Mass casualty incidents (MCIs) tend to be not only rare but also wide-ranging based on the number of victims, event type, geography, resources, and preparations. Between the years of 1998 and 2002 the first version of the National Public Health Performance Standards (NPHPS) came to light. This system was created to improve the public health system.This study evaluates the degree to which an Eastern PA Hospital’s EMS met NPHPS related to MCIs. The study identified strengths, weaknesses, opportunities, and threats in an Eastern PA Hospital’s EMS performance during MCIs. The main research question was: Which standards does an Eastern PA Hospital’s EMS meet and which standards remain unmet?