HAZARD VULNERABILITY ASSESSMENT TOOL
|
EVENT TYPE(S)
(Listed Below)
| PROBABILITY
| HUMAN IMPACT
| HOSPITAL SERVICE IMPACT
| COMMUNITY IMPACT
| HOSPITAL PROPERTY IMPACT
| HOSPITAL BUSINESS IMPACT
| MITIGATION
| PREPAREDNESS
| RESPONSE
| RECOVERY
| RISK
|
Likelihood of future occurrence.
| Percentage of population likely to be injured or killed under an average occurrence of the hazard.
| Percentage of healthcare services likely to be affected under an average occurrence of the hazard.
| Percentage of community likely to be affected under an average occurrence of the hazard.
| Percentage of properties likely to be affected under an average occurrence of the hazard.
| Percentage of business likely to be affected under an average occurrence of the hazard.
| Internal
(Your LTCF)
| External
(Local)
| Internal
(Your LTCF)
| External
(Local)
| Internal
(Your LTCF)
| External
(Local)
| Internal
(Your LTCF)
| External
(Local)
| Relative threat (increases with percentage)
|
0 = N/A (Implausible)
1 = Low (0-1 event/30 years)
2 = Moderate (2-3 events/30 years)
3 = High (4+ events/30 years)
| 0 = N/A (No impact expected)
1 = Low (<1% affected)
2 = Moderate (1-10% affected)
3 = High (>10% affected)
| 0 = N/A (No impact expected)
1 = Low (<1% affected)
2 = Moderate (1-10% affected)
3 = High (>10% affected)
| 0 = N/A (No impact expected)
1 = Low (<1% affected)
2 = Moderate (1-10% affected)
3 = High (>10% affected)
| 0 = N/A (No impact expected)
1 = Low (<1% affected)
2 = Moderate (1-10% affected)
3 = High (>10% affected)
| 0 = N/A (No impact expected)
1 = Low (<1% affected)
2 = Moderate (1-10% affected)
3 = High (>10% affected)
| 1 = Substantial
2 = Moderate
3 = Limited or None
| 1 = Substantial
2 = Moderate
3 = Limited or None
| 1 = Substantial
2 = Moderate
3 = Limited or None
| 1 = Substantial
2 = Moderate
3 = Limited or None
| 1 = Substantial
2 = Moderate
3 = Limited or None
| 1 = Substantial
2 = Moderate
3 = Limited or None
| 1 = Substantial
2 = Moderate
3 = Limited or None
| 1 = Substantial
2 = Moderate
3 = Limited or None
| 0 - 100%
|
Natural Hazard Scenarios
|
Blizzard
| 0
| 1
| 2
| 2
| 2
| 2
| 3
| 2
| 3
| 2
| 3
| 2
| 3
| 2
| 0%
|
Cold - Extreme & Prolonged
| 1
| 1
| 1
| 2
| 2
| 2
| 3
| 2
| 3
| 2
| 3
| 2
| 3
| 2
| 25%
|
Earthquake
| 2
| 2
| 2
| 2
| 2
| 2
| 3
| 2
| 3
| 2
| 3
| 2
| 3
| 2
| 53%
|
Flood - Flash due to rain & local terrain
| 2
| 1
| 2
| 2
| 2
| 1
| 3
| 2
| 3
| 2
| 3
| 2
| 3
| 2
| 51%
|
Heat - Extreme & Prolonged
| 3
| 2
| 2
| 1
| 2
| 1
| 3
| 2
| 3
| 2
| 3
| 2
| 3
| 2
| 76%
|
Ice Storm
| 2
| 1
| 2
| 2
| 1
| 2
| 3
| 2
| 3
| 2
| 3
| 2
| 3
| 2
| 51%
|
Landslide
| 1
| 1
| 1
| 1
| 0
| 1
| 3
| 2
| 3
| 2
| 3
| 2
| 3
| 2
| 23%
|
Tornado
| 1
| 1
| 1
| 1
| 2
| 1
| 3
| 2
| 3
| 2
| 3
| 2
| 3
| 2
| 24%
|
Wild-Fire
| 2
| 1
| 1
| 2
| 1
| 1
| 3
| 2
| 3
| 2
| 3
| 2
| 3
| 2
| 49%
|
Other:
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Man-Made Hazard Scenarios
|
Airplane Crash
| 2
| 2
| 2
| 2
| 2
| 2
| 3
| 2
| 3
| 2
| 3
| 2
| 3
| 2
|
|
Biological/Infectious Outbreak
| 2
| 1
| 2
| 2
| 2
| 3
| 3
| 2
| 3
| 2
| 3
| 2
| 3
| 2
| 53%
|
Civil Disturbance - Adjacent to Facility
| 1
| 1
| 2
| 2
| 3
| 3
| 3
| 2
| 3
| 2
| 3
| 2
| 3
| 2
| 27%
|
Communication Disruption - Major & Prolonged
| 3
| 1
| 3
| 2
| 3
| 3
| 3
| 2
| 3
| 2
| 3
| 2
| 3
| 2
| 83%
|
Computer Failure - System
| 3
| 2
| 3
| 2
| 3
| 2
| 3
| 2
| 3
| 2
| 3
| 2
| 3
| 2
| 83%
|
Explosion - Adjacent to Facility
| 1
| 2
| 3
| 3
| 3
| 3
| 3
| 2
| 3
| 2
| 3
| 2
| 3
| 2
| 29%
|
Explosion - Within Facility
| 2
| 1
| 1
| 1
| 1
| 1
| 3
| 2
| 3
| 2
| 3
| 2
| 3
| 2
| 48%
|
Flood - Dam or Reservoir Failure
| 1
| 2
| 3
| 3
| 3
| 3
| 3
| 2
| 3
| 2
| 3
| 2
| 3
| 2
| 29%
|
Fuel Shortage - For Facility Operation
| 2
| 1
| 1
| 2
| 1
| 2
| 3
| 2
| 3
| 2
| 3
| 2
| 3
| 2
| 50%
|
HAZMAT Release - From Fixed Facility
| 3
| 2
| 3
| 2
| 2
| 2
| 3
| 2
| 3
| 2
| 3
| 2
| 3
| 2
| 81%
|
HAZMAT Release - From Transportation
| 3
| 3
| 3
| 3
| 3
| 3
| 3
| 2
| 3
| 2
| 3
| 2
| 3
| 2
| 87%
|
Nuclear Facility Incident - Within 10-50 Miles
| 1
| 1
| 2
| 2
| 3
| 3
| 3
| 2
| 3
| 2
| 3
| 2
| 3
| 2
| 27%
|
Power outage - Major & Prolonged
| 3
| 2
| 2
| 2
| 2
| 2
| 3
| 2
| 3
| 2
| 3
| 2
| 3
| 2
| 79%
|
Supply Disruption
| 2
| 2
| 2
| 3
| 3
| 3
| 3
| 2
| 3
| 2
| 3
| 2
| 3
| 2
| 56%
|
Water Supply Contamination - Municipal
| 3
| 2
| 3
| 3
| 3
| 3
| 3
| 2
| 3
| 2
| 3
| 2
| 3
| 2
| 86%
|
Water System Failure - Facility or Municipal
| 3
| 2
| 3
| 3
| 3
| 3
| 3
| 2
| 3
| 2
| 3
| 2
| 3
| 2
| 86%
|
Active Shooter/Violence
| 2
| 2
| 2
| 2
| 3
| 3
| 3
| 2
| 3
| 2
| 3
| 2
| 3
| 2
| 55%
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Other:
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