Nursing Homes Unprepared for Natural Disasters

Although natural disasters are uncommon, like fires, blackouts, domestic and workplace violence, terrorism, and disease outbreaks, they are a foreseeable risk.  One hopes that particularly institutions responsible for caring for vulnerable groups like the sick, impaired,end elderly, would foresee these event and have contingency plans in place.  Not so, says Sen. Ron Wyden (D-OR), ranking member of the Senate Committee on Finance, who concluded nursing homes were woefully unprepared for natural disasters.  He made public his concern, and called for greater oversight in a recent report.

Wyden said hurricanes Harvey and Irma caused problems that were not accidents, including the well-reported deaths of 12 seniors at one facility. He called them “preventable tragedies that resulted from inadequate regulation and oversight, ineffective planning and communications protocols, and questionable decision-making by facility administrators.”

“My investigation found that in too many cases, nursing homes were ill-equipped to keep their residents comfortable and safe in the face of natural disasters, in some cases with fatal consequences,” he said in a statement. “This is a failure of responsible governing from top to bottom.”

The Democratic senator said that federal rules need to be “more robust and clear,” along with “dramatically” improving planning and communication between local and state officials, and nursing home leaders.  “Until changes are made, seniors in America’s nursing homes will continue to be at risk when disaster strikes,” he said.

In a lengthy statement, LeadingAge President and CEO Katie Smith Sloan acknowledged that the nursing home field shares senators’ concerns. She noted that the deaths of more than a dozen residents at a Hollywood Hills, FL, facility in 2017 “should never have happened."  "We make no apology for poor quality nursing home care. Errors should be addressed. Continual improvement is a must,” she said.

She noted that substantial changes were put into place in late 2017, as part of new Centers for Medicare & Medicaid Services (CMS) regulations, in response to concerns arising from hurricanes. She suggested that elected officials should wait for those new rules to take hold, along with speaking to nursing home leaders before enacting any further regulations.  “Room must be allowed for human judgment in emergency and disaster situations,” Smith Sloan said.

“Nobody entrusted with making the decision to evacuate or shelter in place takes it lightly. As we’ve seen, lives depend on leaders making the right decision — and learning from what happened before,” she said, later adding, “Let’s give the new system a chance to work.”

According to an article in Skilled Nursing News, in a separate statement, American Health Care Association (AHCA) President and CEO Mark Parkinson noted that the “vast majority” of long-term care facilities have successfully implemented their emergency response plans. The industry’s focus is learning from best-in-class operators.  “Unfortunately, this report largely focuses on isolated incidents with tragic outcomes where existing regulations were ignored,” he said.

Parkinson added that nursing homes and assisted living facilities “must be a priority” for power restoration and supplies in emergency situations. And systems must be put in place so that providers can work more closely with authorities when deciding whether to evacuate or shelter in place.

The report, entitled "Sheltering in Danger,"produced by minority staff of the Finance Committee, comes in response to hurricane-related deaths that followed Irma, along with incidents at Texas long-term care facilities after Harvey. It asserts that rules put in place by CMS are “wholly inadequate” when it comes to giving nursing homes direction in an emergency.

The report offers 18 recommendations that officials can take to help providers better prepare for such natural disasters.  The recommendations range from revising the safe and comfortable temperature standard, to highlighting the vulnerability of seniors in heat emergencies. A two-page summary of the report and its recommendations can be found here.