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A useful hospital or clinic emergency preparedness checklist covers four connected areas: risk assessment and emergency planning, policies and procedures, communication, and training and testing. CMS uses these as core elements for participating providers and suppliers, but the detailed requirements vary by provider category. Use this checklist as a planning aid—not as a finding of compliance—and confirm the rules for each facility’s certification category, location, and applicable federal, state, local, accreditation, and facility requirements.
1. Establish scope, ownership, and document control
Start by determining which requirements apply to each site. A hospital subject to 42 CFR § 482.15 should not assume that the same exercise schedule applies to every outpatient clinic. CMS’s provider guidance describes a shared emergency preparedness framework with category-specific variation, including variation related to inpatient and outpatient settings.
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- Identify each location, its CMS certification or provider category, the applicable federal emergency preparedness rule, and relevant state and local requirements.
- Name an accountable executive sponsor and an emergency management lead. Assign incident command roles, alternates, and operational contacts for clinical care, facilities, staffing, supplies, communications, information technology, and other essential functions.
- Specify how separately certified locations, outpatient clinics, departments, contracted services, and health-system leadership participate in planning and response.
- Set a process for plan review and approval, version control, distribution, and withdrawal of outdated copies.
- Keep a current version accessible to staff when normal IT systems are unavailable—for example, through an approved offline copy or another facility-controlled method.
2. Assess hazards and plan for continuity of care
Build the plan from a documented, all-hazards assessment of the facility, the services it provides, the people it serves, and the dependencies needed to keep care operating. CMS’s emergency preparedness materials identify examples such as care-related emergencies, equipment and power failures, communications interruption—including cyberattacks—and loss of part or all of a facility or its supplies.
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Include local hazards and operational vulnerabilities
- Consider natural hazards and public health events, including infectious disease incidents, as well as mass-casualty events or other sudden increases in demand.
- Assess failures or interruptions involving electricity, generators, water, HVAC, medical equipment, oxygen, communications, information systems, supply chains, and vendor support.
- Consider cyber disruption, facility damage, restricted access, and loss of a site, service, or critical supply.
- Record the assumptions behind the assessment, existing safeguards, remaining risks, priority actions, and dependencies that could interrupt patient care.
Set response triggers and continuity priorities
For significant scenarios, define who can activate the plan and what conditions prompt escalation, shelter-in-place, service restriction, relocation, transfer, evacuation, or recovery. Specify how essential services will continue, move, or be safely reduced if staffing, equipment, space, utilities, or supplies are constrained.
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- 72 HOUR EMERGENCY KIT FOR 2 PEOPLE WITH FOOD AND WATER: Includes 2 emergency food bars totaling 4800 calories and 12 sealed drinking water pouches to support hydration and energy during disasters. Designed for emergency preparedness, survival kits, earthquake kits, and evacuation planning.
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- EMERGENCY LIGHTING AND SIGNALING TOOLS INCLUDED: Comes with 2 long lasting 12 hour lightsticks and a safety whistle for visibility and communication in low light or rescue situations. Ideal for blackout emergencies, nighttime evacuation, and search scenarios.
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Use the facility’s actual patient population and services to identify people who may need additional support. Consider, as applicable, dependence on powered equipment, oxygen, medication access, refrigeration, dialysis, mobility assistance, communication support, or specialized care. These are prompts for a local assessment, not a universal inventory prescribed for every facility by CMS’s core-elements guidance.
3. Turn the plan into usable policies and procedures
Policies and procedures should connect the risk assessment to actions staff can take. Tailor them to the facility’s provider category and applicable requirements; CMS states that policies and procedures must comply with relevant laws.
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- ESSENTIAL EVACUATION SUPPLIES: Designed to help people escape a building and get through the first hours of an emergency.
- FOOD AND WATER: Includes one 400-calorie food bar and one 4.225-ounce water pouch; both have a five-year shelf life.
- EMERGENCY GEAR: Includes a 12-hour emergency lightstick, emergency whistle, dust mask, two nitrile gloves, survival blanket, pocket tissue pack, and safety goggles.
- ONE-PERSON KIT: Provide one for every person in a facility.
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- Describe decision authority, leadership succession, how responders are reached, and how incident management connects clinical and support departments.
- Set out activation, escalation, and deactivation steps, including how staff receive instructions and how changes are documented.
- Address patient tracking, continuity of care and records, patient movement, evacuation or relocation, and coordination with receiving facilities where applicable.
- Establish how the facility handles family inquiries and communicates service changes or other relevant information.
- Plan for staffing contingencies, vendor or supply disruption, restoration of services, and recovery of affected operations.
- Identify how procedures are adapted when a department, building, or entire location cannot operate.
4. Make communication work during disruption
The communication plan should cover both communication inside the facility and coordination with outside partners. CMS’s framework includes communication with staff and relevant authorities; the facility should make the actual contact paths and information flows usable under stress.
