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During heat events, administrators and care teams should focus on four areas:

1. Resident Care

Heat-related illness often develops gradually. Changes in condition may first present as fatigue, confusion, weakness, dizziness, reduced fluid intake, changes in gait, increased fall risk, or altered behavior before a resident reports feeling ill.

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2. Facility Environment

• Ensure resident rooms and other high-risk areas receive routine monitoring.
• Check HVAC systems.
• Monitor temperatures throughout the building.
• Adjust activity schedules and programming, and control access to outdoor areas when appropriate.
• Confirm availability of additional cooling resources and equipment.

A comfortable common area does not necessarily mean all resident spaces are safe. Resident apartments, upper floors, memory care neighborhoods, and sun-facing units may experience significantly different temperatures and should be monitored accordingly.

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3. Operations and Emergency Plans

• Review emergency preparedness and heat response protocols, including evacuation procedures and logistics.
• Confirm staffing contingency plans.
• Confirm vendor relationships and emergency support contacts for HVAC and utilities.
• Ensure leadership and staff understand escalation and notification procedures.

Extreme heat events can quickly become operational emergencies. Organizations should ensure emergency preparedness plans address prolonged heat events, including shelter-in-place, relocation, evacuation, and continuity of care.

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4. Communication and Documentation

• Document all actions taken to protect residents and maintain continuity of care.
• Communicate proactively with families during significant heat events.
• Establish clear internal communication protocols for staff.
• Coordinate with healthcare providers, emergency agencies, and community partners as needed.

Residents and families understandably want reassurance. Proactive communication about facility conditions, resident monitoring efforts, and contingency planning can reduce anxiety and build trust.

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Facility Compliance

Heat preparedness is fundamentally an extension of the protective care obligations providers fulfill every day. The goal is to ensure residents remain safe, healthy, and comfortable during periods of elevated risk. The organizations best positioned to achieve that goal are those that proactively assess risk, strengthen operational readiness, support staff, maintain safe environments, and closely monitor vulnerable residents before a heat-related emergency occurs.

Compliance assessments focus on whether the organization recognized foreseeable risks, implemented appropriate protective measures, and can demonstrate the steps taken to protect residents. With documented risk assessment and planning, your facility is prepared to keep residents safe and show how you did it.

Operational documentation should include:

• Temperature monitoring logs
• Resident wellness checks
• Hydration monitoring efforts
• Maintenance and HVAC service records
• Family communications
• Emergency response actions
• Staffing contingency measures

Do you have questions or need additional support? Hansen Hunter’s Clinical and Regulatory Consulting team is available to assist providers with operational assessments, regulatory compliance, emergency preparedness planning, and clinical best practices.

Resources – Extreme Heat Guidance for Skilled Nursing and Assisted Living:

California Department of Public Health

Brown Health