Emergency Preparedness for Nursing Homes

EMERGENCY PREPAREDNESS FOR NURSING HOMES

GAP ANALYSIS TABLETOP EXERCISE

SCENARIO

Thursday evening, winter storms began blasting through most of Minnesota. The National Weather Service (NWS) predicts that snow and ice storms will continue through the weekend with temperatures expected to drop and remain near zero. The NWS predicts that (your county) will be the worst hit, receiving significant amounts of ice accumulation that can potentially cause large numbers of downed trees and power lines. The Electrical Company is currently dealing with power outages affecting some customers throughout parts of your county. Local public announcements recommend that residents and businesses implement proactive measures to prepare for power outages and extreme cold conditions for the next several days.

The Minnesota State Patrol issued a warning that roads in the area are very hazardous and some are even impassable. On-duty staff and personnel are becoming concerned about getting home to their families. Clearly, backup and on-coming shift personnel will have difficulty getting to work or will not show up at all due to extremely hazardous driving conditions.

Your facility and your county are now experiencing power outages, with backup power generators working intermittently. Building temperatures are starting to drop, and staff expresses concern that, without electricity, supporting residents would be problematic. Communications (telephone and computer) are becoming sporadic. It is getting difficult to communicate internally to staff and externally to healthcare partners and supporting resource groups (via phone and computers).

A growing number of hypothermia cases, as well as carbon monoxide incidents and people with injuries due to accidents related to the ice storm, are being reported to the local hospital facility.

Temperatures continue to fall in the facility due to an improperly working heating, ventilation, and air conditioning (HVAC) system. Your facility’s staff are concerned about providing adequate heating to staff and residents throughout this area of the facility. TABLETOP EXERCISE QUESTIONS

Infrastructure (e.g. power)

1. Do you have a generator? a. If yes, how much fuel is available in hours? b. Do you have a Memo of Understanding (MOU) to get more fuel? c. Are your essential functions on generator power (e.g. heat, lights, oxygen equipment, Electronic Medical Record (EMR/computers), food preparation areas, well water, vital equipment, etc.) 2. Without any food delivery, how many days can you sustain healthy dietary needs for residents and staff? a. What is your plan? MOU? 3. Do you have an adequate supply of potable water? a. If not, what is your plan? MOU? 4. Without delivery, your medication supply is down to 2-days remaining, what is your plan? 5. How are you going to address the above gaps?

Communications

1. Do you have an Emergency Call Down List? 2. During this emergency, who at the local or county level would you communicate with and how do you do that? 3. If phones (i.e. land-line and cell) are disabled, what means of communication will you use for staff and the local community? 4. How will you receive storm updates without phone, cable, and internet? 5. Who is the “Incident Commander” (e.g. person in charge) during this incident? 6. During this emergency, what does your Organizational Chart look like?

Transportation & Staffing

1. Do you have a staff list of those willing to shelter-in-place with residents? 2. Can you provide emergency transportation to and from work for staff? 3. What are the triggers to determine the need for evacuation and begin procedures if necessary? 4. Do you have MOUs/arrangements for emergency transportation of patients and staff? a. Does the transportation company know they are part of your plan? b. If yes, how many and type of resources do they have? 5. What is your plan for mortuary services, if the local mortician can’t come? 6. You have a resident that is acutely ill and needs hospital-care. What would your plan be?