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- Define backup methods and procedures for loss of normal phone, internet, or internal messaging systems, including during a cyber incident.
- Set a process for sharing operational status, needs, and ability to assist with authorities or incident coordination.
- Determine how patient information is shared in a way consistent with applicable privacy and other laws.
- Test message routing, acknowledgement, and contact-list accuracy. Make communications accessible to patients and staff with language, sensory, or functional needs.
- Coordinate with the local healthcare coalition where relevant. HHS ASPR’s 2017–2022 Hospital Preparedness Program implementation guide provides historical context for coalition planning, information sharing, and resource coordination; it is not evidence of current program funding or performance measures.
5. Train staff and exercise the plan
Training and testing should show that people understand their expected roles and that the organization can carry out its procedures. Requirements and cadence depend on the provider category. For hospitals covered by 42 CFR § 482.15, the 2024 annual CFR compilation specifies hospital requirements; check the current e-CFR and CMS guidance before using these details for compliance decisions.
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- FIRST AID KIT AND PERSONAL SAFETY EQUIPMENT: Features an 18 piece first aid kit with essential first aid supplies, nitrile gloves for protection from debris. Built for emergencies, injury care, and safety preparedness
- EMERGENCY LIGHTING AND SIGNALING TOOLS: Includes a 12 hour lightstick and safety whistle for visibility and communication in low light or rescue situations. Critical for blackout kits, evacuation gear, and search and rescue signaling
- COMPACT BACKPACK GO BAG FOR FAST EVACUATION: Lightweight survival backpack keeps all supplies organized and ready for immediate use. Go bag for home emergency kits, car emergency kits, office preparedness, and travel safety
Train according to assigned roles
- Train new and existing staff, volunteers, and individuals providing services under arrangement according to their expected emergency roles.
- Document training, confirm staff know what to do, and provide training after significant policy or procedure updates as required for the facility.
- For hospitals under § 482.15, the hospital rule requires initial training and recurring training at least every two years, documentation, and demonstrated knowledge of emergency procedures.
Test the hospital plan at the required cadence
For hospitals subject to 42 CFR § 482.15, the rule requires testing the emergency plan at least twice a year. It calls for an annual community-based full-scale exercise or, when such an exercise is not accessible, an annual facility-based functional exercise. Consult the current regulatory text for other permitted testing options and details. Do not apply this hospital schedule automatically to a clinic with a different certification category.
Use exercise findings to improve the plan
- Include the clinical and nonclinical functions needed to test command, communication, patient movement, resource status, continuity, and external coordination.
- Record objectives, participants, observations, and corrective actions, with a named owner and deadline for each action.
- Check that corrective actions were completed and effective in a later exercise or review.
- CMS’s core-elements page describes reviewing and updating the plan at least annually. Because CMS also notes provider-type variation, follow the cadence applicable to the facility’s category rather than assuming one schedule fits every site.
6. Track operational readiness and facility status
A complete written plan is not a live picture of whether a facility can continue care. Maintain a current status inventory, set local minimum operating levels and replenishment triggers, and identify who reports changes. HHS ASPR’s All-Hazards Plan identifies the categories below as facility status information; it does not establish universal stock quantities, staffing ratios, or readiness thresholds.
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- FOOD & WATER FOR 3-DAY PREPAREDNESS: Includes four 2,400-calorie emergency food bars and four 1-liter Aqua Literz cartons, plus survival blankets, ponchos and lightsticks to help support your household during outages, evacuations and major disasters.
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- Patients and capacity: census, service capacity, ability to accept patients, and ability to discharge safely.
- Staffing: available staff, coverage of critical roles, and gaps that could create unsafe conditions.
- Supplies and resupply: medical supplies, pharmaceuticals, blood, PPE, food, oxygen, and fuel, along with resupply arrangements.
- Utilities and infrastructure: power, generators, water, HVAC, communications, and dependencies such as vendor support.
- Facility and care status: structural impact, usable areas, treatment status, evacuation status, and specialized capabilities.
- Assistance: unmet requests for help and the mutual-aid, authority, or coalition paths for escalating them.
Use these categories to shape facility-specific reporting and resource decisions, not as a generic shopping list. The appropriate supplies, quantities, and operating thresholds depend on the local hazard assessment and continuity plan; the cited federal status categories do not set them for an individual site.
7. Keep the checklist tied to the right rule
CMS’s Emergency Preparedness Requirements apply to provider and supplier categories with variation based on characteristics such as inpatient versus outpatient status. The four core elements are a useful structure for organizing work, but they do not replace the detailed regulation for a specific certification category. Before relying on a checklist for compliance, confirm the current federal regulation, CMS interpretive guidance, state and local rules, accreditation requirements, and facility policy for each location.
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