What Are Important Disaster Preparation Tips for an RCFE Facility?

Many residential care facilities for the elderly emphasize resident safety. For example, RCFEs prioritize fall prevention, security, and other measures. However, disaster preparation might not get the same level of attention that it deserves. The good news is that informed preparation can go a long way if you own or operate such a facility. Similarly, if you’re exploring or completing education regarding senior care communities, your RCFE education should include disaster training.

1. Meet State Requirements

In California, Title 22, Section 87212 and Health and Safety Codes 1569.695 cover emergency disaster plans. RCFEs also need a current LIC 610E and facility sketch.

It’s important to learn about these requirements, among others, when you start an assisted living business. The guidelines cover areas such as utility shutoff, resident assembly points, and making disaster plans available to residents and others. Many of these requirements can be found below.

2. Train Staff

Your facility needs a comprehensive disaster binder. It should include contingencies for different types of disasters and various types of contact information. Staff members must know where it is and what information is in it. Here’s an overview of a disaster training module that ALE offers. It covers much of what to include in your binder.

• During regular reviews of your disaster plan, ensure that staffers’ first aid cards are current. Hold quarterly fire and disaster drills for each shift.
• Staff training should cover areas such as utility shut offs and emergency exits (including those leading directly outside).
• Train staff on how to work with residents who have dementia or who are bedridden. For example, how to evacuate them? How to supervise them?
• Orientation for new employees should cover disaster procedures.
• Residents and their family members should get disaster training, too.

Have a plan for keeping residents’ family members in the loop. Staff training should include who contacts DSS, families, hospice, doctors, and others, as well as what contact channels to use.

3. Prepare for Specific Disasters as Well as General Disasters

There are two types of disaster conditions: internal and external. As the name implies, internal disasters originate inside RCFEs. Fire is one example, and RCFE caregiver training needs to include preparedness and response for fire situations. These trainings come with unique prevention strategies, like changing smoke detector batteries at least once a year.

Power, water, and gas outages are other types of internal disasters that you should prepare and train for.

External disasters originate outside of the facility. Earthquakes and heat waves (or extreme heat), for example, fall under the category of external disasters and should be included in your training.

4. Go Online and Stay Current

Store all documents online as soon as you can so that emergency responders, residents’ caregivers, family members, and others can access what they need to, when they need it. Of course, this registry needs to be secure and compliant with regulations. Staff members must input details about medication changes and ADL care notes in this registry.

Both online and physical disaster plans need to be kept complete and up-to-date at all times. For example, it’s crucial to keep your resident rosters current and include ability details, such as whether a resident is bedridden. DSS Form LIC 9020 can serve as your resident roster. Other good information to include:

• LIC 601s (emergency information)
• Physician reports
• Medication lists
• Insurance cards
• DNRs, POLSTs, and similar orders

5. Encourage Individual Disaster Kits

It’s a good idea for each resident to have their own kit. These can include:

• Contact information of the resident’s doctor
• Extra ID bracelets
• Copies of power of attorney and other legal documents
• Copies of medical details about the resident’s condition and current medications
• Copies of Social Security and insurance cards

The kits should be accessible, with waterproof bags for the documents and medications.

6. Remain Up-to-Date

RCFE administrators need to stay current on their training, too. Stay in touch with local contacts such as the fire department and your Red Cross chapter. They can help with disaster prevention, preparation, mitigation, and training.

RCFE staff should be trained in emergency procedures, especially evacuation preparedness.

7. Prioritize Evacuations

There’s a lot involved to facilitate smooth evacuations. If you have only one evacuation site, what happens if it’s inaccessible? It’s crucial to designate at least two sites for evacuation.

You must also evacuate medications and support devices as well as residents. Keep in mind that some medications may need refrigeration. Having online medication records for the residents can be vital, so start building online files if you do not have them already.

Some residents may be able to evacuate using walkers and wheelchairs. Staffers may also be able to roll some residents out in their beds. Carries include hip, saddle, and blanket. Educate RCFE caregivers about these and have them practice using them regularly.

Transportation is an important consideration. Will residents leave the premises in cars or by bus? If by bus, you should triage residents for specific buses. 

Load residents who can move on their own first. The last residents to load should be the ones who need the most support. They should also be the first to unload at the destination. Try to put roommates together on the bus since familiarity can be a great asset in a difficult time.

8. Plan for a Smooth Reentry

Evacuations may have gone well, and all residents are safe. However, your work is not quite done. A chaotic, jumbled reentry can pose safety issues that jeopardize your RCFE license. Your disaster plan should be able to answer questions such as these.

• Who authorizes reentry?
• What are the RCFE inspection procedures, and how do you determine whether returning is safe?
• How do you transport residents back?

Some residents may have trauma from what happened (transfer trauma or relocation stress syndrome). Watch for signs of this trauma, and remember that these situations affect residents differently. Distress may also occur when residents move into your RCFE for the first time from home, so administrators and staffers may just need to tap into already-established support skills.

9. Plan for Sheltering in Place

Aim for your RCFE to be self-sufficient for at least 72 hours (about three days) during a disaster. Think about food and resident activities as well as employees who may worry about their families. If you lose power, what happens when residents use motorized scooters, oxygen, or nebulizers? These are crucial aspects to consider.

Emergency call buttons probably won’t work during power outages. You can try to compensate with strategies such as constant supervision of residents with dementia, hourly checks on other residents, or whistles and bells.

For food, DSS mandates two days of perishables and seven days of nonperishables. The requirements do not explicitly mention water. It’s a good practice  to have a three-day supply of water, with about a gallon of water per resident every day. Don’t forget to include your staff in preparing for emergency supplies.

Get Training for Your RCFE

Whether you already operate your RCFE or want to be an administrator someday, comprehensive, professional response training can open many doors. At Assisted Living Education, we offer many certification and training (CEU) opportunities.

Learn more today about disaster preparation, dementia plans of operation, RCFE regulations, and much more.