The Nursing Home Incident Command System

The Incident Command System, or ICS, is a uniform management model which allows its users to adopt a standard approach for responding to incidents. An incident is defined as an occurrence, either caused by humans or natural phenomenon, which requires response actions to prevent or minimize loss of life or damage to property and/or the environment. While the ICS may be unfamiliar to the long term care community, it has been in existence since the 1970’s and it is utilized by hospitals as the Hospital Incident Command System (HICS).

A proven emergency management system based on successful business and military practices, ICS is the result of decades of lessons learned in the organization and management of emergency incidents. ICS has been tested over many decades in emergency and nonemergency applications, and by all levels of government and in the private sector. It represents organizational best practices and, as a component of the National Incident Management System (NIMS), has become the standard for emergency management across the country.

An Incident Command System designed for nursing homes emerged from work funded by The John A. Hartford Foundation (2006-2008) in a grant to the Florida Health Care Association (FHCA). The initial draft of the Nursing Home Incident Command System (NHICS) was developed by FHCA, the Florida Department of Health Bureau of Preparedness and Response, and FHCA member nursing home providers. This was the first version of an ICS for nursing homes and while it was true to the core components of ICS, it reflected the unique care characteristics, regulatory requirements, and organizational structures of nursing home healthcare providers. The resulting Nursing Home Incident Command System was incorporated in FHCA’s Emergency Management Guide for Nursing Homes. The tool helped nursing homes assign staff to key emergency management roles and designate the needed equipment and supplies to carry out assigned duties.

Building on the work of the Florida Health Care Association, the California Association of Health Facilities (CAHF) further developed and expanded the Nursing Home Incident Command System, providing a manual and train-the-trainer program as a method of organizing and coordinating emergency efforts in the long term care community. Originally available in 2010, NHICS was revised again in 2011 by the American Health Care Association Disaster Preparedness Committee to increase its national applicability and relevancy to long-term care health facilities.

Download NHICS: Click here to go to the CAHF’s NHIC webpage and download the Nursing Home Incident Command System Guidebook and related materials.