The Emergency Preparedness Index

Every Medicare-certified nursing home must keep an emergency preparedness program — a risk assessment, a plan, policies for sheltering and evacuation, a communication plan, training, and exercises — under 42 CFR §483.73. Surveyors check it alongside the Life Safety survey and record findings as E-tags. Those records are public. This is a plain reference to them, from the same CMS file as the Life Safety Index.

6,693

Facilities with an E-tag citation

46% of 14,686 certified

21,625

E-tag citations on file

CMS's current file

1,353

Cited on the same E-tag twice

At separate surveys

312

Cited on E-tags only

Nothing on the building itself

Most of these findings are about paper, not the building. The most-cited tag nationally is the testing and exercise requirement — a drill not held, or held and not documented. A facility can have a clean building and still be cited here, and 312 are.

The tags, most-cited first

All 26 Emergency Preparedness tags cited at US nursing homes. Descriptions are CMS’s own.

Emergency Preparedness tags cited at US nursing homes
Tag	What the surveyor checks	Facilities	Cited twice or more
E-0039	Conduct testing and exercise requirements.	2,836	566
E-0004	Develop and maintain an Emergency Preparedness Program (EP).	2,051	237
E-0041	Implement emergency and standby power systems.	1,413	232
E-0015	Address subsistence needs for staff and patients.	1,272	192
E-0037	Establish staff and initial training requirements.	1,269	188
E-0006	Conduct risk assessment and an All-Hazards approach.	1,104	92
E-0030	List the names and contact information of those in the facility.	857	67
E-0036	Establish emergency prep training and testing.	788	68
E-0026	Establish roles under a Waiver declared by secretary.	738	54
E-0013	Develop Emergency Preparedness policies and procedures.	673	44
E-0031	Provide emergency officials' contact information.	642	47
E-0007	Address patient/client population and determine types of services needed.	576	45
E-0025	Create arrangements with other facilities to receive patients.	539	27
E-0029	Develop a communication plan.	483	33
E-0024	Establish policies and procedures for volunteers.	481	30
E-0020	Establish policies and procedures including evacuation.	481	42
E-0032	Provide primary/alternate means for communication.	466	35
E-0035	Provide family notifications of emergency plan.	429	30
E-0009	Include a process for Emergency Preparedness collaboration.	425	41
E-0018	Establish procedures for tracking staff and patients during an emergency.	420	23
E-0023	Establish policies and procedures for medical documentation.	304	24
E-0034	Provide a means of sharing information on occupancy/needs.	295	15
E-0022	Establish policies and procedures for sheltering.	279	19
E-0033	Establish methods for sharing information.	190	9
E-0001	Establish an Emergency Preparedness Program (EP).	183	7
E-0042	Meet the requirements of an integrated health system.	43	1

Before a hazard season

Hurricane season on the Gulf and Atlantic coasts, fire season in the West, ice storms across the middle of the country: the same handful of tags are the ones a surveyor reaches for when the plan meets the weather. In CMS’s own words, what each checks:

E-0006 Conduct risk assessment and an All-Hazards approach. · 1,104 facilities cited
E-0015 Address subsistence needs for staff and patients. · 1,272 facilities cited
E-0041 Implement emergency and standby power systems. · 1,413 facilities cited
E-0018 Establish procedures for tracking staff and patients during an emergency. · 420 facilities cited
E-0020 Establish policies and procedures including evacuation. · 481 facilities cited
E-0039 Conduct testing and exercise requirements. · 2,836 facilities cited

By state

The share of a state’s certified facilities with at least one E-tag on file. As with the Life Safety tags, the spread says as much about how state agencies survey as about the homes — which is why every facility page compares within its own state.

Facilities with an Emergency Preparedness citation, by state
State	Certified facilities	With an E-tag	Share
WA	193	180	93%
NV	66	59	89%
WY	36	29	81%
CA	1,165	878	75%
IL	664	470	71%
NE	180	126	70%
OR	128	89	70%
ID	80	55	69%
MA	341	227	67%
MD	221	149	67%
NM	68	45	66%
WI	323	214	66%
AK	20	13	65%
KS	296	191	65%
IN	507	306	60%
MO	486	294	60%
ME	78	46	59%
IA	387	219	57%
MT	61	35	57%
MI	422	238	56%
AZ	140	72	51%
NY	592	285	48%
UT	97	47	48%
TN	303	140	46%
WV	123	49	40%
PA	656	245	37%
OH	924	334	36%
FL	694	240	35%
MN	337	117	35%
CT	191	64	34%
CO	210	69	33%
HI	43	14	33%
NJ	348	116	33%
AL	224	69	31%
DC	16	5	31%
VA	289	91	31%
AR	222	67	30%
DE	44	13	30%
GA	356	106	30%
TX	1,177	348	30%
NH	73	21	29%
SD	96	28	29%
OK	283	77	27%
RI	72	19	26%
KY	266	66	25%
SC	187	44	24%
VT	33	8	24%
NC	419	45	11%
ND	72	4	6%
LA	265	10	4%
MS	202	8	4%

E-tags are surveyed under State Operations Manual Appendix Z and published by CMS in the same file as the Life Safety survey. Each facility’s page lists its E-tag citations alongside its K-tags. No regulation text is reproduced here; requirements are referenced by section number only.