Introduction

Purpose

To enable Newark Manor Nursing Home to provide timely, integrated, and coordinated responses to emergency situations involving or impacting the facility.
To describe the roles and responsibilities of Newark Manor Nursing Home in preparing for, responding to, and recovering from the impacts of all hazards.
To describe the coordination within Newark Manor Nursing Home and other stakeholder groups necessary to provide services to those affected by the impacts of all hazards.

Scope

This plan applies to Newark Manor Nursing Home as a facility.
Nothing in this plan will alter or prevent Newark Manor Nursing Home from conducting its normal operations or will be construed in a manner that limits the use of good judgment and common sense in incidents not covered by the plan.

Policy

It is the policy of Newark Manor Nursing Home to be prepared to respond to a natural, man-made, or other public health emergency or disaster incident in a manner that protects the health and safety of its residents, visitors, and staff, and that is coordinated with a community-wide response to a public health emergency or disaster incident. All employees will know and be prepared to fulfill their duties and responsibilities as part of a team effort to provide the best possible emergency care in any situation. Supervisors at each level of the organization will ensure that employees are aware of their responsibilities.

Situation and Assumptions

Situation

All areas of Delaware are vulnerable to hazards. See the State of Delaware Hazard Mitigation Plan for a detailed analysis of all statewide hazard vulnerabilities. The Hazard Vulnerability Analysis (HVA) provides a general overview of the types of hazards in the state and aid in planning and preparedness activities.
The primary hazards for New Castle County include the following:
1. Pandemic A. A pandemic incident is the top planning priority for New Castle County, due to its impact on the healthcare services and its high probability. The demand for primary care doctors will increase, along with the need for hospital beds that are set up and staffed. This hazard is also ranked first due to its possible continual impact on DPH for more than 14 days. At‐risk populations will also need to be carefully considered in the planning process.
2. Tornado A. A tornado was ranked second in the planning priority category due to a high human impact. The number of fatalities, emergency room visits, and trauma center injuries will greatly increase after a tornado. Along with these factors, this hazard will have a large impact on the community and will cause interruptions within healthcare services.
3. Hazardous Materials Release A. A hazardous materials release was scored third in planning priority due to a high human impact score. The scores for mortality and emergency department visits were at least 150 times greater than the baseline data. The community impact score was also higher in business continuity, population disruption, and environment impact. All three would be interrupted for at least 14 days, resulting in an increased score.
4. Radiation Dispersal Release A. When reviewing the results of an RDD incident, it is evident that this hazard is a planning priority for New Castle County due to its anticipated impact on the community, particularly in the areas of business continuity and population displacement. There was also a large mental health impact score, along with a high at‐risk population score.
5. Biological Terrorism A. Biological terrorism is ranked fifth in planning priority due to an extremely high human impact score. The number of fatalities will be 139 times greater than the baseline data, along with a greater increase in the number of EMS transports and emergency department visits. Due to these high numbers, healthcare services and public health service will also be impacted. Healthcare facilities and providers have specific vulnerabilities that have been analyzed by the Delaware Division of Public Health (DPH), Emergency Medical Services and Preparedness Section, Office of Preparedness. For hazards specific to healthcare facilities and Delaware State Emergency Operations Plan Emergency Support Function #8: Health and Medical (ESF #8) of the Delaware State Emergency Operations Plan (DE SEOP), please consult Appendix 3: Hazard Vulnerability Analysis in this plan.
All disaster incidents are the responsibility of the local jurisdiction, and thus Newark Manor is expected to be prepared for any public health emergency or disaster incident and be self-sufficient for at least 72 to 96 hours after the onset of the public health emergency or disaster incident.
The Incident Command System (ICS) is a management system for disaster incidents that employs a logical management structure, defined responsibilities, clear reporting channels, and a common nomenclature to help unify healthcare facilities with other emergency responders. It is a management system made up of positions on an organizational chart. Each position has a specific mission to address in a disaster incident, with a corresponding checklist of duties. ICS includes forms to enhance this overall system and promote accountability.
According to the Delaware Code Title 16, Section 6701A—Authority of Fire Officers-in-Charge, there may only be one incident commander (IC) for a disaster incident. A facility IC will only have authority within the confines of the facility or facilities under his/her direct supervision. Activities external to the facility will fall under responsibility of the local response agency’s IC.

