Surge Capacity refers to the ability of the health care system to convert quickly from their normal operation of services to a significantly increased capacity in order to serve an influx of patients during an emergency.  An effective surge capacity plan involves all the health care resources in a community, including long-term care providers.

In 2007, the California Department of Public Health (CDPH) undertook a collaborative project to develop the Standards and Guidelines for a Healthcare Surge during Emergencies.  On February 19, 2008, CDPH released the Standards and Guidelines; which, address the scope of practice, licensure flexibility, and reimbursement, liability for licensed health care facilities and professionals, and planning for surge and alternate care sites.  These documents create a common and coordinated approach toward development of healthcare surge response plans by providing guidance, operational tools and training curriculum.  For more information and to view the Surge Standards and Guidelines, please visit:

It is also important to have sections of the plan that address response and recovery.  In the response section, you may wish to include the Nursing Home Incident Command System (NHICS) Incident Management Team Charts and Job Action Sheets based on the needs of your organization.  Make sure your EOP has a process for identifying and assigning staff to cover all of your essential staff functions in a disaster situation.  You may have all of your staff available to you after a disaster situation.  You may not have all of your staff available to you after a disaster, but you can increase your chances of retaining staff if they have personal emergency plans (Encourage Personal Preparedness for Staff and Volunteers) at home, understand their disaster roles and responsibilities at work, have ready access to transportation and understand that the organization will still pay them for coming to work.  Staff will also be more likely to return to work or stay at work if the facility EOP includes provisions for their dependents (including pets-even if it is to simply determine the nearest pet disaster shelter) and family, and if they understand that the EOP takes into account caregiver disaster mental health needs (such as incident debriefing).

The facility EOP should also address the important issue of evacuation and surge capacity. The following are pertinent materials and guidelines: 




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