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Emergency preparedness is crucial for skilled nursing, rehabilitation providers

Published on Feb 21, 2019

Disasters happen and can immediately threaten the well-being of nursing home residents and employees. From natural disasters such as hurricanes or wildfires to intruders threatening harm to residents and employees, skilled nursing and rehabilitation centers must be ready to deal with the unexpected.

Nursing home teams use pre-planned and unannounced mock emergency drills for training purposes. All employees are required to participate, and when possible, drills will be planned and reviewed with community support from emergency preparedness and response professionals.

While every emergency is different, skilled nursing and rehabilitation centers have plans in place for some common disruptions or emergencies. This blog is to provide a broad overview and education on the most common situations and how nursing homes plan for protecting their residents, staff and community.  

Loss of water:

While boil water advisories are quite common, a complete loss of water is rare. In early 2014, a chemical leak in Charleston, West Virginia tainted the water for more than 300,000 people across multiple skilled nursing centers. There was a wide spread “do not use” water advisory that included no drinking or bathing in water in the region for more than two weeks.

Nursing homes should have at least a 96-hour supply of drinking water that can be used for drinking and cooking, and centers have arrangements with local vendors to provide water if the emergency loss of water is more than the 96 hours.

Local emergency agencies can aid in bringing potable water for use in flushing toilets. Another tip for skilled nursing centers is to have an ample supply of coins to go to a laundromat and have clean linens and clothing for the residents. 

Loss of power and emergency generators

When a community loses commercial power, a back-up generator kicks on for lighting and for those residents who rely on oxygen and other medical equipment. Emergency power outlets are typically throughout a facility and extension cords are plugged into these outlets for those medical devices. During a power outage, only these outlets will have emergency power. Staff can be provided with flashlights to better light the center along with emergency lighting.

Nursing homes should have back-up generator and fuel for a minimum of 72 hours.

Environmental teams conduct weekly visual inspections of the generator and verification of the battery’s charge. The generator is tested monthly and is inspected annually by the service provider. Routine maintenance ensures the generator will be ready when needed.


Evacuation plans are made and completed when a disaster is imminent or has occurred. Center leadership and local emergency authorities can determine if the center is unsafe and order the total evacuation. All residents and staff along with emergency responders relocate to a pre-determined and temporary assembly area. 

Temporary shelters are required and must be approved and have a means of cooking meals, bathing, adequate sleeping accommodations and able to maintain safe temperatures. Nursing homes should have multiple sites within 10 miles of the center and some outside 50 miles in the event of a widespread disaster. Typically, local churches or community centers serve as the emergency shelter.

Medical records and resident’s medications can be transferred under supervision to ensure proper clinical care until if or when the center is deemed safe for residents to return.

Fire preparations and drills:

Practicing for the event of a fire in a nursing center is the key to ensuring safety. Centers will have a policy of conducting a minimum of one fire drill per shift, per quarter under different conditions, days and times. Fire drills include the transmission of a fire alarm signal and simulate what to do during an actual fire within the facility.

Drill performance is monitored to ensure the team is adequately trained in fire escape, extinguishing and containing the fire and the safe removal of residents to a safe area. Drills allow for team members to look for areas of improvement.  

These are just a few emergency situations skilled nursing and rehabilitation plan for routinely. Please watch for part two in this series coming soon.