Assumptions

A public health emergency or disaster incident may occur at any time, and pre-disaster warning time may vary from no warning time to several days.
Public health emergencies or disaster incidents within and/or outside of the facility may impact the facility and require activation of this plan.
Public health emergencies or disaster incidents may occur simultaneously in more than one part of a facility.
A public health emergency or disaster incident may be of such magnitude that response and recovery requirements exceed facility resources so that assistance from the host county and/or the state may be necessary.
A public health emergency or disaster incident may cause shortages, in the local area, of a wide variety of necessary supplies.
Throughout the course of a public health emergency or disaster incident, Newark Manor Nursing Home will maintain essential services to its residents.
The external human or material resources identified in the response strategy may not be available for 24 to 72 hours following a public health emergency or disaster incident due to jurisdiction-specific considerations of resource management in times of crisis(es).
All operational personnel are trained on the EOP and their role within this plan.
Newark Manor Nursing Home staff is aware of the hazards faced at the facility, have documented these hazards, and where possible, have taken mitigation actions to protect the facility.
Newark Manor Nursing Home staff work with their residents and residents’ families to assist in educating them on personal preparedness.
Actions in this plan attributed to a specific person may be delegated to another per the Newark Manor Nursing Home standard operating procedures as outlined in the facility Policy Manual.

Preparedness

Newark Manor Nursing Home Emergency Preparedness Committee (EPC)

In order to maintain this plan and ensure that all emergency management planning, training, and exercises are properly completed, Newark Manor Nursing Home has created an Emergency Preparedness Committee (EPC)
A complete list of internal and external stakeholders and their contact information is listed in Appendix 2: Emergency Preparedness Committee in this plan.
This group is charged with the following tasks:
1. Maintaining the Newark Manor Nursing Home EOP.
2. Ensuring that all staff receive up-to-date training and information on ICS.
3. Ensuring that compliance with federal guidance and integrating applicable best practices is maintained in facility emergency mitigation, preparedness, response, and recovery efforts through the utilization of an incident management system consistent with the NIMS.
4. Ensuring that all state and federal regulatory and statutory standards related to emergency management are maintained.
5. Forming the core of the Newark Manor Nursing Home incident command and General staff.
6. Maintaining training records of Newark Manor Nursing Home personnel as they pertain to the ICS and NIMS guidance.
7. Facilitating training opportunities for Newark Manor Nursing Home personnel in ICS and related knowledge and skill areas, through either hosting opportunities or advertising training opportunities available at other facilities.
8. Identifying funding opportunities to support designated initiatives.
9. Identifying mitigation actions based on the Newark Manor Nursing Home HVA for inclusion in future county or facility construction or planning efforts.
10. Ensuring that at least 72 to 96 hours of supplies, including pharmaceuticals, are available on-site or via vendors.
11. Regular testing of backup communications and life safety systems to ensure working status.
12. Tracking and assessing fire drills and related emergency preparedness activities.
13. Ensuring that up-to-date communicable disease information from the Delaware DPH is briefed and assessed for any impact on the facility.
The group will meet monthly at a day, time, and location established by the designated EPC Chair.

Mitigation

The top hazards and threats specific to Newark Manor Nursing Home and the immediate surrounding community, as identified from the DPH Statewide Public Health HVA, are summarized in Appendix 3: Hazard Vulnerability Analysis in this plan.
A floodplain map for the facility is also located in Appendix 3: Hazard Vulnerability Analysis in this plan.
Patient mitigation strategies based on the Newark Manor Nursing Home HVA are included in Appendix 3: Hazard Vulnerability Analysis in this plan.

