As perils of all types, including wildfires, floods, tornados, earthquakes, mass shootings and a wide variety of other adverse events, impact our nation, providers of senior services must understand the ultimate importance of establishing robust and compliant protocols that will address an “All Hazards” approach to emergency preparedness, response and recovery.

The concept of “All Hazards” Emergency Management essentially means that providers must be prepared to address the ever-expanding scope of emergencies that could potentially impact a community.

While it is impossible to anticipate the “specific” parameters of every type of emergency situation, the concept of “All Hazards” Disaster Planning and Emergency Management is based on the principle that regardless of the root cause of the event, the situation will be managed in an organized manner with a standardized emergency management model like the Incident Command System. 

Organizations such as the Joint Commission provide a snapshot of All Hazards Emergency Management that focuses on these critical capabilities:

When a facility can ensure that it has all of these essential areas of operations adequately addressed with appropriate levels of redundancy and “back-up,” it is understood that an “All Hazards” approach is being utilized.  It would be impossible to have a specific plan on file that identifies the unique nature of every type of emergency that can conceivably occur.  

  • Communications
  • Rsources and Assets
  • Safety and Security
  • Staff Responsibilities
  • Utilities
  • Patient Clinical and Support Activities

For example, a long-term care facility would not have a written plan on file that would address the specificities on an incident where a tanker truck containing hazardous materials rolls over and causes a major incident on the northwest corner of the facility’s property. Instead, it would have plans and protocols in place for a situation requiring either emergency evacuation or sheltering in place with strong focus on the critical capabilities previously cited. 

As a former deputy fire chief, I never knew the specific nature of the next emergency situation but relied on an “All Hazards” approach by utilizing a standardized system of command and control to manage the emergency scene.  In long-term care, this system of command and control is known as the Nursing Home Incident Command System (NHICS)– Originally adapted from the Hospital Incident Command System or HICS, the Nursing Home Incident Command System is a standardized emergency management model that is slowly starting to find its way into providers’ facilities around the country. NHICS was championed by leaders in long-term care from states such as California and Florida, as well as by the American Health Care Association, where the need for a standardized method of command and control became very apparent during large-scale events like hurricanes, wildfires and earthquakes.

The positive elements of NHICS, just like HICS or any adaptation of the Incident Command System (ICS) as promoted by the National Incident Management System, is that it utilizes the same titles, positions, language and concepts as all other variations of ICS. All associated forms and tools utilized in NHICS are organized by the same numbering system as all FEMA-related ICS documents. 

Specific elements of the system including Job Action Sheets have been customized for use and applicability in the long-term care sector of healthcare. While HICS and the management of an emergency in a hospital may be similar to a long-term care facility, many of the positions cited in HICS cannot be filled in a nursing home as these two types of healthcare facilities are not staffed or organized in the exact same manner. As long-term providers become more sophisticated in the Disaster Management Continuum, it will be essential for providers to learn and integrate NHICS into their operations. NHICS will help promote an “interoperable” environment where LTC providers will be able to manage an incident in a standardized, All Hazards manner as well as effectively communicate with emergency response partners and other stakeholders in the community-at-large like fire, law enforcement, EMS, emergency management, hospitals, other “like” facilities and any other organization involved with the management of an emergent event. 

Failure to incorporate this critical emergency management concept into a facility’s Emergency Operations Plan (aka Disaster Plan, Crisis Plan, etc.) can cause miscommunication, un-coordination and an overall ineffective response to crisis or disaster when multiple agencies or organizations are involved with an individual incident or series of incidents. Additionally, failing to have adequate disaster planning and emergency management protocols in place can represent significant risk exposure to a senior services provider. A great “first step” would be to check with long-term care associations in your state to see what type of assistance and resources are available to assist providers with this essential component of operations.

Stan Szpytek is the Life Safety/Disaster Planning Consultant for the Arizona Health Care Association and California Association of Health Facilities (CAHF). A former deputy fire chief and fire marshal with more than 35 years of experience in life safety compliance and emergency preparedness, Szpytek also is the president of Fire and Life Safety Inc.