Betty Norman, BSN, MBA, CPHRM

As discussed in Part 1, disaster planning for long-term care facilities requires a deep understanding of your organization and past emergencies. Here, we outline the remaining organizational issues to address.


One of the biggest issues for long-term care facilities is deciding when to evacuate. Clearly it’s a last resort, and even prior to Sandy, FEMA recommended healthcare facilities “shelter in place.”

In creating an evacuation plan, outline, review and practice step-by-step procedures with staff. Running drills helps everyone understand their roles, identifies problems or gaps and helps your organization better understand the plan and its strengths and weaknesses.

As we learned during Sandy, it’s essential to know where residents will be evacuated and to have protocols to account for everyone’s safety. Connect with facilities in your community about where they are evacuating, so you can ensure there is adequate room. Also find ways to guarantee everyone is getting their treatment with appropriate staff and equipment. Finally, consider the scope of potential disasters. Some hurricanes require evacuations many miles away.


Closely tied to evacuation is transportation. While some residents may be transported in vans, others may require emergency services vehicles with specialized equipment. Ask yourself: Which residents will require staff to accompany them, and how will that affect overall staffing levels?

Be sure your contracted transport is not over-committed with other facilities. Many providers learned a hard lesson during Katrina, as some facilities that had made prior arrangements could not be accommodated.


For long-term care facilities, generators are essential to maintain operations during power outages, but having a generator is not enough. If your generators are on lower levels, they could be damaged by flooding. If you move them to high levels, what about fuel pumps in the basement? Identify what operations will be powered by your generators and how long they will run.


Communications are critical to any disaster response and it may be time to review and upgrade your organization’s communications systems. This includes developing a family notification process and maintaining updated contact lists. During Sandy, many facilities discovered they did not have current family contact names and/or phone numbers. Some family members had trouble finding out where their loved one had been relocated.

Furthermore, you need the ability to communicate beyond standard telephone and Internet services. Options include automated telephone alert systems (used by many school systems), satellite phones that work when cell phone service is down and a plan to notify government agencies.

Lastly, it is essential to create a media response plan and identify one spokesman in the event of an emergency. This is often the administrator or director. Clearly define what the spokesman can and cannot say, especially to the media. A media response plan with specific protocols is essential.

Business Operations

If your facility is computerized with electronic medical records, you need back up systems, including a remote system, so you can continue operations. If you have paper records, make sure they are secure from water, wind and fire damage.

If you have to evacuate your facility, have a plan for securing your facility, turning off utilities and contacting your insurance company. Also consider Business Interruption insurance. This coverage goes beyond just property damage. It covers loss of revenue from being out of service.

Learn, Plan and Practice

It is important to learn from disasters such as Sandy and continually update your plan. Be sure to practice; drills are essential to your success. As in Sandy, those who fared the best knew what to do ahead of time. When disaster strikes it’s too late to begin planning.

Betty Norman, BSN, MBA, CPHRM, is Risk Control Director at Glatfelter Healthcare Practice, part of Glatfelter Program Managers.