Business Continuity

It is the policy of Newark Manor Nursing Home to maintain service delivery or restore services as rapidly as possible following a disaster incident that disrupts those services.
As soon as the safety of residents, visitors, and staff has been assured, Newark Manor Nursing Home will give priority to providing or ensuring residents’ access to healthcare.
A complete business continuity plan for Newark Manor Nursing Home is available in Appendix 10: Business Continuity Plan in this document.

Concept of Operations

Organization for Response

The two main components of the facility ICS for Newark Manor Nursing Home are the Command and General staff.

Command Staff

The Command staff is composed of the following:
1. IC
2. Liaison Officer
3. Public Information Officer
4. Safety Officer
5. Other positions as designated by the Newark Manor Nursing Home IC, such as Medical Officer
The Command staff is responsible for the following:
1. Determining the need to open the facility emergency operations center (EOC)
2. Overarching policy decisions
3. Authorizing the implementation of the Incident Action Plan (IAP) developed by the Planning Section
4. Final authority for evacuation or receiving evacuees
5. Authorizing deviations from contractual obligations
6. Authorizing contracts and procurement
7. Liaison with external governmental and regulatory officials
The Command staff will consider the following options, depending on the nature, severity, and immediacy of the expected emergency:
1. Reviewing plans and procedures
2. Checking the inventory of supplies and pharmaceuticals, and augmenting as needed
3. Ensuring that essential equipment is secured, computer files are backed up, and essential records are stored off-site
4. Notifying medical professionals, community members, and staff to cancel scheduled appointments
5. If time permits, encouraging staff to return to their homes
6. If staff remain in the facility, taking shelter as appropriate for the expected disaster
7. Ensuring that staff is informed of callback procedures and actions they should take if communications are not available
8. Taking protective action appropriate for the disaster incident
9. Ensuring that follow-up services are available to any residents who have been sent home
10. Closing and securing the facility until the disaster incident has passed; ensuring that residents and visitors can return home safely
  General Staff
The General staff comprises the positions designated within this plan as needed for the incident.
The General staff coordinates the facility’s response, including but not limited to the following:
1. Developing and revising an IAP (see Appendix 15: Incident Management Resources for forms and job aids)
2. Assessing and monitoring resident census and status
3. Assessing and monitoring vital systems and structural status
4. Assessing and monitoring the status of pharmaceutical and non-pharmaceutical supplies
5. Assessing and monitoring staffing levels and needs for the expected duration of the public health emergency or disaster incident
6. Establishing and maintaining communications with county first responders, as appropriate
7. Establishing and maintaining a flow of communications to the families of residents
8. Establishing and maintaining a flow of communications regarding the facility to the general public in conjunction with the New Castle County OEM and external stakeholder agencies
9. Forecasting the potential impact of the public health emergency or disaster incident on facility residents, staff, visitors, and operations for the duration of the public health emergency or disaster incident
10. Identifying courses of action to mitigate or prevent non-desirable public health emergency or disaster incident-related impact
11. Developing recommendations for the Command staff on courses of action to address policy and/or other legal issues related to the incident
12. Coordinating with external stakeholders and vendors, as appropriate
13. Identifying and implementing protective action decisions if necessary
14. Planning for the resumption of normal services post-public health emergency or disaster incident
15. Maintaining the flow of information to the Newark Manor Nursing Home Command staff and employees on situation status and expectations
16. Maintaining a flow of information to Newark Manor Nursing Home residents and families on situation status and protective actions
17. Maintaining continuity of all programs and services
18. Ensuring coordination with the New Castle County Emergency Management Agency (EMA) and other first responders, including the external IC
19. Providing support for all roles and responsibilities as outlined in Appendix 15: Incident Support Team Resources
Continuing Actions
1. Staff Augmentation
  1. Once the nature of the emergency is determined and a resource assessment is undertaken, the Planning Section Chief may request that the Newark Manor Nursing Home IC recall staff or reach beyond the facility for additional staff augmentation to address existing or to forecast resource gaps.
    1. The type of public health emergency or disaster incident will determine the minimum number and categories of personnel needed to care for residents, and the duration for which they are required.
  2. Upon authorization by the Newark Manor Nursing Home IC, the Staffing/Scheduling Unit Leader will take the following actions, in this order, to recruit enough staff to support the unit’s operations:
    1. Retain current shift beyond normal time
    2. Recall internal staff starting with the next successively scheduled shift
    3. Request support from other facilities with whom there is an MOU
    4. Request support of Medical Temporary Staffing Agencies with whom Newark Manor Nursing Home has an agreement
    5. Request support of private practitioners with whom Newark Manor Nursing Home has an agreement
    6. Request support of the New Castle County EMA
    7. Request support of the DPH State Emergency Registry of Volunteers and Healthcare Personnel for Delaware (SERVDE) Volunteer Management System
  3. All activated staff will be provided information on the following:
    1. The nature and scope of the public health emergency or disaster incident
    2. An expectation of the duration of the shift
    3. Information on personal preparedness requirements beyond their normal survival kit
    4. Who their supervisor is, for those working in a new facility or in a different area than normal
