Nursing Home Emergency Plans Often Lacking

Government investigators report that nursing home emergency plans often leave a lot to be desired, with vulnerable residents in danger should an emergency occur.

The findings reveal that, in the event of a tornado, hurricane, or flood, nursing homes are ill-prepared to protect their residents, said The Associated Press (AP). The plans, which are government-mandated—tend not to contain specific steps that include local authority coordination, relative notification, and pinning residents with name tags and drug lists.

“We identified many of the same gaps in nursing home preparedness and response,” investigators from the inspector general’s office of the Health and Human Services Department (HHS) wrote in the report being released Monday and referring to the lacks revealed following Hurricane Katrina, said the AP. “Emergency plans lacked relevant information…. Nursing homes faced challenges with unreliable transportation contracts, lack of collaboration with local emergency management, and residents who developed health problems,” the report said.

HHS recommends Medicare and Medicaid include emergency planning and training steps to the current federal requirement that nursing homes must have a disaster plan in place, said the AP, which noted that many of these steps are contained in nonbinding federal guidelines that the HHS said were disregarded.

Medicare chief Marilyn Tavenner, in her written response, agreed with the HHS’ recommendation, but did not indicate when the changes would be made, said the AP.

Meanwhile, over three million people spent time in a nursing home in 2009, according to the most current data. Of them, about 40% (1.2 million) were located in the top 10 disaster prone states, said the AP. Of note, most residents are female, in their 80s, and diagnosed with a mental or physical limitation that necessitated reliance on others.

It was when inspectors visited 24 select nursing homes that files and staff interviews revealed gaps. The facilities were located in California, Louisiana, Minnesota, North Carolina, North Dakota, Tennessee, and Texas; none were identified by name in the report, said the AP. All of the facilities had been affected by disasters; 14 required evacuation and the rest were sheltered in place.

The report indicated that, in part, in one facility, the emergency plan was spread out in a number of boxes while another had the plan written on a legal plan; 23 facilities never indicated how to handle a resident illness or death during an evacuation, 15 did not discuss specific patient medical needs (feeding tubes, breathing equipment), seven did not mention how to identify patients, and 15 had no provisions for drug lists, said the AP.

Drinking water supplies, staff back-up plans, transportation, and collaboration with local emergency workers—to name a few others—were items not fully covered in many plans, said the AP.

The top 10 disaster-prone states, according to the report, are: Texas, California, Oklahoma, New York, Florida, Louisiana, Alabama, Kentucky, Arkansas, and Missouri. , The states were ranked by “historical statistics on major disaster declarations, “the AP explained.

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