An Immediate Jeopardy (IJ) citation signals that residents face serious and immediate risk, and how a facility responds in the first hour can determine regulatory outcomes. This article outlines the critical leadership actions nursing homes must take the moment an IJ is declared. It emphasizes rapid mobilization, clear role assignments, proactive surveyor communication, and real-time documentation. By pausing all other priorities and aligning teams quickly, facilities can protect residents and demonstrate control under pressure. With defined responsibilities, from the Administrator to the Director of Nursing and department leads—facilities that prepare for these moments can turn chaos into coordinated action. Qsource helps nursing homes build crisis-ready leadership structures, run mock IJ drills, and strengthen real-time survey response practices.