  4. The Staffing/Scheduling Unit will be responsible for credentialing incoming personnel. This will include ensuring that all licenses are current and applicable to their assigned tasks, logging them into the incident, and tracking their on-shift time.
2. Medical Management
  1. Residents, employees, visitors, or others at the facility who are injured during a public health emergency or disaster incident will be provided first aid by the highest licensed or certified Newark Manor Nursing Home staff member available, to the extent allowed by their licensing and training.
  2. If injuries exceed the capacity of the Newark Manor Nursing Home staff or resources, 9-1-1 will be called and the injured will be sent to the nearest emergency department.
    1. If 9-1-1 services are not available, a request for medical transport will be conveyed to TransCare or other contracted ambulance service.
3. Infectious Disease Management
  1. If the incident involves the outbreak of a reportable disease, and if the situation requires, the facility medical director, nursing supervisor, or infection control officer will notify DPH per protocol and arrange for the resident(s) to be transported to a facility qualified to handle the disease.
  2. Standard precautions will be implemented per protocol for the type of infectious disease suspected for all staff and residents who have come into contact with the resident.
  3. Prophylaxis, if available, will be dispensed to residents and staff at the facility per protocols outlined by DPH.
  4. Notification will be made to the family with a recommendation for them to see their medical provider for assessment and prophylaxis as appropriate.
  5. More information on management of infectious diseases is located in Appendix 11: Hazard-Specific Annexes.
4. Medical Surge
  1. Medical surge may occur when other facilities invoke agreements requesting Newark Manor Nursing Home to take on additional residents. This may occur as the sending facility evacuates or experiences a medical surge requiring them to move residents to another facility.
  2. In the event of a public health emergency or disaster incident causing medical surge, the Newark Manor Nursing Home EOC will be activated per this plan.
  3. The Planning Section Chief will assess current resident census and staffing levels and recommend to the Newark Manor Nursing Home IC staff recall actions, how many residents can be taken in by resident type, and where residents would be placed.
  4. In the event more residents are being sent than the current facility licenses allow for, the Newark Manor Nursing Home IC will notify the DLTCRP.
  5. The Newark Manor Nursing Home EOC will ensure that all received residents are admitted.
  6. The Newark Manor Nursing Home EOC will assess medical and nonmedical support requirements for the additional residents and staff beyond 72 hours and identify additional vendor support for medical and nonmedical supplies as necessary.
  7. The Newark Manor Nursing Home EOC will coordinate with the sending facility to ensure that family support services are sufficiently available and communicated to residents’ families.
5. Fatality Management
  1. In the event of any deaths at the facility as a result of a public health emergency, disaster incident, or other unspecified cause, the Newark Manor Nursing Home will notify the DLTCRP per current policy.
  2. The facility medical director will coordinate with the Office of the Chief Medical Examiner (OCME) to handle the decedents’ remains in a respectful and appropriate manner for deaths in the facility that are suspected to be related to the public health emergency or disaster incident.
  3. The OCME will be responsible for ascertaining the cause of death and coordinating with the Newark Manor Nursing Home medical director regarding protective actions that should be taken involving future deaths, per the OCME Mass Fatality Plan.
6. Family Assistance
  1. General
    1. Before a public health emergency or disaster incident, resident families will be asked to maintain up-to-date contact information on file.
    2. Resident families will be notified of any public health emergency or disaster incident that will impact the facility, with actions being taken to provide for the safety and security of the resident once the situation is stable.
    3. The facility EOC will coordinate access for family members to the resident once the resident is in a safe and secure location.
  2. Support Services
    1. Social Services will be responsible for coordinating and providing support to residents and their families during and after a public health emergency or disaster incident.
    2. Counseling services for residents will be provided as needed.
    3. Staff will provide up-to-date information to residents they work with at each interaction.
    4. Staff will assess each resident’s need for additional support from spiritual or psychosocial counselors and report their determination to supervisors.
    5. Supervisors will provide residents’ names to psychosocial and spiritual counselors as appropriate for each resident’s needs.
  3. Counseling and information services for family members will be available in the following ways:
    1. In person at Newark Manor
    2. Via phone at 302 731-5576
    3. All counseling services will be provided per the facility’s procedures for providing such services.
  4. Additional information is available in Appendix 12: Family and Public Affairs in this document.
7. Evacuation
  1. The Newark Manor Nursing Home IC may determine that evacuation is necessary based upon the recommendation of the local EMA or upon the recommendation of the General staff.
  2. The facility is prepared to execute a partial or total evacuation in the event the facility becomes unsafe or uninhabitable for a period of time. In the event of a partial evacuation, the affected residents and staff will be moved horizontally or vertically within the facility or to an external facility with whom there is a MOU.
  3. In the event of a total evacuation, affected residents and staff will be moved to a designated assembly area in coordination with the New Castle County EMA.
8. Fire Evacuation
  1. The facility maintains and tests its fire evacuation plan per Delaware State Code – Title 16 Chapter 10.
  2. A copy of the fire evacuation plan is in Appendix 8: Incident Support Resources of this document.
9. Incidents requiring evacuation of residents may require residents’ families to be called upon to pick up their family member and take them home, as appropriate.
10. Evacuation details are located in Appendix 8: Evacuation Standard Operating Guideline.

