Disaster Plans Not Complete For Most Nursing Homes, Study Finds
A recent report has found that while most nursing homes had some written emergency plans, a closer look showed many of the plans were inadequate and lacked specifics of how to handle emergencies.
June 30, 2012
The news seems full of stories of natural disasters, from the massive scale, like the 2011 tsunami in Japan and the devastation of Hurricane Katrina in New Orleans, to the more localized disasters of the Joplin, Missouri tornado and the recent flash flooding in Duluth, Minnesota that caused $100 million in damage in a single rainstorm.Many elements of a community's infrastructure can be overwhelmed, leaving ordinary residents without power and water for days, with even the roads impassable, blocked by flooding, downed trees and power lines.
What Happens to the Nursing Homes?
Those living in the damaged area may find it difficult to go about their daily activities, with power unavailable, the water supply compromised and local stores closed or short on products. This can be inconvenient, and may force a temporary relocation, but generally these issues are not life threatening.
For residents in nursing homes and long-term care facilities, the situation can be much more dire, as Hurricane Katrina demonstrated by nursing home neglect that occurred after the storm struck New Orleans. The average nursing home resident is a female in her 80s, who often needs behavioral and medical assistance to meet her basic needs.
A recent report issued by the Department of Health and Human Services Office of Inspector General raises even more concerns.
The Inspector General's Report
The report found that 92 percent of nursing homes had written emergency plans and preparedness training. Unfortunately, that was the end of the good news. While most had plans, many were literally on paper only, and even then, many were deficient in the details.
The report examined 24 nursing homes that had experienced some form of actual emergency, with 14 of the homes having been evacuated and the other 10 had had residents shelter in place during an emergency.
Missing Information
Missing information in the emergency plans included such issues as how to identify residents during an evacuation, how to keep track of residents medication, how to provide for staff that was absent during a disaster, plans for medication transportation and storage during a disaster, and 23 of 24 lacked plans for communicating with local emergency authorities during an event.
The Centers for Medicare & Medicaid Services (CMS) had developed a checklist to provide guidance to nursing homes and long-term care facilities in the creation of their emergency plans.
The Inspector General's report found only 13 of 24 administrators were even aware of the CMS checklist and only seven of the 13 had used it in creating their plan. Of those that used the checklist, the report found that only about half of the tasks from checklist were actually included on the emergency plans.
Do You Have a Plan for that?
Many of the plans did not deal with specific instructions for different types of disasters; for instance, one nursing home on a flood plain had failed to plan for dealing with flooding.
In many actual emergencies, nursing homes have found that the method for transporting residents breaks down because transportation contracts were not honored, making for even more confusion and making it more difficult for the staff to follow and track their residents.
If transportation is available, there may not be enough room in a single facility, leading to the dispersion of residents. This creates significant follow-up care issues for staff; one home's residents were relocated to 20 different facilities.
None of the 24 plans reviewed included provisions for a food supply and water for residents and most lack plans for provision of critical supplies and equipment during an emergency.
What Can You Do?
If you or a family member is considering a nursing home or long-term care facility, or are already a resident, a good first step is to ask what the emergency plans look like.
Ask specifics--not simply do you have a plan, but how do you evacuate the resident in case of a fire and how that is different from a flood.
Ask how often the staff of the facility trains for these situations, and how often? Do they have plans for staff unavailability and replacement during an emergency? Have they ever had to evacuate?
The Inspector General's report raises many questions, and their suggestions include having CMS making specific elements required in any emergency plan. This and other recommendations may take years to percolate through the system, so while it is a step in the right direction, they may be little in way of a quick solution.
Article provided by Adams Law Firm, P.C.
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