The fragmentation of the US healthcare delivery system lends itself to issues with coordinating disaster response because the burden of response for the most part seems to fall on the tertiary care facilities. Collective community response and preparedness drives local medical involvement but does not necessarily draw in all levels of care. As a hospital administrator, I would work to ensure a solid, practical and regularly exercised plan was established. Coordinating with first responders and local authorities to organize a community wide response strategy would be essential in targeting needs and efforts required to respond. Ensuring all personnel, on all levels, are trained and prepared for a variety of disasters on a consistent basis and can step in at any time, on any level, is essential in any response plan. Additionally, all departments within the facility must have ready access to a stockpile supplies, approved in advance as part of the plan. Access to the Strategic National