Response

General
1. Newark Manor Nursing Home may play a variety of roles in responding to public health emergencies or disaster incidents within this facility, neighboring facilities, or in the host community.
2. Newark Manor Nursing Home may also provide emergency medical care to the injured and serve as a conduit for information dissemination to affected communities and families of residents.
3. Newark Manor Nursing Home’s roles may be constrained by limited resources, technical capability, and/or by the impact of the disaster on the facility.
Notification
1. The staff member who initially witnesses or becomes aware of a situation that poses a potential or immediate threat to the safety of residents, staff, or visitors will assess the situation and report the following to their supervisor:
  1. Where the public health emergency or disaster incident is located
  2. The nature of the public health emergency or disaster incident
  3. How large an area is involved (e.g., room, floors, etc.)
  4. What actions have been taken to mitigate the impact of the public health emergency or disaster incident and to ensure resident safety
  5. What resources are needed to resolve the problem and/or ensure resident safety
  6. Who notified them of the situation (if applicable)
  7. Notification will be face-to-face or via a communications system as outlined in Section 4.2.4.
Activation
1. General
  1. Upon notification, the staff member’s supervisor will collect the information on the incident, assess the public health emergency or disaster incident for themselves, and notify the senior staff member on duty, the Chair of the Newark Manor Nursing Home <EPC>, and the facility’s Chief Executive Officer (CEO).
  2. For a disaster incident requiring external support from emergency services (e.g., fire, law enforcement, emergency medical services [EMS], public health), the supervisor will call 9-1-1 and notify the county of the disaster incident and request assistance.
  3. Regardless of the status of the facility EOC, the Chair of the <EPC> will maintain contact with the senior leadership of the facility and follow any corporate health and safety reporting policy beyond facility leadership and outside this plan.
  4. Supervisors will be notified of the nature, scope, and location of the incident by the senior staff member on shift. Supervisors will be responsible for accountability for their staff and residents within their area of responsibility.
  5. Supervisors will report the staff and resident census information to the facility EOC. If the Newark Manor Nursing Home EOC is not activated, then the supervisors will send the information to the senior staff member on shift.
Communication Systems
1. General
  1. The formal communications plans are located in Appendix 5: Communications.
  2. Information in Appendix 5: Communications will be treated confidentially, as it may contain sensitive and personal information.
    1. Additional communications resources are available through an unmet needs request to the New Castle County EMA.
  3. The Logistics Section Chief in the facility EOC is responsible for organizing communications during an incident.
    1. A Communications Unit may be established under the Logistics Section as required.
    2. The Communications Unit is led by the Communications Hardware Unit Leader.
  4. The Logistics Section/Communications Unit will be responsible for the following:
    1. Incident-specific communications plans
    2. Maintaining communications systems for contact with internal and external stakeholders
    3. Maintaining the staff contact list during an incident
2. Internal Communications Resources
  1. Public address system
  2. Phone (landline, cellular, voice, text)
  3. E-mail
  4. Two-way radio
  5. Runners
3. External Communications Resources
  1. Phone (landline, cellular, voice, text)
  2. E-mail
  3. Facility web page
  4. Social media
  5. Delaware Health Alert Network (DHAN)
  6. Backup Runners
  7. Plain old telephone service (POTS)
  8. Other county and state resources
4. Monitoring Public Health Emergency or Disaster Incident Status
  1. The facility will utilize media outlets, DHAN, National Oceanic and Atmospheric Administration (NOAA) all-hazard weather radios, and the Internet to monitor an impending public health emergency or disaster incident.
