Emergency Water Plans for New Jersey Hospitals and Nursing Homes

Published November 4, 2026 · A Clear Alternative Water, Pennsauken NJ, since 1991

Every hospital and nursing home in New Jersey is required to have a way to get water if its normal supply fails. State licensing rules require hospitals and long-term care facilities to have access to an alternative supply of water in an emergency, and federal emergency preparedness rules require plans for water for patients and staff. A workable plan starts with knowing how much water the facility actually needs, which areas get it first, how hauled water will get into the building, and who will deliver it on short notice. A Clear Alternative delivers certified potable water to healthcare facilities in all 21 New Jersey counties, 24 hours a day; call 1-888-577-8088.

What the Rules Require

New Jersey Licensing Standards

The New Jersey hospital licensing standards (N.J.A.C. 8:43G) state that a hospital shall maintain at least a three-day supply of food and have access to an alternative supply of water in case of an emergency. Long-term care facilities have the same requirement in their own licensing rules, and state survey reports show it is enforced: in one New Jersey Department of Health inspection, a facility was cited because it had not established an effective procedure to ensure water availability in an emergency.

Federal Emergency Preparedness Rules

Facilities that take Medicare or Medicaid must also meet the CMS Emergency Preparedness Rule. Its policies and procedures must cover subsistence needs for staff and patients, including food, water, and medical and pharmaceutical supplies, whether the facility evacuates or shelters in place. Hospitals and long-term care facilities must review their plans regularly and test them with drills and exercises.

The CDC notes that The Joint Commission and CMS require hospitals to plan for an emergency supply of potable water as part of their disaster planning.

Why Water Outages Happen

• Water main breaks that cut pressure to a neighborhood.
• Boil water advisories after a pressure loss or a positive bacteria test.
• Storms, flooding and long power outages that knock out pumping stations.
• Planned shutdowns for repairs, connections or construction.
• Problems inside the building, such as a failed booster pump or a contaminated tank.
• For facilities on their own wells, pump failures or a well that runs low in a drought.

Many of these events give little warning and can last from a few hours to several days. A plan that only covers a short interruption may not hold up when a repair runs into a second or third day, so build the plan around the longest outage your facility could reasonably face, and decide in advance when to shift from bottled water to a steady tanker supply.

Our guide to boil water advisories for New Jersey businesses covers what changes when water is still flowing but not safe to drink.

Building an Emergency Water Supply Plan

The CDC's Emergency Water Supply Planning Guide for Hospitals and Healthcare Facilities lays out a four-step process: assemble a planning team, understand your water use through a water use audit, analyze your alternatives, and develop and exercise the plan.

Step 1: Build the Team

Include facilities and engineering, infection prevention, nursing leadership, dietary, environmental services, and the emergency manager. Each department knows where water is used in ways others may not.

Step 2: Audit Your Water Use

Find out how much water the facility uses on a normal day, then work out the minimum needed to keep essential services running. List every use and rank it:

• Critical: drinking water for patients and staff, medication preparation, hand hygiene, dialysis, sterile processing, and some medical equipment.
• Essential: food preparation and dishwashing, toilet flushing, bathing, and laundry.
• Building systems: boilers, cooling towers and chillers, which may need large volumes and may be able to use non-drinking water.
• Fire protection: sprinklers and standpipes, which need their own plan with your fire marshal.

Even with strict conservation, a facility uses far more than the household planning figure of one gallon per person per day. Your own audit, not a rule of thumb, should set the number.

Step 3: Analyze Your Alternatives

Most plans combine several sources:

• Bottled water for drinking and medication, stored on site and rotated.
• Bulk potable water delivered by tanker to keep the building's plumbing running.
• A second feed or interconnection from the public supply, if one is available.
• On-site storage tanks that can be filled before a planned shutdown or after an outage begins.

