Missin: Organize and direct the Nursing Hme Cmmand Center (NHCC). Give verall strategic directin fr incident management and supprt activities, including emergency respnse and recvery. Authrize ttal facility evacuatin if warranted. Date: Start: End: Name f Persn Assigned t Psitin: Phne: Signature: Initial: NHCC Lcatin: Email: Immediate Respnse (0-2 hurs) Time Initial Receive appintment (rle may be filled by the Nursing Hme Administratr r designee) Assume the psitin f Incident Cmmander Put n psitin identificatin (e.g., vest, cap, etc.) Read this entire Jb Actin Sheet Ntify yur usual supervisr that yu have been assigned t the Incident Management Team (IMT) Reprt t the Incident Cmmander until dembilized Assess the peratinal situatin Activate the emergency peratins plan and initiate internal ntificatins as apprpriate Determine need fr and apprpriately appint Cmmand Staff and Sectin Chiefs, r Branch Directrs, and Medical/Technical Specialists as needed Initiate the Incident Briefing Frm (see NHICS 201) and brief all appinted staff. Include the fllwing: Nature f the prblem (incident type, victim cunt, injury/illness type, etc.) Safety f staff, residents, and visitrs Risks t persnnel and need fr prtective equipment Risks t the physical plant Estimated duratin f incident Need fr mdifying daily peratins Prbability f need fr shelter-in-place, partial r ttal evacuatin Verificatin f transprtatin plans IMT psitins required t manage the incident Need t ntify state licensing agency Overall cmmunity respnse actins being taken Status f lcal, cunty, and state Emergency Operatins Centers (EOC)
Immediate Respnse (0-2 hurs) Time Initial Distribute crrespnding Jb Actin Sheets and psitin identificatin (see NHICS 207) Prvide guidance n cmpleting and submitting the fllwing frms: NHICS 200: IAP Quick Start (delegate t the Planning Sectin Chief) NHICS 214: Activity Lg (All NHCC Psitins) NHICS 215A: IAP Safety Analysis (Safety Officer) NHICS 251: Facility System Status Reprt (Infrastructure Branch Directr) Designate time fr the next Briefing r Incident Actin Planning meeting Determine the incident bjectives, tactics, and assignments Receive verbal status reprts frm Cmmand Staff t determine respnse and recvery levels and incident bjectives Identify the peratinal perid and NHCC shift change (e.g. every 12 hurs) Develp the NHICS 200. Receive initial facility damage survey reprt frm Infrastructure Branch Chief and evaluate the need fr evacuatin Obtain resident census and status frm Planning Sectin Chief, and request a facility-wide prjectin reprt fr 4, 8, 12, 24, and 48 hurs frm time f incident nset. Adjust prjectins as necessary Cnsider the use f an alternative staff time tracking methd (see NHICS 252). Delegate t Finance Administratin Sectin Chief if activated: Distribute time sheets t staff and Medical Directr/Specialist assigned t Cmmand, and ensure time is recrded apprpriately Determine the frequency that staff shuld submit these time sheets t the Finance/Administratin Sectin Chief (e.g. at the cmpletin f a shift r at the end f each peratinal perid) Seek infrmatin frm Sectin Chiefs regarding current n-hand resurces f medical equipment, supplies, medicatins, fd, and water as indicated by the incident and authrize as needed. Delegate t Lgistics Sectin Chief if activated Ensure that apprpriate cntact with utside agencies has been established and that facility status/resurce infrmatin is prvided t apprpriate agencies thrugh the Liaisn/Public Infrmatin Officer (PIO) Wrk with Liaisn/PIO t draft initial message fr ntificatin t family members, respnsible parties, and/r ther need t knw parties regarding the resident and facility status As apprpriate t the incident, authrize a resident priritizatin assessment fr the purpses f designating apprpriate transfer r discharge (e.g. ventilatr and /r dialysis residents may need t be discharged t higher level f care r ambulatry residents may need t g first) Assess current r prjected generatr lad and fuel supply
