Table 21: Continuity Facilities Table 22: Roles and Responsibilities 1. INTRODUCTION A. Purpose The Minimum Standards for Institutions for the Aged or Infirm, Subchapter 14, Rule 45.14.1 states: The licensed entity shall develop and maintain a written preparedness plan utilizing the “All Hazards” approach to emergency and disaster planning. The plan must include procedures to be followed in the event of any act of terrorism or man-made or natural disaster. The Emergency Operations Plan (EOP) will be reviewed by the Mississippi State Department of Health (MSDH) Office of Emergency Planning and Response (OEPR) or designees for conformance with the “All Hazards Emergency Preparedness and Response Plan.” Particular attention shall be given to critical areas of concern which may arise during any “all hazards” emergency whether required to evacuate or to sustain in place. Additional plan criteria or a specified EOP format may be required as deemed necessary by the OEPR. The six (6) critical areas of consideration are: Communications - Facility status reports shall be submitted in a format and a frequency as required by the OEPR. Resources and Assets Safety and Security Staffing Utilities Clinical Activities EOPs must be exercised and reviewed annually or as directed by OEPR. Written evidence of current approval or review of provider EOPs, by OEPR, shall accompany all applications for facility license renewals. Regulatory and Centers for Medicare and Medicaid Services require the following supporting plan documents: Alternate Care Sites (on and off campus) Transportation contracts with designated patient transporters Communications plan Concept of Operations Evacuation maps and floor plans Mutual aid agreements
C. Authorities and References <Insert title and date of local city and/or county emergency operations plan > <Insert titles of other organizational plans or policies that have a connection to the Emergency Operations Plan> Mississippi Emergency Management Agency (MEMA) Minimum Standards for Institutions for the Aged or Infirm Mississippi State Department of Health Title 15, Part III, Subpart 01, Chapter 45 Institutions for the Aged or Infirm Mississippi Code Annotated 43-11-1 through 43-25-17 Emergency Management Guide for Nursing Homes Health Care Association, 2008 National Incident Management System (NIMS) Federal Emergency Management Agency (FEMA) Incident Command System (ICS) FEMA The Joint Commission Strategic National Stockpile Centers for Disease Control and Prevention Mississippi Responder Management System Mississippi State Department of Health State Medical Asset and Resource Tracking Tool EMS Emergency Performance Improvement Center Centers for Medicare & Medicaid Services (CMS)
Incident management activities are divided into four phases: mitigation, preparedness, response, and recovery. These four phases are described below: Mitigation: Mitigation activities are those that eliminate or reduce the possibility of a disaster occurring. For healthcare operations, this may include installing generators for backup power, installing hurricane shutters, and raising electrical panels to protect them from possible flood damage. <Insert facility’s strategies for mitigation> Preparedness: Preparedness activities develop the response capabilities that are needed in the event an emergency occurs. These activities may include developing emergency operations plans and procedures, conducting training for personnel in those procedures, and conducting exercises with staff to ensure they are capable of implementing response procedures when necessary. <Insert facility’s strategies for preparedness> Response: Response includes those actions that are taken when a disruption or emergency occurs. It encompasses the activities that address the short-term, direct effects of an incident. Response activities in the healthcare setting can include activating emergency plans, and triaging and treating residents who have been affected by an incident. <Insert facility’s strategies for response> Recovery: Recovery focuses on restoring operations to a normal or improved state of affairs. It occurs after the stabilization and recovery of essential functions. Examples of recovery activities include the restoration of non-vital functions, replacement of damaged equipment, facility repairs, organized return of residents into the facility, and reconstitution of resident records and other vital information systems. Another key consideration in the recovery and response phases of an incident is the tracking of staff hours, expenses, and damages incurred as a result of the emergency. Detailed records will need to be maintained throughout an emergency to document expenses and damages for possible reimbursement or to properly file insurance claims. <Insert facility’s strategies for recovery> B. Plan Activation The Emergency Operations Plan will be activated in response to internal or external threats to the facility. Internal threats could include fire, bomb threat, loss of power or other utility disruption, or other incidents that threaten the well-being of residents, staff, and/or the facility itself. External threats include events that may not affect the facility directly but have the potential to overwhelm long term care resources or put the facility on alert. Persons Responsible for Plan Activation Once a threat has been confirmed, the employee obtaining the information must notify their supervisor immediately. If the employee cannot contact their supervisor, they must immediately contact the <Insert position title> directly.
The <Insert position title> will coordinate planning and response activities with public health. Activities may include: Following disease reporting requirements at In the event the Emergency Operation Plan is activated by the facility, the MSDH Emergency Response Coordinator (ERC) shall be notified along with the local Emergency Management Agency. Reference District Public Health Emergency Preparedness Map in Annex A: Communications. Providing regular updates to the Statewide Medical Asset and Resource Tracking Tool as required (See Annex E). Participating in and providing support for the Mississippi Responder Management System (MRMS) (See Annex F). Participating in public health planning initiatives. Receiving guidance and health alerts through the Health Alert Network. Participating in any after-action planning as requested from public health officials. <Describe/outline below how the facility will coordinate planning and response activities with public health> 7. RESOURCES AND ASSETS A. Acquiring and Replenishing Medications and Supplies
E. Evacuation Locations If the facility is damaged to the extent that resident care cannot be rendered, or it is determined that evacuation is warranted due to fire, an approaching hurricane, or other hazard, residents may be transported to a receiving facility for temporary care. The terms “close”, “within area”, and “outside of area” represent the concept that healthcare facility residents need to move as short a distance as possible. The farther frail residents must travel, the less safe the evacuation becomes for them. Therefore, the distance traveled must be balanced with the possible harm extended travel may cause. Close Proximity Close proximity locations are within a short distance (within 10 miles) from the facility and will be utilized when unplanned or immediate evacuations are necessary. Table 13 Close Proximity Evacuation Locations Location Facility Name Address Phone Number Alternate Contact Memorandum of Agreement/ Mutual Aid Agreement Primary Backup 1 Backup 2 Within Area Within area locations are those within a reasonable distance (within 10 - 50 miles) from the facility and will be utilized for unplanned or planned evacuations relative to the type of hazard or threat to the facility. Table 14 Within Area Evacuation Locations Location Facility Name Address Phone Number Alternate Contact Memorandum of Agreement/ Mutual Aid Agreement Primary Backup 1 Backup 2 Out of Area Out of area locations are a significant distance (over 50 miles) from the facility and will be utilized for planned evacuations.
Delegations of Authority: Located in Command and Coordination Section. Risk Assessments and Hazard Vulnerability Analysis: Located in Attachment 1 and 2 of this annex. Continuity Facilities The <Insert name of facility > has identified continuity facilities to conduct business and/or provide clinical care to maintain essential functions when the original property, host facility, or contracted arrangement where the facility conducts operations is unavailable for the duration of the continuity event. The table below lists the alternate sites, devolution sites, and telework options. Table 21 Continuity Facilities Continuity Facility Type of Facility Location of Facility Accommodations Sister Facility* Alternate/Devolution Site 1234 Medical Center Drive, Niceville Identified meeting rooms with telephones, internet access, ham radio access, satellite radio access, 2 desktop computers, and laptop connectivity