Is Your Organization Really Prepared?

Corporate Partners | August 17, 2014 | by Aon

A crisis like fire, power failure, severe weather, acts of terror or natural disaster can occur with little or no warning. It is essential for businesses and organizations providing healthcare and senior living services to develop comprehensive written plans and procedures to help prepare them to respond to a crisis, survive a disaster, limit financial losses and avoid costly business interruption. It is also important to understand that disaster planning doesn’t end with the development of a written plan.

The following whitepaper is was written by Stan Szpytek, president of Fire and Life Safety, Inc., and used here with permission from Aon. Be sure to sign up for Aon's Sept. 18, 2014, webinar on the proposed rule changes for emergency preparedness.

Does your skilled nursing facility, assisted living community or CCRC have formalized and written plans to adequately address an emergency situation? The answer is likely, “Yes, of course it does.” A crisis like fire, power failure, severe weather, acts of terror or natural disaster can occur with little or no warning.

It is essential for businesses and organizations providing healthcare and senior living services to develop comprehensive written plans and procedures to help prepare them to respond to a crisis, survive a disaster, limit financial losses and avoid costly business interruption. It is also important to understand that disaster planning doesn’t end with the development of a written plan.

Preparing for crises or disaster requires an enterprise-wide commitment that continuously assesses potential threats and perils, develops multi-dimensional contingencies to manage emergencies, provides regular training to all levels of staff/management and periodically puts procedures in action by conducting regular drills.    


In a word, a good disaster preparedness program requires the development of “culture.”  The question that really needs to be asked is this- “Is your facility really prepared?”

The worst time to think about disaster preparedness planning and /or improving emergency management protocol is after a crisis has occurred.  All too often, safety committees convene within a facility after a problem has already happened and failures have been vividly demonstrated.  When it comes to risks like fire, facilities of all types often appear to feel a sense of security when minimal requirements including the presence of automatic fire protection systems are satisfied.    


In recent years, several significant fires have occurred and various major disasters have seriously impacted long-term healthcare and other facilities providing supportive services to the elderly.   Many of these adverse events could have been prevented or handled in a more efficient manner had better planning programs been implemented. 

The scope of your facility’s emergency planning program depends on multiple factors including the size of your operation, applicable regulations, types of services and levels of care provided as well as the threat assessment that applies not only to the facility but, the entire region. Utilization of the concept known as “All Hazards Emergency Planning” is an excellent way to prepare, respond and recover from a crisis or disaster.  

All Hazards Emergency Planning means that a facility will not limit its scope of planning to a select few hazards and will develop plans to manage all potential emergency and disaster situations in a consistent manner regardless of the individual characteristics of the emergency; which of course will always vary.  The primary elements of a good emergency plan or procedure is that it is well written, easy to understand and clearly places someone in charge of the incident.  

A recipe-type format is ideal for the development of most emergency procedures.  A description of the problem, what to do and how to do it is essentially the formula to use.  


Minimally, written emergency plans should be created for the following situations:


  • Fire / Explosion.
  • Severe Weather Conditions (Monsoon, Tornado, Thunderstorms, etc.).
  • Prolonged Weather Conditions (Extreme Heat / Cold / Blizzard, etc.).
  • Flood.
  • Earthquake.
  • Power Failure / Utility Interruption.
  • Mechanical / Systems Failure.
  • Pandemic.
  • Civil Disturbance.
  • Bomb Threat.
  • Terrorism- National / International Crisis.
  • Labor Disruption.
  • Natural Disasters (Wildland Fires, Mudslides, Tidal Surge, etc.).
  • Evacuation and Relocation.
  • Shelter-in-Place.
  • Take Cover (Potential Building Collapse, Fall-out, Hazardous Atmosphere, etc.).
  • Facility Expansion (Receiving Plan to Accept Evacuees From a Stricken Area).
  • Recovery Plans.
  • Any Hazard or Peril Unique to the Facility


The list can clearly go on and on; especially when a facility is situated near unique hazards like power plants, military installations, prisons, active fault lines or other potential perils.  


Again, while a specific plan cannot reasonably be developed for every conceivable event, it is important for facilities to utilize a management model like the Incident Command System (ICS) to systematically and logically manage a crisis or disaster situation.  


The ICS is a management model promoted by agencies like the United States Department of Homeland Security and Federal Emergency Management Agency (FEMA) and likely utilized by your local fire department, law enforcement agencies, county emergency managers and community hospital.   

Healthcare workers can obtain free on-line training on ICS from the Federal Emergency Management Agency (FEMA). 

Comprehensive plans need to be developed that address the concepts of either staying or evacuating.  

Depending on the event, a decision will be needed as to whether to shelter-in-place or re-locate to a place of safety sufficiently away from the facility.  If the decision is made to stay, the facility must be able to sustain critical elements of operation including patient care, safety, sustenance (food and water) medication regimens and physical plant in accordance with all regulations and in consideration of best practices.  

While agencies like FEMA and individual state regulators recommend or require minimal amounts of provisions for a period of time that typically consists of 72 hours, it is not uncommon to hear emergency managers around the country express the opinion that contingencies or provisions for longer periods of time must be considered.  Of course, opinions vary but a common line of thinking appears to be 7 to 10 days.

If evacuation is required, facilities must consider how evacuation will be implemented and where evacuees will go. Many facilities believe that community resources (fire department, emergency medical© 2014 Agility Recovery service, law enforcement, etc.) will always be available to assist with evacuation including providing modes of transportation and deciding where evacuees will be taken. 

In a localized emergency like a fire within a nursing home, it is reasonable to assume that plenty of help will be available from local emergency responders.  

During a disaster, those same local emergency responders will likely be spread thin and will rely on the self-sufficiency of healthcare occupancies to facilitate their own evacuation. 


Facilities need to develop transportation plans and accountability systems as well as develop agreements with receiving sites to accept evacuees without the immediate assistance of community-based emergency response agencies during a disaster.

All employees need to clearly understand their roles and responsibilities during a crisis or disaster situation.  Life-safety can only be reasonably expected during an emergency if a plan of action is in place and
practiced on a regular basis.


In today’s modern and uncertain times, nothing can be left to chance. It is essential to ensure that plans are designed to protect your facility as well as its most important assets, which
of course are the people in your care and the staff who care for them.  

We learned in September of 2001 that “anything” can happen, even the unimaginable.    

Again, I ask you this question: “Is Your Facility Really Prepared?”