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Creating a Risk Assessment for your Long Term Care Facility

Long-term care facilities are at high risk during disasters. They’re especially vulnerable because of their reliance on electricity, internet access, medical supplies, and trained personnel. Within moments of a crisis, patient health can plunge.

This was painfully obvious after hurricanes ravaged Texas and Florida in the fall of 2017. Facilities for older and critical-care patients struggled to cope with a large-scale natural disaster that caused weeks of high-risk issues.

How can your long-term care facility learn from their experiences and prepare for emergencies? The first step is creating a risk assessment.

Assessing a Spectrum of Risk

Emergency management consultant Guy Robertson advises long-term care companies to start by summarizing the risks that prevail at their individual facilities. It’s not enough to simply assume your company could cope with abstract disasters; you must itemize specific risks to your actual building and patients.

Robertson’s advice falls right into line with governmental CMS emergency preparedness rules, which state that emergency plans must be created at the local level, not just at the corporate level. What risks does one of your patients face? Your employees? Your building infrastructure?

The risk summary should start with major categories of crises, which are generally natural, human, and technological. They include:

Disease epidemics. In this category, consider everything from worldwide pandemics to outbreaks that are limited to your facility. Epidemics often come with the secondary crises of government inspection and public relations management.

Natural disasters. Blizzards, wildfires, hurricanes, floods - all kinds of natural disasters fall into this category. Remember to include issues related to staffing, which can be severely impacted during natural disasters.

Infrastructure failures. Your facilities depend on the use of electricity, roads, clean air and water, internet access, and so forth. Include them in your assessment.

Violent and cyber attacks. From active shooters to computer hackers, your facility is vulnerable to deliberate attacks. These can come from outside your organization, or from within it.

Getting Specific About Risks

Now that you have identified your major risk categories and some of the risks associated with them, continue to round out your list by seeking out diverse opinions and considering additional factors. Invite feedback from representatives of local agencies, first responders, emergency management experts, and your own staff members.

For example, you could start a roundtable discussion about the issue of infrastructure failure. Attendees might be your facility supervisors, someone from the public works department, an EMT, your IT manager, and a patient liaison.

During the infrastructure roundtable, brainstorming points could include:

Historical data. What are your community’s historically most-common failures of public infrastructure? What’s old or out of date?

Vendor/partner vulnerabilities. Which parts of your operation are outsourced or monitored by outside companies?

Life-threatening risks. Which issues would become life-threatening within moments of an infrastructure disaster?

Community trust. What are the effects beyond the building? Consider patients’ families, the media, your reputation, and financing.

Legal. What legal issues would you face? How would government regulation factor in? What about insurance?

Backup and resources. Do you currently have any backup plans in place for infrastructure failures? Are there community resources available? Could you hire private vendors?


As you develop your risk assessment, it’s a good idea to gather all information into a structured format that helps your facility stay organized. This is particularly important because government surveyors are out in the field after new rules took effect in November 2017. They’re on the lookout for clear, written plans.

Fortunately, there are software solutions and free guides that can help you do this. The free ebook from Brightgray Solutions even has a detailed chart you can use to assess your long-term care facility’s risks and stay ahead of emergencies.

Click here to request the CMS Emergency Preparedness Planning Guide.

Free Emergency Preparedness Guide