Step 4: Write It Down and Practice

Put the plan in writing, name who makes the call to activate it, and include vendor contacts with after-hours numbers. Run a tabletop exercise at least once a year and walk the delivery route with your water hauler.

Before a Planned Shutdown

Not every outage is a surprise. Water main work, new connections and building repairs are often scheduled days or weeks ahead. When you get notice:

• Confirm the window. Get the start time, expected length and a contact who can tell you if it runs long.
• Book delivery early. Give your hauler the date, the hours and the connection point so trucks are lined up before the water goes off.
• Fill storage ahead of time. Top off any on-site tanks and confirm bottled water stock for drinking and medication.
• Brief staff. Tell nursing, dietary and environmental services what will change, which fixtures to use, and how long it will last.
• Plan the restart. Decide in advance who will flush lines and check water quality when normal service returns.

A planned shutdown is also a good, low-stress test of your emergency plan. Note what worked and what did not, and update the plan afterward.

Getting Hauled Water Into the Building

The most common gap in emergency water plans is not finding water. It is getting the water into the building's plumbing. The EPA's guide on water and healthcare suggests healthcare facilities install exterior water hook-ups for hauled water, consider a booster pump in a multi-story building, and keep both potable and non-potable emergency water supplies on hand or under contract.

• A dedicated connection point. An exterior hook-up with the right fitting and a backflow preventer lets a tanker feed the building directly.
• Pressure. A tanker pump can supply a low-rise building. Taller buildings usually need the building's own booster pumps running, on generator power.
• Truck access. Mark a tanker staging spot near the connection that stays clear of ambulance routes and loading docks.
• Disinfection afterward. After an outage, follow CDC guidance and your infection prevention team's plan to flush and, if needed, disinfect the system before returning to normal use.

Choosing a Water Hauler

• Licensing. Ask for the hauler's New Jersey potable water hauler license. A Clear Alternative operates under license #0704582.
• Dedicated potable equipment. Tankers, hoses and fittings should be used only for drinking water.
• Around-the-clock availability. Outages do not wait for business hours.
• Capacity. Our standard tanker carries 6,200 gallons. Ask how many trucks can be sent and how quickly they can turn around.
• A pre-arranged agreement. Set up the account, delivery address, connection details and contacts before you need them.

Serving Healthcare Facilities Across New Jersey

We deliver to hospitals, nursing homes, assisted living communities, rehabilitation centers, dialysis centers and medical offices from Sussex to Cape May. See our commercial water delivery page, our 24/7 emergency water delivery service, and our service areas.

When to Call A Clear Alternative

Call us to add a licensed potable water hauler to your emergency plan, to walk your site and confirm truck access and connection points, or when an outage is already under way. A Clear Alternative is a family-run company that has served New Jersey since 1991 from 9230 Collins Ave in Pennsauken. Call 1-888-577-8088 any time, or request a quote online to set up an account before the next emergency.

Frequently Asked Questions

Do New Jersey hospitals need an emergency water supply?

Yes. New Jersey hospital licensing rules require hospitals to have access to an alternative supply of water in an emergency, and long-term care facilities have the same requirement.

What does the CMS Emergency Preparedness Rule say about water?

Facilities must have policies and procedures for subsistence needs for patients and staff, including food, water, and medical and pharmaceutical supplies, whether they evacuate or shelter in place.

How much water does a healthcare facility need in an outage?

It depends on the facility. The CDC's emergency water planning guide recommends a water use audit to find the minimum needed to keep critical and essential services running.

How does a tanker supply water to a building?

Through an exterior hook-up with a backflow preventer. Low-rise buildings can often be fed by the tanker pump; taller buildings usually need their booster pumps on generator power.

Can you deliver water to a nursing home in an emergency?

Yes. A Clear Alternative delivers certified potable water 24 hours a day to healthcare facilities in all 21 New Jersey counties.

Should we set up a water hauler before an emergency?

Yes. Setting up the account, delivery address, connection details and contacts in advance makes delivery much faster when an outage happens.