Attorney Offers Emergent Situation Guidance to Long-Term Care Facilities

July 10, 2018

UNCASVILLE, CT—In today’s security-conscious environment, long-term care (LTC) facilities must have plans in place for just about any kind of emergent threat or disaster, attorney Nancy Reynolds told an audience at the recent 2nd Annual Long-Term Care Insurance ExecuSummit conference in Uncasville.

“Emergent situations are unexpected events calling for quick action,” said Reynolds, a Roanoke-based member of national law firm LeClairRyan, who served on a panel, 911 in LTC Facilities: How to Prepare and Respond to Emergent Situations Ahead of Disaster. “Each situation—from an armed intruder to a flood or other natural peril—is unique and requires a different plan and response.”

Her presentation focused on “hot button” natural or manmade disasters that can threaten life and property at LTCs. “The goal is to protect residents, staff, and physical assets,” she advised. “The way to do this to have a plan, support the plan, and periodically train to implement it. There are four basic steps: The What, the Why, the How, and the Implementation.”

The first step, the ‘What,’ involves identifying the risks, explained Reynolds, leader of LeClairRyan’s Long-Term Care industry team. “In accordance with federal codes, an LTC should conduct a facility and community-based risk assessment to highlight potential threats.”

Once the risks are identified, the ‘Why’ step involves analyzing the threats, she said.  “The precise analysis will depend on the type of risks that were identified, and on the characteristics of the resident population.”

In step three, the ‘How,’ an LTC will determine the components of the plan. “This means developing mitigation strategies to address the risks; and the specifics of the response will depend on the situation,” she advised. “It may involve evacuating or sheltering in place, or it could require alternate transportation or housing. In any situation, however, plans should be developed to alert and work with local officials.”

The final step is to implement the plan. “You shouldn’t wait for a situation to occur before ‘test driving’ your response,” cautioned Reynolds. “Early on, an LTC should develop policies and procedures to support and enforce the plan, and educate and train the appropriate individuals in executing it. Once that’s done, test it periodically to ensure it works, and to familiarize everyone with the details.”

The specifics of the threat responses will vary by the nature of the situation and by the LTC’s circumstances, but Reynolds noted that there are some common best practices. “A primary one is location readiness,” she explained. “Has the facility established receiving areas with provisions for sign-ins and sign-outs so everyone is accounted for? Backup generators and portable heaters should be readily available, along with backup potable water, nonperishable food, and AEDs (automated external defibrillators) and other medical devices and supplies.”

Communication is another vital component. “Designated staff should be aware of their responsibilities for internal and external communications, and an emergency contact list—consisting of contact names and titles in priority order—should be maintained,” said Reynolds. “This list should be on phones, laptops and hard copies at designated locations. The primary emergency contacts will typically include police and fire departments, names of residents’ physicians and family members. Additional contacts will include emergency response vendors, employee assistance programs, crisis counselors, and others.”

Addressing the issue of an evacuation response, Reynolds said that appropriate individuals should be familiar with evacuation routes and locations, and any special needs of residents. They should also know where and how to access emergency travel kits, if necessary. If a shelter-in-place response is required, appropriate individuals should know the specified locations, which should also have proper backup and other supplies.

“Everyone hopes they’ll never need to activate an emergency plan,” she concluded. “But structuring one and training for it early on may save a lot of confusion and grief later.”

Reynolds appeared on the panel with attorney Chastiti N. Horne of Horne Rota Moos LLP; Paul Marshall, a managing director at McGowan Program Administrators; and Thomas Masiello, VP enterprise risk management, at Benchmark Senior Living.