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WASHINGTON (AP) — Tornado, hurricane or flood, nursing homes are woefully unprepared to protect frail residents in a natural disaster, government investigators say. Emergency plans required by the government often lack specific steps such as coordinating with local authorities, notifying relatives or even pinning name tags and medication lists to residents in an evacuation, according to the findings.
Nearly seven years after Hurricane Katrina’s devastation of New Orleans exposed the vulnerability of nursing homes, serious shortcomings persist.
The report recommends that Medicare and Medicaid add specific emergency planning and training steps to the existing federal requirement that nursing homes have a disaster plan. In a written response, Medicare chief Marilyn Tavenner agreed with the recommendation, but gave no timetable for carrying it out.
Nationally, more than 3 million people spent at least some time in a nursing home during 2009, according to the latest available data. A different story emerged when inspectors showed up at 24 selected nursing homes and started pulling files and interviewing staff.
The specific facilities in California, Louisiana, Minnesota, North Carolina, North Dakota, Tennessee, and Texas were not identified in the report. A detailed, well-rehearsed emergency plan is a basic requirement for disaster preparedness. Of the 24 emergency plans, 23 did not describe how to handle a resident’s illness or death during an evacuation. None of the nursing homes met a government recommendation for a seven-day supply of drinking water if residents had to shelter in place and their regular source of water was unsafe or unavailable. Twenty-two had no backup plans to replace staff members unable to report for work during a disaster.
Seventeen had no specific plan for working with local emergency coordinators to decide whether to evacuate or shelter in place. Not surprisingly, administrators and staff from 17 of the nursing homes told investigators they faced substantial challenges in responding to the disasters that hit their areas. The vulnerability of nursing home patients became a national issue when 35 residents of St. Prosecutors charged the owners of the facility with negligent homicide, saying they should have evacuated the home. A Houston Chronicle investigation found that, all told, at least 139 nursing home residents died during the hurricane or its aftermath.

The top 10 disaster-prone states, as ranked by historical statistics on major disaster declarations, are Texas, California, Oklahoma, New York, Florida, Louisiana, Alabama, Kentucky, Arkansas, and Missouri. This entry was posted in Nation, News and tagged Food, Health, Legal, mph7p3, National, Seniors, Severe Weather, South, test. Subscribe to our Daily Digest for independent journalism through the lens of social justice & human rights directly in your inbox.
Disaster Preparedness for Long-Term Care Facilities Katrina of 2005 affected 120 of 300 nursing homes in the DISASTER PLANS Disaster plans should be reviewed every best practices for nursing homes and assisted care facilities to follow in developing their preparedness plans. Nursing Homes Disaster Preparedness Plans Show Gaps Senior safety during natural disasters is a topic we’ve blogged about before. In 2001, older adults and disabled residents were left behind for days near Ground Zero after the September 11 attacks. A year after the grant’s completion, we are pleased to report that the initiative has improved the capacity of nursing homes to care for their residents in the event of a disaster. While we recognize that nursing homes and other long-term care facilities need to continue to improve their disaster response planning, we are pleased that the Hurricane and Disaster Preparedness for Long-Term Care Facilities initiative has had a significant impact on many states’ and federal agencies’ readiness to help older and disabled residents in emergencies. Many such steps are now in nonbinding federal guidelines that investigators found were disregarded.
First they looked at the number of nursing homes that met federal regulations for emergency planning and training. Ninety-two percent of the nation’s 16,000 nursing homes met federal regulations for emergency planning, while 72 percent met the standards for emergency training. Also, 15 had no information about specific medical needs of patients, such as feeding tubes and breathing equipment. None of the nursing homes had planned to ensure transportation of adequate food and water for evacuated residents, while 19 had no specific plan for transporting wheelchairs and similar equipment. A common problem was that transportation contracts were not honored after an evacuation was called. Emergency Preparedness Training and Exercise Guide for Nursing Homes on gaps in nursing home emergency preparedness plan.
Tornado, hurricane or flood, nursing homes are woefully unprepared to protect frail residents in a None of the emergency plans in place in these nursing homes included Few people think to ask about disaster preparedness when selecting a nursing home "We identified many of the same gaps in nursing home preparedness and steps to the existing federal requirement that nursing homes have a disaster plan. Our elderly population is Emergency Preparedness Checklist for Nursing Homes, staff assembled a Disaster Emergency Preparedness Checklist 1 Does the facility have a plan to The report, Nursing Home Emergency Preparedness and Response 20 facilities’ emergency preparedness plans.

In 2005, Hurricanes Katrina, Rita, and Wilma struck the southern United States, with a particularly devastating effect on older adults in long-term care facilities.
For example, nursing homes in Alabama, Florida, Louisiana, Mississippi, and Texas are now classified as health care providers, giving them priority for utility restoration.  In addition, FHCA spearheaded creation of the Emergency Management Guide for Nursing Homes, which includes extensive emergency response tools and guidelines for long-term care providers.
Berman, BS, RN, is a Senior Program Officer at the Hartford Foundation, with primary oversight of the Developing and Disseminating Models of Care portfolio. The typical nursing home resident is a woman in her 80s or older, dealing with physical and mental limitations that leave her dependent on others for help with basic daily activities. Then they went into the field to test how solid those plans were, in a sample of homes drawn from 210 facilities substantially affected by floods, hurricanes and wildfires across seven states during 2007-2010.
Seven plans were silent on how to identify residents in an evacuation, such as by attaching wristbands or name tags. Four nursing homes that did evacuate said they had problems trying to keep track of residents and supplies, in some cases temporarily losing patients.
Some jurors said afterward that Louisiana authorities should have taken responsibility for the safety of nursing home residents ahead of the monster storm. In addition to the manual there is a companion CD to Emergency Preparedness for Nursing Homes.
Katrina took the lives of at least 78 nursing home residents in New Orleans, and 23 long-term care residents were killed in a bus accident in Texas during evacuations caused by Hurricane Rita. Detailed information about the initiative is available in our paper, “Helping Nursing Homes Prepare for Disasters,” published in the October 2010 issue of Health Affairs. This CD will help administrators and lead staff to develop disaster with nursing, homemaker, HCA, and companion the beginning stages of developing plans for disaster preparedness. In response, the following year the Hartford Foundation funded a three-year, $361,556 grant entitled “Hurricane and Disaster Preparedness for Long-Term Care Facilities,” administered by the Florida Health Care Association (FHCA).

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