  2. The facility also will coordinate with the New Castle County EMA and 9-1-1 to maintain situational awareness of incidents as appropriate.
Initial Response
1. Newark Manor Nursing Home EOC Layout and Setup
  1. The Newark Manor Nursing Home EOC Logistics Section will set up the Newark Manor Nursing Home EOC at 254 West Main Street in the first floor dining room.
  2. The alternate Newark Manor Nursing Home EOC will be located at the First Presbyterian Church in accordance with the graphic in Appendix 12: Incident Support Resources in this document.
2. Newark Manor Nursing Home Emergency Operations Center
  1. The Administrator will determine the need to open the Newark Manor Nursing Home EOC.
  2. The Newark Manor Nursing Home EOC will be activated upon the following situations:
    1. Newark Manor Nursing Home will be inoperable for more than 24 hours.
    2. Coordination is required with local healthcare responders or facilities over an extended period of time.
    3. Newark Manor Nursing Home needs to coordinate the movement of residents to other facilities through the New Castle County OEM.
    4. Damage to the facility, facility operations, or infrastructure is sufficient to require the management to set priorities for restoring services and manage the full restoration of services over an extended period of time.
    5. The facility requires evacuation.
    6. A state or locally declared emergency has the potential to threaten the safety of residents or visitors to the facility.
    7. A Memorandum of Understanding (MOU) is activated with another facility due to a disaster incident at the other facility.
  3. If there is a decision to activate the facility’s EOC, the Chairperson of the EPC will become the IC and manage the EOC.
  4. If the decision is made to activate the EOC, the IC will activate only those members of the Command and/or General staff who are required based upon the scale of the disaster incident.
  5. . Once activated, the Command and General staff will assemble in the facility and manage the disaster incident.
3. External Notifications
  1. If the disaster incident is going to exceed eight (8) hours, require facility evacuation, or involve support from federal, state, or county response partners, a situation report (ICS 209) will be sent to the Delaware Division of Long-Term Care Resident Protection (DLTCRP). The message will contain the following information:
    1. Name and title of the person making the report
    2. Facility name, location, and license reference
    3. Location of the disaster incident
    4. Nature of the disaster incident
    5. Size of the area involved
    6. Actions that have been taken to mitigate the impact of the public health emergency or disaster incident and to ensure resident safety
    7. Resources needed to resolve the problem and/or ensure resident safety
    8. Who is providing resource support, if established
    9. Notifications that have been made
  2. This report should be transmitted to DLTCRP as the situation merits or every 12 hours, and again at the conclusion of the incident with updated information.
  3. DLTCRP may send a representative to the facility depending on the scope of the public health emergency or disaster incident.
4. Protective Action Decisions
  1. Depending upon the nature of the warning and the potential impact of the emergency, the Newark Manor Nursing Home IC may implement one, or more, of the following:
    1. Protect-in-place
    2. Evacuate the facility horizontally or vertically
    3. Suspend or curtail clinical operations
    4. Take actions to protect equipment, supplies, and records
    5. Move equipment and supplies to secondary sites
    6. Back up and secure computer files
    7. Perform other measures that may be appropriate to reduce the exposure to risk for the facility, staff, and residents
  2. Upon authorization of the protective actions, the Newark Manor Nursing Home IC will do the following:
    1. Have the Resident Services and Infrastructure Branches implement the actions
    2. Have the Public Information Officer (PIO) communicate the actions to families and the general public
  3. For more information, consult the Appendix 8: Evacuation Standard Operating Guideline.

