Respond
Active Shooter/Workplace Violence
PDF
Keep It With You: Personal Medical Information Form
The “Keep It With You” Personal Medical Information Form is intended to be a voluntary and temporary record that lists medical care and other health information for people who need care during disasters and similar situations.
Updated 4/10/2018
PDF
Ready Set Go - Armed Assailant
Brief information regarding preparedness and response to an armed assailant.
Updated 4/10/2018
Earthquakes
PDF
NHICS Incident Response Guide - Earthquake (2017)
How to respond to a major earthquake and maintain facility operations for a minimum of 96-hours following such event that may impact the structural integrity of the facility, and to insure the continuum of care for patients, visitors, and casualties of the event.
Updated 4/10/2018
PDF
Ready Set Go - Earthquake
Brief explanation of steps that should be taken for a facility to prepare for and respond to an earthquake.
Updated 4/10/2018
Evacuation
DOC
CAHF: Resident Assessment Form for Transport & Destination
This form is used to periodically review and assess the facility population for evacuation transport and relocation, transport and relocation needs.
Updated 4/10/2018
PDF
Evacuation Client "GO KIT"
Use form as a checklist for suggested contents that a facility might need during an evacuation.
Updated 4/10/2018
PDF
Individual Resident Evacuation Tracking Form: NHICS Form 260 (2017)
Used for the documentation for each resident transferred to another facility
Updated 4/10/2018
PDF
Keep It With You: Personal Medical Information Form
The “Keep It With You” Personal Medical Information Form is intended to be a voluntary and temporary record that lists medical care and other health information for people who need care during disasters and similar situations.
Updated 4/10/2018
PDF
Master Resident Evacuation Tracking Form: NHICS Form 255 (2017)
Record Information Concerning Resident Disposition During a Facility Evacuation
Updated 4/10/2018
PDF
NHICS Activation Guidance
NHICS is a framework for response that can be easily integrated into a long-term care facility's existing emergency operation plan (EOP). Regular utilization of NHICS on non‐emergency situations that require a coordinated response can help develop a consistent and disciplined approach to incident management. This guidance will promote this practice.
Updated 4/10/2018
PDF
Ready Set Go - Wildfire
Brief information regarding preparedness and response to wildfire.
Updated 4/10/2018
Extreme Weather (Cold & Heat)
PDF
NHICS Incident Response Guide - Severe Weather (2017)
To safely manage the operation of the nursing home (including providing for the safety of residents, visitors, and staff) during a sever weather emergency such as an ice storm, snowstorm, rain, flooding, etc.
Updated 4/10/2018
PDF
Ready Set Go - Extreme Cold
Brief information regarding preparedness and response to extremely cold weather.
Updated 4/10/2018
PDF
Ready Set Go - Extreme Heat
Brief information regarding preparedness and response to extreme heat.
Updated 4/10/2018
Fire (Internal, External, Wildfires)
Flooding (Internal & External)
PDF
NHICS Incident Response Guide - Flooding (2017)
To safely manage the operations of the nursing home during response to internal flooding and system restoration.
Updated 4/10/2018
PDF
NHICS Incident Response Guide - Severe Weather (2017)
To safely manage the operation of the nursing home (including providing for the safety of residents, visitors, and staff) during a sever weather emergency such as an ice storm, snowstorm, rain, flooding, etc.
Updated 4/10/2018
PDF
Ready Set Go - Flood
Brief information regarding preparedness and response to flood.
Updated 4/10/2018
General Information & Links
WWW
CAHF: Updated Emergency Operations Plan Template (2017)
This template is a tool that should be customized to fit the circumstances and needs of your facility.
Updated 4/10/2018
WWW
CDC: Respiratory Hygiene/Cough Etiquette in Healthcare Settings (weblink)
Link to a page on CDC - provides infection control measures to be implemented at the first point of contact with a potentially infected person.
Updated 4/10/2018
PDF
Keep It With You: Personal Medical Information Form
The “Keep It With You” Personal Medical Information Form is intended to be a voluntary and temporary record that lists medical care and other health information for people who need care during disasters and similar situations.
Updated 4/10/2018
PDF
NHICS Incident Response Guide - Earthquake (2017)
How to respond to a major earthquake and maintain facility operations for a minimum of 96-hours following such event that may impact the structural integrity of the facility, and to insure the continuum of care for patients, visitors, and casualties of the event.
Updated 4/10/2018
PDF
Ready Set Go - EHR
Have a Facility action plan for for an Electronic Health Record Outage
Updated 4/10/2018
Infectious Disease
PDF
CDC: Procedures for Properly Putting On and Taking Off a Disposable Respirator - Poster
General Procedures for Properly Putting on and Taking Off a Disposable Respirator - Prepared by the Centers for Disease Control and Prevention (CDC)
Updated 4/10/2018
WWW
CDC: Respiratory Hygiene/Cough Etiquette in Healthcare Settings (weblink)
Link to a page on CDC - provides infection control measures to be implemented at the first point of contact with a potentially infected person.
Updated 4/10/2018
PDF
Checklist for Suspected Outbreak of H1N1 Influenza
Checklist for suspected outbreak of H1N1 Influenza (Swine Flu) in a long term care facility.
Updated 4/10/2018
PDF
Flu Screening Form
This tool can be used by
employees to screen themselves for symptoms during an outbreak before
coming to work, and it can also be used to screen employees for symptoms
at the beginning of each shift.
employees to screen themselves for symptoms during an outbreak before
coming to work, and it can also be used to screen employees for symptoms
at the beginning of each shift.
Updated 4/10/2018
PDF
NHICS Incident Response Guide - Infectious Disease (2017)
To effectively and efficiently identify, triage, isolate, treat, and track a surge of potentially infectious residents and staff; and to manage the uninjured/asymptomatic persons, family members, and the media.
Updated 4/10/2018
PDF
Ready Set Go - H1N1
Brief information regarding preparedness and response to Infection Control of H1N1.
Updated 4/10/2018
Shelter-In-Place/Lockdown
PDF
NHICS Activation Guidance
NHICS is a framework for response that can be easily integrated into a long-term care facility's existing emergency operation plan (EOP). Regular utilization of NHICS on non‐emergency situations that require a coordinated response can help develop a consistent and disciplined approach to incident management. This guidance will promote this practice.
Updated 4/10/2018
Utility Failure
PDF
NHICS Incident Response Guide - Flooding (2017)
To safely manage the operations of the nursing home during response to internal flooding and system restoration.
Updated 4/10/2018
PDF
NHICS Incident Response Guide - Utility Failure (2017)
To safely manage the operations of the nursing home during a power outage and its restoration.
Updated 4/10/2018
PDF
Ready Set Go - EHR
Have a Facility action plan for for an Electronic Health Record Outage
Updated 4/10/2018
PDF
Ready Set Go - Power Outages
Brief information regarding preparedness and response to power outages.
Updated 4/10/2018