on the most common natural disasters occurring in Iowa. Information, too, is available on nuclear power plant emergencies as three power plants are located in or near the State of Iowa. Each sheet contains information identifying the risks associated with the hazard, as well as information about what to do before, during, and after the event. To download the fact sheet, click on the subject matter below. (Note: You will need to have an Adobe Reader installed on your computer to download the information. If you do not have a free Adobe Reader, it may be obtained at the following website: http://www.adobe.com/acrobat/.)
Nuclear Power Plant Emergency
Thunderstorms and Lighting
Winter Storms and Extreme Cold
Disaster Preparedness “Continuity Binder” - Emergencies never occur at a convenient time. During a disaster, seconds count. The Iowa Department of Inspections and Appeals (DIA) recommends that all nursing facilities develop a “continuity binder” containing essential contact information for essential services and personnel. A sample contact sheet is provided which can be used to assist nursing home personnel during an emergency situation. In addition to the contact sheet, DIA recommends that a continuity binder be developed that would include such information as a resident roster, a list of the resident’s legal representatives, staff roster, as well as the name, location, and telephone numbers for pharmacy services, medical suppliers, utility companies, emergency transportation services, local Red Cross chapter, local or area hospitals, etc. During an emergency, this simple binder could serve as a valuable tool to help restore services and care to the facility’s residents.