Immediate Respnse (0-2 hurs) Time Initial Dcumentatin NHICS 200: Fr ease f use thrughut an emergency r t get yu started at the nset f an activatin NHICS 201: Initiate the Incident Briefing Frm NHICS 207: Assign r cmplete the IMT Chart fr assigned psitins NHICS 214: Cntinue dcumentatin f key activities, actins, cmmunicatins, and decisins n a Activity Lg NHICS 215A: Cmplete r btain (frm the Safety Officer) the IAP Safety Analysis NHICS 251: Obtain and review the Facility System Status Reprt frm the Infrastructure Branch Directr, if available NHICS 252: Ensure Sectin Persnnel Time Sheets (r ther methd f tracking staff time) is cmmunicated Resurces Assign ne r mre clerical persnnel frm current staffing t functin as the NHCC Scribe/Runner at IMT Briefings r ther meetings as apprpriate Delegate tasks as the demand and wrklad increase Cmmunicatin Utilize available cmmunicatins technlgy r a runner t alert staff regarding the incident Initiate emergency ntificatin t residents, families and external partners Ntify nursing hme Chief Executive Officer, Bard f Directrs, state survey agency, and ther apprpriate internal and external fficials f situatin status Safety and security Review security and facility surge capacity and capability plans as apprpriate NHICS 215A: Ensure that the IAP Safety Analysis is cmpleted and distributed NHICS 251: Ensure that a Facility System Status Reprt is cmpleted if the incident warrants Intermediate Respnse (2-12 hurs) Time Initial Cntinue t authrize resurces as needed r requested by Cmmand Staff/Sectin Chiefs Designate regular briefings with Cmmand Staff/Sectin Chiefs t identify and plan fr: Update f current situatin/respnse and status f ther area lng-term care facilities, hspitals, emergency management/lcal emergency peratin centers, and public health fficials and ther cmmunity respnse agencies Facility peratinal supprt issues Risk cmmunicatin and situatin updates t staff and families Implementatin f facility surge capacity prcedures Ensuring resident tracking system is established and linked with apprpriate utside agencies and/r lcal Emergency Operatins Center Apprpriate use and activatin f safety practices and prcedures Enhanced staff prtectin measures as apprpriate Media relatins and briefings
Intermediate Respnse (2-12 hurs) Time Initial Staff and family supprt As needed, cnduct Incident Actin Planning meetings r cllect infrmatin frm Sectin Chiefs and Cmmand Staff t determine apprpriate respnse t changing cnditins and recvery levels Oversee and apprve revisin f the IAP develped by the Planning Sectin Chief Update verall bjectives, tactics, and assignments Initiate planning fr transfer f cmmand as apprpriate Apprve media releases submitted by the Liaisn/PIO Ensure that the apprved IAP is cmmunicated t all Cmmand Staff and Sectin Chiefs Cmmunicate facility and incident status and the IAP t CEO r designee, r t ther executives n a need-t-knw basis Dcumentatin NHICS 214: Cntinue dcumentatin f key activities, actins, cmmunicatins, and decisins n a Activity Lg Resurces Authrize resurces as needed r requested by Cmmand Staff and Sectin Chiefs Cmmunicatin Cmmunicate with ther health care facilities t determine their ability t accept residents if transferred Cntinue crdinatin with the Liaisn/PIO fr internal and external messaging and briefings Safety and security Ensure that resident and persnnel safety measures and risk reductin actins are fllwed Extended Respnse (greater than 12 hurs) Time Initial Ensure that briefings f staff, residents and the medical cmmunity are regularly cnducted Review and revise the IAP Safety Analysis (see NHICS 215A) and implement crrectin r mitigatin strategies Evaluate verall peratinal status, and ensure critical issues are addressed Review /revise the IAP with the Planning Sectin Chief fr each peratinal perid and reprt n plan at shift change/briefings Upn transfer f cmmand, brief yur replacement n the status f all nging peratins, critical issues, relevant incident infrmatin, and IAP fr the next peratinal perid Ensure cntinued cmmunicatins with lcal, reginal, and state respnse crdinatin centers, families, and ther Nursing Hme Incident Cmmand Centers (NHCCs) thrugh the Liaisn/PIO and thers Dcumentatin NHICS 214: Cntinue dcumentatin f key activities, actins, cmmunicatins, and decisins n a Activity Lg
