To assess the implementation of preparedness measures for stockpiling of essential supplies and sanitation in Japanese aged-care facilities, as specified in Japan’s Business Continuity Planning guidelines.

A prefecture-wide survey was conducted from February to August 2023 among all residential aged-care facilities in Shizuoka Prefecture, Japan. Self-reported anticipated evacuation strategies were classified into four types. Preparedness indicators were compared by evacuation strategy, provider sector, and resident mobility using chi-square tests. Indicators included stockpiling items and sanitation measures, as well as staff supplies not explicitly addressed in the guidelines.

The response rate was 46% (632/1366). Of the 632 facilities analyzed, 96% anticipated providing onsite care. Although approximately three-quarters had 3-day food and water supplies for residents, only 64% of facilities with an explicit shelter-in-place plan had supplies for staff. Sanitation preparedness was limited: only 43% had emergency toilet supplies, and 17% had toilet waste solidifying agents.

We identified gaps between Japan’s guidelines and disaster preparedness practices in aged-care facilities. Facilities with explicit shelter-in-place plans were not necessarily better prepared, particularly regarding sanitation measures. Limited preparedness for staff support was a critical challenge. Addressing these gaps is essential for continuity of care during disasters.