Long-Term Health Care Facilities

The information and resources listed here are specifically for long term care facilities (LTCF). Each of these resources can help LTCFs plan and prepare for emergencies. The categories, with descriptions, were created to help you find the information you need. If you have any questions please contact your local Emergency Manager or Public Health Emergency Preparedness Coordinator.

None of these resources are legally binding in their current format. Please work with your legal counsel for final approval and legal needs. These resources may help with CMS, OAR, and/or ORS requirements.

REGULATORY REQUIREMENTS

• Emergency Preparedness Rule (Centers for Medicare & Medicaid Services, Sept 2016)

• Emergency Preparedness Requirements for Medicare and Medicaid Participating Providers and Suppliers (ASPR TRACIE)

• CMS Requirements Chart (by Provider Type)

• Emergency and Disaster Planning Requirements (Oregon Administrative Rules - Nursing Facilities/Licensing)

MUTUAL AID

AGREEMENT TEMPLATES/EXAMPLES

• (NEED) Mutual Aid Agreement with Health Care Facility (Template)

• (NEED) Mutual Aid Agreement between facility and facility (Template)

• (NEED) Mutual Aid Agreement between facility and facility (Template 2)

• (NEED) Memorandum of Understanding between health care entities (Template)

• (NEED) Transportation Mutual Aid Agreement (Template 1)

• (NEED) Transportation Mutual Aid Agreement (Template 2)

PLAN/PROCEDURE TEMPLATES

• Emergency Operations Plans, Tools, Templates (ASPR TRACIE)

• Disaster Preparedness Plan (Template)

• (NEED) Emergency Preparedness and Response Plan (Template)

• (NEED) Personal Protective Equipment (PPE) Inventory Procedure (Template)

GUIDES & REFERENCE

• LTC Plan Crosswalk Matrix (State of New Jersey)

• Nursing Home Incident Command System Guidebook (California)

• Implementing NHICS into Your Facility (NHICS Module 5, PowerPoint)

• (NEED) CMS Emergency Preparedness Checklist for LTCF

• CMS Emergency Preparedness Checklist (For persons in LTCF, family members, friends, caregivers, guardians, and LTC ombudsmen)

• LTC Resources (Centers for Disease Control)

EXERCISE EXAMPLES/TEMPLATES

• (NEED) Exercise After Action Report and Improvement Plan (Template)

• Exercise Resources (ASPR TRACIE)

CONTACT LIST

• (NEED) 2015-2016 Oregon Hospital and Healthcare Guide