It's not 96 hours or bust for EC.4.12

Contrary to popular interpretation, EC.4.12, EP #6 does not require hospitals to be self-sustaining for 96 hours.

No, really!

There is a note following this EP that indicates an "acceptable response effort would be to temporarily close or evacuate the facility, consistent with their designated role in their community response plan." And, interestingly enough, this is a "B" element of performance, so the burden of proof is on the organization to determine what they need to do to meet this EP.

So, what EP #6 does require is that each organization has some sense of how such an event (effectively being cut off from the outside world for 96 hours) would be managed. Some hospitals might be able to do a 96-hour solo standing on their heads, while others might struggle to do 24 hours.

One of the clear lessons learned during Katrina is that many (if not most) of the hospitals involved didn't know that an "acceptable" part of their response plan would be to get out in the event that they could no longer safely care for patients. I think this is partially the result of the whole "defend-in-place" strategy that has always applied to hospitals from a fire and life safety perspective. I think somehow defend-in-place crossed over into the management of disasters and catastrophes.