The short answer. Emergency preparedness training is required under the CMS Emergency Preparedness rule, 42 CFR § 483.73(d): a nursing home must train all staff, contractors and volunteers initially and at least annually, and must run two exercises a year — a full-scale, community-based exercise plus one more (which can be a tabletop). Training and testing sit on top of the facility’s emergency plan, policies and communication plan.

The Emergency Preparedness rule pulls disaster planning into the same world as every other CMS requirement: written, trained, tested, and documented. The plan and the exercises belong to the facility’s safety leadership, but the annual staff training is, in practice, a required in-service — and that piece often lands with the Director of Staff Development. This guide covers what § 483.73(d) requires, with the citation attached.

The rule and its four parts (§ 483.73)

42 CFR § 483.73 requires a comprehensive emergency preparedness program built on four elements:

  • A risk assessment and emergency plan (all-hazards);
  • Policies and procedures based on that plan;
  • A communication plan; and
  • A training and testing program — paragraph (d), the focus of this guide.

The training requirement (§ 483.73(d))

  • Who: all new and existing staff, individuals providing services under arrangement (contractors), and volunteers, consistent with their expected role;
  • When: initial training, then at least annually. Long-term care kept the annual requirement even after CMS moved some other provider types to a two-year cycle; and
  • Proof: the facility must maintain documentation of the training and be able to demonstrate staff knowledge of the emergency procedures.

The testing requirement — two exercises a year

Training is only half of (d). The facility must also conduct at least two exercises a year: (1) an annual full-scale exercise that is community-based — or, if one is not available, an individual facility-based functional exercise; and (2) one additional exercise — a second full-scale/functional exercise, a mock disaster drill, or a facilitated tabletop exercise using a narrated, clinically relevant scenario. After each, the facility analyzes its response and revises the plan as needed.

The part a DSD usually owns

Emergency preparedness is broader than staff development — it involves the administrator, the safety committee, and often a designated emergency-preparedness coordinator. But the annual staff training is a required in-service with attendance, content and competency to document, which is exactly the Director of Staff Development’s wheelhouse. Folding EP training into the in-service calendar, and keeping the records, is a natural DSD responsibility.

California and local layers

California nursing homes also operate under state and local emergency-planning expectations (Title 22 and local emergency-management requirements) in addition to the federal § 483.73 program. The federal training and testing requirements are the floor; confirm any additional state or county requirements that apply to your facility.

Documenting it so it survives survey

Emergency preparedness is surveyed under its own E-tags (separate from the F-tags), and both the training and the exercises must be documented: the dates, the content, who attended, the exercise type, the after-action analysis, and any plan revisions. As always, undocumented training is treated as training that did not happen.

Our In-Service Lesson-Plan Library includes emergency-preparedness and fire-safety in-services — each with a lesson plan, handout, quiz and slide deck — to support the annual staff training required under § 483.73(d).

Putting it together

  1. Maintain the four-part EP program — plan, policies, communication, training & testing (§ 483.73).
  2. Train all staff, contractors and volunteers initially and annually (§ 483.73(d)).
  3. Run two exercises a year (a full-scale community-based one plus one more).
  4. Demonstrate staff knowledge and document everything for the E-tags.

Coordinating that annual training and keeping the records is squarely the Director of Staff Development’s job. Our DSD certification course teaches you to run and document an in-service program from the regulation up; see also the full in-service topic list.

Frequently asked questions

Is emergency preparedness training required in nursing homes?

Yes. Under the CMS Emergency Preparedness rule, 42 CFR § 483.73(d), a long-term-care facility must maintain a training and testing program and provide emergency preparedness training at least annually to staff.

How often is emergency preparedness training required?

For long-term-care facilities, initial training plus annual refresher training. (LTC facilities kept the annual requirement when CMS moved some other provider types to every two years.) Facilities must also be able to demonstrate staff knowledge of the emergency procedures.

Who must be trained?

All new and existing staff, individuals providing services under arrangement (contractors), and volunteers — consistent with their expected role in an emergency.

What are the testing/exercise requirements?

At least two exercises a year: (1) an annual full-scale exercise that is community-based (or, if a community-based one is unavailable, an individual facility-based functional exercise); and (2) one additional exercise, which may be a second full-scale/functional exercise, a mock disaster drill, or a facilitated tabletop exercise using a clinically relevant scenario.

What does the emergency preparedness program itself include?

Beyond training and testing, § 483.73 requires a risk assessment and emergency plan, policies and procedures, and a communication plan — reviewed and updated on the schedule the rule sets. Training and testing (paragraph (d)) is how staff learn and the plan gets validated.

Whose job is the annual staff training?

The facility’s emergency-preparedness or safety leadership owns the overall program, but the annual staff training is frequently coordinated and documented by the Director of Staff Development as part of the in-service program — because it is, at its core, a required staff in-service with a paper trail.

Which tags cover this at survey?

Emergency preparedness has its own E-tags in the CMS Appendix Z / State Operations Manual (for example the training and testing E-tags), separate from the F-tags. A surveyor checks both that the program exists and that staff were trained and exercises were conducted and documented.

Where can I get emergency-preparedness training materials?

Our In-Service Lesson-Plan Library includes emergency-preparedness, fire-safety and disaster in-services — each with a lesson plan, handout, quiz and slide deck — that support the annual staff training required under § 483.73(d).