Policy Date: August 2006 Revised: 10/06

Approved: _____________________________ Date:________________

________________________________________________________________________

       I.      Policy

Hospice of Rutherford County has developed procedures should any event or situation occur that could hinder the organization’s ability to operate or damage the organization’s reputation with stakeholders whose support is essential to its ongoing operation and success. Hospice shall make every effort to continue services during a crisis/disaster/emergency. To assist staff during a crisis/disaster/emergency, there are administrative personnel on call at all times. The crisis communications officer will direct the plan under the supervision of the Executive Director. This plan is designed to prepare staff and volunteers to effectively handle communications and ensure services continue. Staff and volunteers will be educated no less than annually regarding the plan.

A crisis could include, but not be limited to, issues involving:

·        Quality of Care

·        Accidents involving employees, visitors and/or patients

·        Crime/Bomb Threat

·        Management Issues

·        National Trends/Stories

·        Natural/ Environmental disasters

II. Crisis Team/Communications Officer

A.           A crisis team has been established consisting of the Executive Director and senior management. The Board of Director’s executive committee, legal counsel from the firm Kennedy Covington, and if necessary, National Hospice and Palliative Care Organization staff, supervisors in the department where the crisis occurs, and support staff will also function as members of the team when deemed necessary by the Executive Director. An up to date list of all members will be included in the administrative procedures manual at the nurse’s station in the Hospice House and available to the Executive Director and all senior management.

B.           The responsibilities of the crisis team include working with the crisis communications officer and Executive Director to be prepared to assemble and address a situation as soon as it arises to include coordination of continual patient care when indicated. The team will assist in a preliminary assessment regarding the scope of the incident and an assessment to determine the level of media interest.

The crisis communications team will also assist the Executive Director and Communication Officer in:

1.      Determining if a media response is appropriate

2.      Alerting all staff and volunteers involved in the crisis regarding how to handle the media and to whom to direct media inquiries.

3.      Designating the primary spokesperson and keeping that person informed.

4.      Assisting senior management and supervisors in coordination of patient care if indicated during the crisis.

5.      Assisting in determining whether a crisis team member should be sent to the incident site.

The Crisis Communication Officer will:

1.      Prepare press releases.

2.      Ensure the Executive Director is informed and legal counsel if necessary to approve all media communications.

3.      Field inquiries conduct regular media briefings and establish an on-site media center if necessary.

4.      Ensure continual communications through the duration of the incident and attempt to bring closure to the crisis as soon as possible.

6.      Analyze all aspects of the crisis response after the crisis is over.

III. Crisis Identification and Response to Media

All staff and volunteers are made aware of situations that may constitute a crisis. Staff immediately contacts their supervisor who will complete an occurrence report if indicated. The crisis situation information will then be given in written or verbal form to the crisis communications officer during regular business hours who will inform the Executive Director. If the incident occurs after hours, the designated Department Director on-call will receive the occurrence report information and contact the communications officer and/or Executive Director.

A.           Media Response Procedure

1.If the crisis is of an extremely urgent nature, the crisis communications officer will immediately notify personnel who have contact with the public to advise how incoming calls and news media arriving on the premises should be handled.

2.      The crisis communications officer and crisis team will ensure access to cellular phones, two-way radio or other form of communication, laptop computers, a printing source, fax machine and cable-equipped television and radio and identify and arrange a location to be used for a media command center.

3.      The crisis communications officer will develop a press release and statement regarding the incident and will handle all media inquiries and interviews unless the issue warrants a statement from the Executive Director. Each media and public contact and inquiry will be logged in by the communications officer with appropriate contact information and request in order to organize and track media and public activity. Only the crisis communications officer and Executive Director or the Executive Director’s designee will have access to the media and public to respond to the incident.

4.      The Executive Director will inform staff regarding incidents prior to media contact if at all possible.

5.      The communications officer and/or the Executive Director will contact other members of the crisis team when necessary including Board, legal counsel, etc.

IV. Hazardous Materials Accident

A.         The report of a hazardous materials accident requiring protective action will normally be received from either emergency services personnel or from Emergency Broadcast System reports. When a report is received during regular business hours the immediate supervisor is informed. The supervisor will then inform the crisis communications officer who will notify the Executive Director. If the incident is not within regular business hours the Department Director on- call shall be informed. The Department Director on- call will notify the communications officer and Executive Director.

B.          If evacuation or in-place sheltering is required, the Executive Director in conjunction with the Crisis Team shall make the decision after consulting with local public safety officials. Either decision will require closing of all exterior doors and windows and shutting down of air conditioning/heating systems that have external air intakes.

C.         In-place sheltering will require all residents and staff to remain indoors, and ingest no food or drink until declared safe by local health officials.

