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.

6,757

Facilities with an E-tag citation

46% of 14,690 certified

21,954

E-tag citations on file

Rolling three-year window

1,388

Cited on the same E-tag twice

At separate surveys

322

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 322 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.	2,835	567
E-0004	Develop and maintain an Emergency Preparedness Program (EP).	2,077	230
E-0041	Implement emergency and standby power systems.	1,468	249
E-0015	Address subsistence needs for staff and patients.	1,301	203
E-0037	Establish staff and initial training requirements.	1,289	194
E-0006	Conduct risk assessment and an All-Hazards approach.	1,101	98
E-0030	List the names and contact information of those in the facility.	855	76
E-0036	Establish emergency prep training and testing.	799	65
E-0026	Establish roles under a Waiver declared by secretary.	756	56
E-0013	Develop Emergency Preparedness policies and procedures.	668	46
E-0031	Provide emergency officials' contact information.	656	48
E-0007	Address patient/client population and determine types of services needed.	590	44
E-0025	Create arrangements with other facilities to receive patients.	526	27
E-0024	Establish policies and procedures for volunteers.	503	32
E-0029	Develop a communication plan.	494	33
E-0020	Establish policies and procedures including evacuation.	477	43
E-0032	Provide primary/alternate means for communication.	470	32
E-0035	Provide family notifications of emergency plan.	449	29
E-0018	Establish procedures for tracking staff and patients during an emergency.	432	27
E-0009	Include a process for Emergency Preparedness collaboration.	413	41
E-0023	Establish policies and procedures for medical documentation.	316	24
E-0034	Provide a means of sharing information on occupancy/needs.	306	15
E-0022	Establish policies and procedures for sheltering.	293	20
E-0001	Establish an Emergency Preparedness Program (EP).	200	9
E-0033	Establish methods for sharing information.	195	11
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. · 1,101 facilities cited
E-0015 Address subsistence needs for staff and patients. · 1,301 facilities cited
E-0041 Implement emergency and standby power systems. · 1,468 facilities cited
E-0018 Establish procedures for tracking staff and patients during an emergency. · 432 facilities cited
E-0020 Establish policies and procedures including evacuation. · 477 facilities cited
E-0039 Conduct testing and exercise requirements. · 2,835 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	181	94%
NV	66	59	89%
WY	36	30	83%
CA	1,165	891	76%
ID	80	58	73%
NE	180	132	73%
IL	666	481	72%
OR	128	89	70%
MA	341	230	67%
KS	296	196	66%
MD	221	146	66%
NM	68	45	66%
WI	323	213	66%
AK	20	13	65%
IN	507	309	61%
MO	487	293	60%
ME	78	46	59%
IA	387	224	58%
MT	61	35	57%
MI	422	237	56%
AZ	140	71	51%
UT	97	48	49%
NY	593	285	48%
TN	303	139	46%
WV	123	50	41%
MN	338	136	40%
OH	922	345	37%
PA	656	245	37%
CT	191	66	35%
DC	17	6	35%
CO	210	71	34%
FL	694	235	34%
HI	43	14	33%
DE	44	14	32%
AL	224	69	31%
VA	289	90	31%
AR	221	67	30%
GA	356	108	30%
NH	73	22	30%
NJ	348	106	30%
OK	283	83	29%
TX	1,177	337	29%
SD	96	26	27%
RI	72	18	25%
SC	187	44	24%
VT	33	8	24%
KY	267	62	23%
NC	419	50	12%
ND	72	6	8%
LA	265	11	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.