NAC449.5415. Preparations for emergencies and disasters.

     1. Each facility shall adopt a written procedure to be followed by each patient and member of the staff of the facility if any emergency occurs at the facility, including, without limitation, any fire, equipment failure, power outage, medical emergency or natural disaster that may threaten the health or safety of any patient or member of the staff of the facility or any member of the general public.

     2. Each facility shall prepare a plan for obtaining emergency medical services that are available for use by the facility.

     3. Each facility shall employ personnel who are qualified to operate emergency equipment at the facility and to provide emergency care at the facility. The personnel must be available to operate the emergency equipment and provide emergency care during each period in which treatment is provided to a patient of the facility. A charge nurse who is qualified to provide basic cardiopulmonary life support must be present at the facility and available in the treatment area during any period in which a patient of the facility is present in that area. Each member of the clinical staff of the facility must maintain current certification and competency in basic cardiopulmonary life support.

     4. Each facility shall enter into an agreement with at least one hospital that provides acute dialysis service, inpatient care and other hospital services to the patients of the facility. The agreement must include:

     (a) Documentation from the hospital indicating that the patients of the facility will be accepted and treated during any emergency that occurs at the facility; and

     (b) Reasonable assurances that:

          (1) The transfer or referral of a patient will occur between the hospital and the facility if the transfer or referral is determined to be medically appropriate by the attending physician of the patient;

          (2) The exchange of medical and other information necessary or useful in the care and treatment of the patient transferred will occur within 1 working day after the transfer or referral of the patient; and

          (3) All personal property belonging to and transferred with the patient will be accounted for and protected from theft, loss or damage.

     5. Each facility shall establish and comply with a written plan to protect each patient of the facility if a fire occurs at the facility. The written plan must include:

     (a) Provisions concerning the evacuation of each person from each building of the facility during a fire; and

     (b) A diagram that specifies the routes to be taken to evacuate each of those buildings. A copy of each diagram prepared pursuant to the provisions of this paragraph must be posted in a conspicuous place in the building for which the diagram is prepared.

     6. Each facility shall, not less than once each quarter, conduct a fire drill at the facility. The facility shall rotate the occurrence of the fire drills to ensure that each patient shift participates in a fire drill at least once each year. Each fire drill must include the use of alarms and equipment and a discussion with the patients, visitors, employees and members of the staff of the facility concerning evacuation from each building of the facility. After conducting a fire drill, the facility shall prepare and maintain a written report concerning the fire drill. The written report must include evidence that the members of the staff and the patients of the facility participated in the fire drill.

     7. Each facility shall ensure that each member of the staff of the facility is familiar with the location of all equipment that is used to suppress fires at the facility. The equipment must be located in such a manner that a person is not required to travel more than 75 feet from any location in the facility to reach the equipment.

     8. Each facility shall prepare and comply with a written plan concerning preparation for any disaster that may occur at the facility. The plan must:

     (a) Be based on an assessment of the probability and type of disaster in each region and the local resources available to the facility;

     (b) Include procedures that are designed to:

          (1) Minimize the harm to the patients and members of the staff of the facility; and

          (2) Ensure the safe operation of the facility during a disaster; and

     (c) Include provisions concerning:

          (1) The assignment of responsibilities for each member of the staff of the facility during a disaster, including the assignment of direction and control of the facility;

          (2) The maintenance of equipment used for communication during a disaster;

          (3) The use of warning systems; and

          (4) Evacuation from and closure of the facility because of a disaster.

     9. Each facility shall adopt written procedures to ensure that water is available to the essential areas of the facility if there is an interruption in the facility’s normal supply of water.

     (Added to NAC by Bd. of Health by R130-99, eff. 8-1-2001; A by R075-04, 8-5-2004)