Respond

Active Shooter/Workplace Violence

PDF

FBI: Bomb Threat Call Checklist

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 All-Hazards Incident Planning Guide (2017)

Updated 4/10/2018
PDF

Ready Set Go - Armed Assailant

Brief information regarding preparedness and response to an armed assailant.
Updated 4/10/2018

Cybersecurity & EHR

PDF

NHICS All-Hazards Incident Planning Guide (2017)

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

Earthquakes

PDF

NHICS All-Hazards Incident Planning Guide (2017)

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 - 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

NHICS All-Hazards Incident Planning Guide (2017)

Updated 4/10/2018
PDF

Ready Set Go - Wildfire

Brief information regarding preparedness and response to wildfire.
Updated 4/10/2018
PDF

Surge Strategies & Regulatory Guidance for SNFs

Updated 4/10/2018

Extreme Weather (Cold & Heat)

WWW

National Weather Service -Western Region (weblink)

Updated 4/10/2018
PDF

NHICS All-Hazards Incident Planning Guide (2017)

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 - 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)

WWW

InciWeb Fire Incidents

Updated 8/1/2019
PDF

NHICS All-Hazards Incident Planning Guide (2017)

Updated 4/10/2018
PDF

NHICS Incident Response Guide - Fire (Internal & External) (2017)

To safely mange the operation of the facility during response to an internal fire incident.
Updated 4/10/2018
PDF

Ready Set Go - Wildfire

Brief information regarding preparedness and response to wildfire.
Updated 4/10/2018

Flooding (Internal & External)

WWW

National Weather Service -Western Region (weblink)

Updated 4/10/2018
PDF

NHICS All-Hazards Incident Planning Guide (2017)

Updated 4/10/2018
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

Emergency Event Media Relations Guide Card

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
WWW

National Weather Service -Western Region (weblink)

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
WWW

Nursing Home Incident Command System (NHICS) Complete Kit (2017)

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

Hazardous Material/Waste Spill

PDF

NHICS All-Hazards Incident Planning Guide (2017)

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.
Updated 4/10/2018
PDF

NHICS All-Hazards Incident Planning Guide (2017)

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

Missing Resident

PDF

NHICS All-Hazards Incident Planning Guide (2017)

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
PDF

NHICS All-Hazards Incident Planning Guide (2017)

Updated 4/10/2018
PDF

Surge Strategies & Regulatory Guidance for SNFs

Updated 4/10/2018

Utility Failure

PDF

NHICS All-Hazards Incident Planning Guide (2017)

Updated 4/10/2018
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