Training and Testing Conducting Exercises at Your Facility

TRAINING AND TESTING – CONDUCTING EXERCISES AT YOUR FACILITY

2016 CMS Emergency Preparedness Rule: “Develop and maintain training and testing programs, including initial training in policies and procedures and demonstrate knowledge of emergency procedures and provide training at least annually. Also annually participate in: A full-scale exercise that is community- or facility-based; an additional exercise of the facility’s choice.” The training and testing program is based on the:  Risk assessment (community-based and facility-based)  Community Emergency Plan  Facility Emergency Plan  Facility Communications Plan  Facility Policies and Procedures

A. Staff Training The training and testing programs must include: Training program must include:  Initial training to new employees and existing staff, individuals providing services (contract dieticians/therapists, etc.), volunteer (consistent with expected role/s)  Refresher training annually  Documentation of training  Demonstrate staff knowledge of emergency procedures

B. Fire Drills

Fire drills required by the Life Safety Codes are posted by the Centers for Medicare and Medicaid on their website which includes provider compliance with National Fire Protection Association (NFPA) 101 Life Safety Code (LSC) requirements and includes links to applicable laws, regulations, and compliance information. LSC Laws, Regulations, and Compliance Information available at: https://www.ssa.gov/OP_Home/ssact/title18/1819.htm

C. Exercises

1. Community-Wide Exercises Kentucky’s 15 Health Care Coalition Regions organize and prepare community-wide exercises with community healthcare partners. See Health Care Coalitions Section for Meeting dates and times. One additional exercise (required by CMS Rule) may include: o Second full-scale exercise, community or o Facility-based (internal) exercise o Tabletop exercise includes group discussion led by facilitator, using narrated, clinically-relevant scenario, set of problem statements, directed messages, or prepared questions designed to challenge the emergency plan

2. Facility-based/Internal Exercises Internal Exercises are facility-based in scope, using the same methods used in a community-wide or functional exercise. 3. Table Top Exercises Tabletop exercises and table-based activities typically held in an informal setting and presented by the Facilitator. There is no hands-on practice or field work. This type of exercise is intended to generate discussion of various issues regarding a hypothetical, simulated emergency. The following link provides 6 tabletop scenarios that can be edited for use by LTC facilities. Included for each of the 6 tabletop scenarios:  Exercise Overview  Exercise Staff  Facilitator Guidelines  Damage Assessment Forms  Events and Evaluation Form for Facilitator and Evaluators  Facilitator/Evaluation Feedback Form  Participant Feedback Form FEMA Community Emergency Response Team; 6/26/2013 Link below to access 6 tabletop exercises: https://www.fema.gov/media-library-data/20130726-1917-25045- 7806/cert_tabletops_combined.pdf 4. Functional Exercises A functional exercise (FA) examines or validates the coordination, command and control among various multi-agency coordination centers which may include emergency management, field office, local health department, etc. A Functional Exercise does not involve “boots on the ground.” An example would be a test and evaluation of the centralized emergency operations capability and timely response of one or more departments under a stress environment. A functional exercise could be centered in the Incident Command Center (ICC), and the use of outside activity (building on fire) and response could be simulated.

5. Real World Event Emergency If an actual emergency occurs in the LTC County, and the Community-Based or Facility- Based Emergency Plan is implemented, the facility is not required to conduct a full-scale community-based exercise for one (1) year following the onset of the emergency event.