D.         Evacuation will require that all staff and or residents not only leave the building but also the area threatened by the hazardous material. Preparations will be made if necessary for residents to be transferred to other care facilities such as Rutherford Hospital.

E.          The emergency shelter location and evacuation route shall be determined prior to departure in conjunction with local public safety officials.

F.          No one should return to the Center of Living and /or Hospice House until declared safe by local public safety officials.

G.         Management staff will be responsible for telephoning all Hospice patients/families, patients’ primary physicians and the Medical Director and advising them of evacuation and sheltering. Management staff shall advise patients/families that the temporary number they shall call for routine and emergency services is 828- 286-7440 due to temporary relocation of the Center of Living and the Hospice House.

H.         Once the Center of Living and/or Hospice House are re-occupied designated staff will contact patients/families to advise them of the change and to resume calling the Center of Living office and Hospice House as normal.

V. Lost / Missing Persons

A.              The possibility of a missing person shall be immediately reported to the management as outlined in section III of this policy. A search of the Center of Living and/ or Hospice House shall be conducted to verify the absence of the reported missing person.

B.               Upon verification of a missing person, Management staff shall immediately notify appropriate law enforcement officials.

C.              Outdoor searches should be restricted to a visual inspection of each side of the building. Driveways and parking areas shall be secured to prevent entrance and exit of unsearched vehicles including those of staff members. These activities should be limited so that footprints tire tracks, and other clues will not be destroyed.

D.              Staff members and visitors who have had recent contact with the missing person shall remain at the Center of Living/ Hospice House until local public safety officials have had an opportunity to interview them. These persons should be prepared to answer questions from local public safety officials regarding the missing person such as the following:

·        Name, age, sex

·        Last known location, last time seen

·        Clothing worn at time last seen

·        Personal habits

·        Medical history that may affect person’s safety

·        Mental status

·        Location of family members, previous residence, birthplace

·        Similar past experiences

VI. Bomb Threat

IF A SUSPICIOUS OBJECT/VHEICLE IS FOUND, DO NOT TOUCH, MOVE, OR JAR NEITHER THE OBJECT/VHEICLE NOR ANYTHING ATTACHED TO THE OBJECT/VHEICLE.

Procedure

A.              A bomb threat may be received by various means, but usually by telephone.

B.               The recipient of the call will attempt to obtain the following information about the call.

1.Exact time of the call

2.Identify background noises (music, laughter, traffic, etc.)

3.Exact time the caller hung up the phone.

C.              Document the following information:

1.Voice type (male/female, adult/child, accent, speech impediments)

2.Location of the bomb

3.Time of detonation

4.Documentation statements made by caller including any unusual remarks.

D.              Recipient will immediately notify the supervisor/designee (preferably in a private setting, so as not to unduly alarm staff). Follow procedure outlined in section III of this policy.

E.               The supervisor/designee will call the Police Department (911).

F.               The Executive Director in conjunction with the Crisis Team will determine the need for immediate evacuation based upon available information (i.e. time of detonation, time required for evacuation, recommendation of public safety officials).

G.              If evacuation is indicated, look closely at doors before opening them to get out. If there is anything suspicious on or near a door, use another exit and evacuate building. Go at least one hundred fifty (150) feet from the building to the lower parking lot.

H.              Do not turn off electrical switches.

I.                 Do not attempt to remove any suspicious object or package.

J.                 Do not search the building until Police arrive, but be available to assist them with their search. Staff will account for all personnel and residents once outside the building. Missing persons and their last known location must be reported to the local public safety officials upon their arrival. If the location of the bomb is outside the building, ie. Car, delivery truck, etc. locate at least 150 feet from the site of the threat.

K.              Should it become necessary to vacate the Center of Living and or the Hospice House, management staff will be responsible for telephoning patients/families, primary care physicians and the Medical Director advising that the Center of Living and/or Hospice House has been temporarily vacated but that services will continue. Management staff shall advise patients/families that the number they will call for routine; emergency and on-call assistance is 828-286-7440.

L.               Management staff shall secure all records with the authorization and assistance of the police.

M.             Once the Hospice staff and/or residents have re-occupied the Center of Living and/or Hospice House, management staff shall ensure the contact of patients/families to advise them of the change and to resume calling the Center of Living and/or Hospice House.

