Guest Columns

What's needed in emergency preparedness

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Mary Helen McSweeney-Feld
Mary Helen McSweeney-Feld

Emergency preparedness is an evolving issue for long-term care providers. While a recent study by the Office of the Inspector General found that most nursing homes nationwide met federal requirements for disaster plans and training, they also saw that gaps in implementing these plans still exist.

Early this year, CMS proposed new standards for emergency preparedness plans for long-term care facilities. Nursing homes will be required to track residents and staff, and account for any missing staff.  Medical records would have to be secure and available, and emergency planning information would have to be shared with residents and family. Where can administrators go for help with this issue?

Here's the good news: many industry associations have developed emergency preparedness tool kits to be used by long-term care facilities. Government websites such as www.ready.gov, the CDC's emergency preparedness and response site as well as FEMA's Emergency Management Institute offer free information and training modules in emergency preparedness. The CMS proposed standards expand the scope of facility-specific activities. But will these resources and new standards meet the real need for coordination of community resources outside a long-term care facility in the event of a real emergency or disaster?

San Diego County in Southern California may have an answer. In response to a series of wildfires in 2007 that caused the evacuation of a large number of nursing homes, administrators of nursing homes, health care organizations and emergency management services formed a model for communication, mutual aid and response in the event of a disaster called the area coordinator system. A recent overview of the San Diego system by researchers at Emory University' School of Public Health noted that the network, headed by seven volunteer emergency preparedness coordinators who are mostly nursing home administrators, provides a master list of information about nursing homes, a nursing home bed tracking system for open beds in the event of a disaster leading to evacuation, and coordination of crisis management information through a web-based system headed by the San Diego County Office of Emergency Services. 

Nursing homes that choose to participate sign a renewable emergency mutual aid memorandum of agreement which supplements their facility's disaster plan, and addresses issues such as the evacuation process, use of medical supplies and pharmaceuticals,  personnel, liability and other legal and regulatory issues. While the system has not yet been tested by a large scale disaster, it appears to be equipped to handle small to medium sized events, and facilitates communication and trust between local long-term care administrators. 

A system of this type helps communities plan for their response to future disasters in a cost-effective fashion, and encourages long-term care administrators to look beyond their own facility's emergency planning process. It is a model that can easily be replicated in other parts of the country at a local level. Some states such as Florida and North Carolina have good models for community-based emergency preparedness for long-term care facilities. Educators can also help to provide information about leading-edge practices in emergency preparedness to the long-term care community. Truly effective emergency planning and preparedness takes a village, and that village can start with you in your local community.

Mary Helen McSweeney-Feld, Ph.D. is an Associate Professor in the Health Care Management Program, College of Health Professions, at Towson University in Towson, Maryland. She is a member of the American College of Health Care Administrators' Academy of Long-Term Care Leadership and Development, and a member of the National Association of Long-Term Care Administrator Boards' Education Committee.
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