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Disaster readiness for residency programs and hospitals

What ACGME, CMS and the Joint Commission require, and a practical checklist for keeping residents safe, supported and on track when a disaster disrupts training, wherever your program is.

Ask about a readiness review See the checklist

The rules

What's required

ACGME: a disaster policy for every sponsoring institution

Under the 2026 Institutional Requirements (section 4.14), the sponsoring institution must keep a policy, consistent with ACGME Policies and Procedures, that addresses support for each ACGME-accredited program and its residents and fellows in a disaster or other substantial disruption in patient care or education. The policy must cover help with continuing salary, benefits, professional liability coverage and resident or fellow assignments (4.14.a).

ACGME: Extraordinary Circumstances

For events such as an abrupt hospital closure, a natural disaster or a catastrophic loss of funding, the ACGME can invoke its Extraordinary Circumstances policy. Once it does, the DIO (or a designee) contacts the ACGME within 10 days and submits a plan for continuing residents' and fellows' education within 30 days, unless the ACGME approves other dates.

CMS: 42 CFR 482.15 for hospitals

Medicare- and Medicaid-participating hospitals need an emergency plan based on a documented facility-based and community-based, all-hazards risk assessment, plus policies and procedures, a communication plan and a training and testing program, each reviewed and updated at least every 2 years. Staff get initial training and training at least every 2 years. Hospitals run two exercises a year: a full-scale community-based exercise (or a facility-based functional exercise if one isn't available) plus a second exercise, which can be a tabletop. A real emergency that activates the plan exempts the hospital from the next full-scale or functional exercise.

The Joint Commission: Accreditation 360

Since January 1, 2026, Joint Commission hospital accreditation runs on its Accreditation 360 model. Emergency management stays a standalone chapter, now aligned with the CMS rule, and is also one of the 14 national performance goals for hospitals. Check your current manual for the exact standards.

MedRise checklist

GME disaster readiness, in eight steps

A practical checklist from GME coordination experience. It isn't a regulatory standard: use it alongside your institution's emergency operations plan.

  1. Keep a live trainee rosterPersonal cell, personal email, home address and an out-of-area contact for every resident and fellow, updated each July and after every change.
  2. Check your policy against 4.14.aSalary, benefits, professional liability coverage and assignments, plus who decides, who tells the ACGME and how fast.
  3. Map every participating siteEach site's emergency plan, who counts as essential staff, and where residents report if their usual site closes.
  4. Plan ride-out and relief teamsWho stays, for how long, with what supervision, and how hours are logged and limited.
  5. Write the messages nowTemplates for residents, faculty, incoming interns, applicants during interview season and the ACGME, ready to send in minutes.
  6. Back up the records and deadlinesOff-site access to the ACGME Accreditation Data System (ADS), your residency management system and evaluations, and a list of ERAS, NRMP and board deadlines that a closure could affect.
  7. Run a GME tabletop once a yearWalk a realistic scenario for your region (a hurricane, tornado, earthquake, wildfire, winter storm or a sudden site closure) with the DIO, program directors and coordinators, and fix what breaks.
  8. Train people before you need themEncourage free FEMA IS-100 and IS-700 and Psychological First Aid for residents and coordinators, plan wellness check-ins, and hold a debrief after every event that updates the policy.

Certifications and teams to point your residents to

Work with MedRise

GME disaster readiness review

Review

Policy review

  • Your disaster and substantial-disruption policy checked against the current Institutional Requirements
  • Plain-language gaps and suggested wording
  • A one-page summary for your GMEC
Templates

Ready-to-send kit

  • Trainee roster template
  • Message templates for residents, applicants and the ACGME
  • A decision log for the DIO's 10-day and 30-day steps
Exercise

Tabletop exercise

  • A scenario built for your region's real hazards, or a sudden site closure
  • Facilitated for the DIO, program directors and coordinators
  • Written findings and an action list

MedRise provides education and consulting, not legal or accreditation advice, and does not guarantee any accreditation or survey outcome. Each engagement is quoted in writing.

General education, not medical, legal or compliance advice. MedRise is not an emergency service and cannot respond to emergencies. For decisions about a specific person, program or hospital, talk to a clinician, your institution or your own advisers.

Talk to MedRise about disaster readiness

A free 10-minute call with a former GME program coordinator to see where your program stands.

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Sources

Where this comes from

Sources last checked November 14, 2026. Rules and links change: open the official page before you rely on a figure.