Nursing Home Fire Evacuation Plan

CMS requirements at 42 CFR 483.73 require Medicare- and Medicaid-certified nursing facilities to have an all-hazards emergency preparedness plan and policies that address evacuation and sheltering in place. The plan must be reviewed and updated at least annually, and tested at least twice a year, including unannounced staff drills. Plans must also address staff responsibilities, resident transportation, and communication procedures.

Horizontal evacuation moves residents through a fire door into an adjacent smoke compartment on the same floor — this is the primary strategy for NFPA 101 healthcare occupancies. Vertical evacuation (moving residents down stairwells to the outside) is only used when horizontal evacuation is not possible. For bed-dependent and non-ambulatory residents, vertical evacuation is extremely difficult and time-consuming, making horizontal evacuation zones and proper smoke barriers essential.

CMS requires annual review and update. The plan must also be updated immediately after any physical plant change, staff reorganization, or modification to fire suppression or detection systems. State health department surveys (which are unannounced) will review the date of the last plan revision as a condition of facility certification.

Resident mobility classification is typically done on admission and updated as residents' conditions change. The evacuation plan should show which rooms or bed locations correspond to ambulatory, wheelchair-assisted, and bed-dependent residents at the current census. Fabrik allows you to add color-coded zone overlays to floor plans so staff can see at a glance which residents in each area need what level of evacuation assistance.