Demobilization

At some point during the emergency or disaster incident, there will be a recognition that it is scaling down and demobilization should occur.
Demobilization of response operations will be at the express request of the Planning Section Chief, but will not occur until all facility response actions have concluded and/or are accounted for and the Newark Manor Nursing Home IC has authorized demobilization.
The Newark Manor Nursing Home IC will coordinate demobilization timing with external stakeholders, particularly the New Castle County OEM, the DLTCRP, and facilities that Newark Manor Nursing Home is providing support to or receiving support from.
The Newark Manor Nursing Home IC coordinates the demobilization of critical resources.
During demobilization, the Documentation Unit Leader will ensure the collection of all notes, forms, and documents generated during the activation.
Participants should provide feedback on their roles and responsibilities during the activation to the Documentation Unit Leader for inclusion in an After-Action Report.

Recovery

Recovery may conclude with demobilization or may take place for many months or years following a public health emergency or disaster incident.
Recovery Unit
1. A Recovery Unit will be established under the Planning Section Chief once response operations are underway.
2. The Recovery Unit will develop plans and advise the Newark Manor Nursing Home IC on priorities related to re-establishing normal operational conditions at the facility.
3. The Recovery Unit will be staffed with representatives from the following:
  1. Business Continuity Unit – Unit Leader
  2. Maintenance Group
  3. Nursing Group
  4. Environmental Services Group
  5. Communications Unit
  6. IT/IS Unit
4. The Recovery Unit will develop an initial recovery plan based on initial damage assessment and will revise the plan as damage assessment information becomes available.
5. The Recovery Unit will coordinate with the Administration/Finance Section and Logistics Section regarding vendor requirements and material needs to repair the facility.
Restoration of Services
1. Newark Manor Nursing Home will take the following steps to restore services as rapidly as possible:
  1. If necessary, repair the facility or relocate services to a new or temporary facility
  2. Replace or repair damaged medical equipment
  3. Expedite structural and licensing inspections required to reopen
  4. Facilitate the return of mental health staff and other staff to work
  5. Replenish expended supplies and pharmaceuticals
  6. Decontaminate equipment and facilities
  7. Attend to the psychological needs of the staff and community
  8. Follow up on rescheduled appointments
Establishment of an Employee Support System
1. Newark Manor Nursing Home recognizes that its staff and their families are impacted by community-wide disasters. It will assist staff in their recovery efforts to the extent possible.
2. Human Resources will establish employee support systems as needed.
3. Human Resources will coordinate critical incident stress debriefing sessions and transition to employee assistance programs as needed.
Accounting for Disaster-Related Expenses
1. The Finance Manager will account for disaster-related expenses.
  1. Documentation will include direct operating costs, costs from increased use, all damaged or destroyed equipment, replacement of capital equipment, and construction-related expenses.
  2. The Finance Manager will submit his/her assessment of financial impact and supporting documentation to the New Castle County OEM in accordance with the New Castle County OEM, Delaware EMA, and Federal Emergency Management Agency (FEMA) requirements in a timely manner.
  3. Reimbursement for disaster-related expenses will be approved or denied according to policies established by the U.S. Department of Homeland Security/FEMA, based upon the disaster declaration type and extent.
Post-disaster Incident Resident and Family Support System
1. Residents and their families will be offered support and counseling services during and following a public health emergency or disaster incident. This support is available through the Division of Health and Social Services.
2. Staff and their families may receive counseling and support services during and following a public health emergency or disaster incident. This support is available through Newark Manor Social Services.