Extended Respnse (greater than 12 hurs) Time Initial Resurces Authrize resurces as needed r requested by Cmmand Staff and Sectin Chiefs Cmmunicatin Cntinue t update fr staff, residents, families and external partners Cntinue crdinatin with the Liaisn/PIO fr internal and external messaging and briefings Update the nursing hme CEO, Bard f Directrs, state survey agency, and ther apprpriate internal and external fficials f situatin status Safety and security Ensure yur physical readiness, and that f all Staff and vlunteers, thrugh prper nutritin, water intake, rest perids and relief, and stress management techniques Dembilizatin/System Recvery Time Initial Assess the plan develped by Planning and Operatins fr the gradual dembilizatin f the NHCC and emergency peratins accrding t the prgressin f the incident and facility status Dembilize psitins in the NHCC and return persnnel t their nrmal jbs as apprpriate until the incident is reslved and there is a return t nrmal peratins Brief staff, administratin, and ther executives Apprve annuncement f ALL CLEAR when the incident n lnger pses a critical safety threat r can be managed using nrmal facility peratins Ensure utside agencies and families are aware f status change Ensure dembilizatin f the facility and restcking f supplies, as apprpriate including: Return f brrwed equipment t apprpriate lcatin Replacement f brken r lst items Clean up facility, cmmand center and envirnment, as warranted. Restck f NHCC supplies and equipment Ensure that after-actin activities are crdinated and cmpleted including: Cllectin f all NHCC dcumentatin by the Planning Sectin Chief Crdinatin and submissin f respnse and recvery csts, and reimbursement dcumentatin by the Finance/Administratin and Planning Sectin Chiefs Cnducting staff debriefings t identify accmplishments, and respnse and imprvement issues Identificatin f needed revisins t the emergency peratins plan, Jb Actin Sheets, peratinal prcedures, recrds, and/r ther related items Writing the facility After Actin Reprt and Imprvement Plan Participatin in external (cmmunity and gvernmental) meetings and ther pstincident discussin and after-actin activities Pst-incident media briefings and facility status updates Pst-incident educatin and infrmatin fr residents, staff, and families
Dembilizatin/System Recvery Time Initial Behaviral health supprt fr staff if needed r requested Dcumentatin NHICS 214: Upn deactivatin f yur psitin, submit Activity Lgs and all cmpleted dcumentatin t the Planning Sectin Chief NHICS 252: Submit Time Sheet t the Finance/Administratin Time Unit Leader at end f shift r peratinal perid as determined Cmmunicatin Cmmunicate final nursing hme status and terminatin f the incident t lcal EOC, area nursing hmes, fficials, and state survey agency Dcuments and Tls NHICS 200: IAP Quick Start which includes a cmbined and abbreviated: NHICS 201: Incident Briefing Frm NHICS 202: Incident Objectives NHICS 203: Organizatin Assignment List NHICS 204: Assignment List NHICS 215A: Incident Actin Plan (IAP) Safety Analysis NHICS 207: Incident Management Team (IMT) Chart NHICS 214: Activity Lg NHICS 251: Facility System Status Reprt NHICS 252: Sectin Persnnel Time Sheet Cmmunicatin plan Business Cntinuity Plan Facility emergency peratins plan and ther plans as cited in the Jb Actin Sheets Facility rganizatinal chart Facility telephne directry Nursing Hme Incident Cmmand System (NHICS) Jb Actin Sheets have been adapted frm the Hspital Incident Cmmand System 5 th Editin (2014) Guidebk by the American Health Care Assciatin (AHCA) Disaster Preparedness Cmmittee