Building Resilient Extended-Care Facilities During Natural Disasters – Lessons Learned from the 2007 Tulsa, Oklahoma Ice Storm. In the last decade, increasing importance has been placed on building resiliency into critical healthcare systems. This has meant shifting the paradigm from focusing on response to one of preparedness. In 2007, an ice storm as part of a series of winter storms occurred in the south central United States causing extensive power outages, in Tulsa, Oklahoma, for a period of up to 3 weeks. Five of the six tertiary care hospitals in Tulsa suffered power outages, phone system failures or oxygen and/or suctioning system failures. Local water treatment plants were without power for 48 hours. During this time, multiple extended-care (nursing home) patients were discharged to homes or transferred to hospitals because the nursing homes were not prepared to cope with an extended power outage. This paper is a retrospective analysis and discussion of lessons learned with respect to the vulnerability of these extended-care healthcare systems and the public health response during natural disasters.