VII. Flood

1. Any person receiving a warning shall follow notification procedures listed in section III of this policy.

B. The Executive Director shall ensure the following notifications are made when the threat of flooding at the Center of Living and/or Hospice House exists:

1. Local Emergency Management Coordinator-287-6075-Fire Marshal’s Office 287-6090
2. Emergency Medical Service/Ambulance Service 911 or 286-2911
3. Rutherford Hospital 286-5000
2. The decision to evacuate and the mode(s) of transportation will be determined/initiated by the Executive Director in conjunction with the Crisis Team and local public safety officials.
3. When evacuation complete, all utilities (i.e. water, electricity, gas) should be turned off by maintenance staff.
4. Management staff shall ensure the removal and relocation of medical records.
5. Management staff shall be responsible for telephoning all patients/families and advising them that the Center of Living has temporarily relocated. Families of the Hospice House residents, primary care physicians and the Medical Director will be notified of evacuation and the temporary location of the residents.
6. Management staff will advise patients/families that the number they shall call for routine, emergency and on-call is 286-7440.
7. Prior to re-entry, the facility must be inspected and certified by local health officials.
8. Once hospice staff and/or residents have re-occupied the Center of Living and/or the Hospice House, management staff shall contact patients/families to advise them of the change and to resume calling the Hospice office and on-call as normal.

VIII. Winter Storm

If the weather forecast indicates a storm warning, home care services staff shall contact home care patients to ensure needed medications, oxygen, and needed supplies are available throughout the duration of the storm. The Home Care Coordinator/ designee will contact the local electrical/power/utilities department and inform them of Hospice patients using oxygen in the event of a power outage due to the storm. The Hospice House Coordinator shall insure there is an adequate amount of food and supplies needed to serve the Hospice House residents during periods of inclement weather. Refer to policy HR019 for further procedures regarding inclement weather/office closings.

IX. Tornado

The National Weather Service will broadcast notification of the threat of severe weather on commercial radio and television stations.

WATCH –

Atmospheric conditions exist that are likely to produce a severe thunderstorm or tornado.

Upon receipt of a watch, staff should review the Disaster Emergency Preparedness Policy. Local weather should be monitored for change in conditions.

WARNING –

A tornado has formed according to radar or has been sighted.

Upon receipt of a WARNING

Center of Living /Home Care Patients

1.      Upon receipt of the Warning, staff in the Center of Living should relocate to rooms and offices in the center of the building. During the warning, everyone should be seated on the floor. If danger is imminent, staff should sit with heads down and use arms as protection from flying debris.

2.      Clinical staff in the field will be paged if time warrants and notified of the warning.

3.      The Home Care Coordinator shall be responsible for contacting patients/families and assuring that necessary drugs and biological needs, medical equipment and supplies are sufficient if needed due to destruction of the tornado/severe thunderstorm.

4.      Home care staff will make emergency home visits as needed.

5.      In the event a patient’s home cannot be occupied due to damaging winds, rain, etc. staff shall assist in making arrangements to relocate patients to a local hospital, nursing home, home of another relative etc.

Hospice House

Each resident is daily assigned an ambulation level in order to assist in moving residents to safe areas within the facility or during evacuation. Below is criteria for each level

Level 1 - Ambulatory without assistance

Level 2 - Ambulatory with assistance or assistive devices

Level 3 – Not Ambulatory, bed bound

If a tornado warning is issued for the area, move all residents according to their

ambulation level. Level 1 and level 2 residents should be moved to interior hallways if time allows or into the kitchen of their rooms. If time allows shut doors and close blinds.

Level 3 residents shall be moved to interior hallways away from windows. Staff shall move to interior rooms and hallways away from windows.

Should the Center of Living have to be evacuated after a tornado due to damage, the Executive Director, in conjunction with the Crisis team will ensure a temporary location for business to continue if possible. Should the Hospice House residents have to be relocated to other facilities temporarily; the Executive Director with assistance from the Crisis team will immediately begin to work with area emergency management officials to transfer residents to other facilities temporarily. Resident’s families, primary physicians and the Hospice Medical Director will be informed.

X. Securing of Electronic Information

The Information Systems Coordinator is responsible for backing up the server at the end of each workday to ensure accurate availability of electronic protected health information. In the event of the Coordinator’s absence, another designated employee will assume this responsibility.

A.           The Coordinator or designee will take the previous days backup from the premises daily.

B.           Two weeks backup medium from the previous two weeks will remain in the server room.

C.           If the National Weather Service or other government agency alerts Hospice to a potential disaster that may occur after normal business hours, the Information Systems Coordinator or designee will back up the information system as soon as possible to prevent further information from being destroyed.

D.           In the event a natural or environmental disaster occurs, the Information Systems Coordinator will contact Secure Computing Systems in New Orleans, Louisiana for retrieval of patient charting information. The information systems coordinator will keep off site backups readily available for the immediate restoration of other patient information stored locally on the Hospice of Rutherford County server.

X. Crisis Evaluation

A.           The crisis communications officer is responsible for conducting an evaluation of the organizations’ crisis response after the resolution of the crisis.

B.           The communications officer will present the evaluation to the Executive Director and senior management for review.

C.           The crisis team will then update the plan as appropriate.