lines for emergency planning (see p.12). The new rules, which became effective November 2017, specifically encourage collaboration with state and local emergency officials. As a public health official, Shah sees a
potential win-win scenario in the deepening of ties between senior living and the emer- gency response world. “We want to know who the point of contact is and we want to know who is in charge of making decisions if that contact is unavailable,” he said. By forging ties with local emergency
personnel well in advance of any actual event, senior living leaders can build for themselves a vital support network. Shah said the emergency response community is eager to learn as much as it can about the most vulnerable populations, in order to be able to respond effectively. “We need to know what plans are in place and we want to be as familiar as possible with that specific facility, so that we can point you in the right direction as you search for solutions. The only way we can know your strengths and limitations is if we talk about that in advance of an incident,” he said. Atria was headed down that road even be-
fore CMS articulated the value of such ties. “We have already been working with state agencies, with regional advisory councils, giv- ing presentations to local emergency medical services professionals to talk about our system and our methods,” Figueroa said. It takes some time and effort on the part
of executive directors and other local lead- ership to reach out to potential partners, but the company sees big dividends in making the push. After all, fire officials and other emergency personnel may not be well versed in the particular needs of a senior population. Early collaboration allows Atria to make its needs known. “We want to help teach not only our company, but emergency providers across the country about the best ways to do this and the best ways to orga- nize this,” Figueroa said. “The more we can communicate with them throughout the year, the better they can know who we are and how we handle things.” Nor are such conversations a one-time af-
fair. If Tagatz makes changes to his physi- cal plant, if he reconfigures spaces or if the resident acuity shifts markedly, he’ll usually engage with local emergency responders. “With communities like ours, they like to come here any time there are changes,” he
said. “They want to train on that, and not wait until there is some emergency to find out about it.” Taken altogether, the above represents
a solid overview of the basic playbook of emergency planning. Build a localized plan based on likely risk, drill it until it is sec- ond nature, and forge partnerships with key community stakeholders to ensure smooth execution. That’s the 10,000-foot view. From there
it’s worthwhile to get down in the weeds, to consider some specific best practices culled from years of experience on the front lines.
Putting it into play The high-level truths about planning, prac- tice, and partnerships could apply in almost any organization. But senior living isn’t just any organization. It’s an exquisitely com- plex social organism, with residents across a breadth of acuity levels supported by staff with varied levels of training and experience.
the front desk be doing? Then on the shifts where we have fewer people on duty, each person carries greater responsibility. There are more detailed, defined roles around what they need to be doing. Everyone has to know what the expectation is so that the emergency is handled the same way regard- ing when it occurs.” At Atria, a “disaster binder” records vital
information on each resident: Mrs. Smith in Room 305 wears glasses and uses a walker and a hearing aid. The all-hands approach requires that everyone on staff be familiar with this critical resource. “When I was an executive director, on day one within the first couple of hours I already knew the location of the disaster binder. Everyone in the com- munity knows where that binder is located,” Figueroa said. “Front-line staff know that that binder is accessible any time, day or night.” Front-line engagement means making additional preparations. At Atria, if the residents go, the staff goes too. “When we
“You need to keep a list of all of your associates and make sure they have been through the training. If you have people on weekends and the nightshift, they can’t get lost in the shuffle. You can’t just do training Monday through Friday. Emergencies happen on nights and weekends and you need to tailor training for those associates,” Pokora said.
For an emergency plan to perform in
these complex circumstances, it’s important to consider the particulars. When it comes to best practices, it’s important to keep in mind these eight factors:
1. Everyone has a job Disaster planning is an all-hands effort. Executive directors need to engage staff members across the board when it comes to emergency response, fine-tuning respon- sibilities based on staffing level. “We have to look at it across the entire 24-
hour period, because staffing patterns vary,” Bertram said. “On the 7 to 3 shift we detail the responsibilities for each person: What should the wait staff be doing, what should
evacuate our residents to a hotel, we provide that same service to our staff and their fami- lies,” Figueroa said. “They know our resi- dents well, they are best equipped to help the residents and accommodate their needs, so we put them in the same hotels and we provide daycare for their children, so they can concentrate on the task at hand.”
2. Engage the families A key component in any emergency plan is family outreach, especially in communities with higher-acuity residents who might be imperiled by an evacuation. For many families, “the major concern
is where we are going to go if something happens,” Tagatz said. “Moving somebody
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