Organization and Assignment of Responsibilities

Training and Exercise

Policy
1. The facility is responsible for the overall preparedness of all staff involved in the facility’s preparedness for, response to, and recovery from a public health emergency or disaster incident. As such, the EPC conducts training and activates this plan as required, to evaluate and maintain the readiness posture of staff.
Exercise Requirements
1. Exercises will be conducted in accordance with the Homeland Security Exercise and Evaluation Program (HSEEP) guidance. As a minimum, the following tasks should be performed:
  1. The facility Administrator should activate this plan at least annually in the form of a discussion-based exercise.
  2. An all-hazards functional exercise that involves the entire facility should be conducted every 2 years.
  3. An After-Action Report will be prepared and an Improvement Plan will be administered for every exercise.
2. Exercises may be either conducted within the confines of the facility or in conjunction with a larger Host County EMA, DLTCRP, or DPH exercise.
Training Requirements
1. All Newark Manor Nursing Home staff will be trained to meet the minimum requirements specified in federal NIMS requirements and DLTCRP training and exercise directives.
  1. The EPC will keep records and ensure that necessary training is available through online sources, community colleges, or scheduled training sessions in the County.
  2. The EPC will conduct regular trainings for internal and external stakeholders to provide program updates and coordinate emergency response and recovery preparedness actions.
  3. Exercises, as indicated above, will be used as training vehicles for personnel who are assigned emergency responsibilities in this plan.
  4. Newark Manor Nursing Home staff will participate in state and federal training programs as prescribed internally and by DLTCRP.
After-Action Reports
1. An After-Action Report that incorporates comments from all participants will be prepared at the following times:
  1. After every activation of this plan in part or its entirety
  2. After every exercise of the facility EOC
2. All After-Action Reports must include an Improvement Plan matrix, and the corrective actions are to be incorporated into this plan as well as other plans and implementing instructions.

Plan Maintenance

This document is maintained by the Newark Manor Nursing Home EPC, is stored for reference at The Nursing Station and the Administrator’s Office, and is reviewed annually and revised every three years or after a major public health emergency or disaster incident, as needed.
1. This plan will also be stored off-site for security and continuity at the Host County EMA.
The Newark Manor Nursing Home EPC will maintain this plan by
1. Developing an After-Action Report that is acted upon by Newark Manor Nursing Home internal and external stakeholders following a public health emergency or disaster incident and exercise;
2. Reviewing and revising the plan at least annually, or after an exercise or actual activation;
3. Developing a schedule for exercising this document; and
4. Ensuring that all department personnel are familiar with its contents.
Changes are indicated in the Record of Changes found in the beginning of this plan.

Appendices