Nursing home emergency plans are a disaster

10 05 2012

A recent article from an issue of Natural Hazards Disaster Research raises concern about the quality of emergency plans in place for nursing homes across the country.  The publication, a product of the University of Colorado at Boulder indicates the following:

From documents scrawled on legal pads to those stored in boxes, a recent investigation into nursing home emergency plans found them severely lacking. The on-site inquiry at 24 nursing homes uncovered a plethora of missing and substandard plans that would leave residents without food, transportation, and medicine during a disaster.

The investigation, conducted by the U.S. Department of Health and Human Services Office of the Inspector General, was part of a larger study that followed up on a 2006 examination of emergency planning and preparedness training in nursing homes. The study found that, despite guidelines and regulations, nursing homes are still sadly ill-prepared to take care of patients during disaster.
“We identified many of the same gaps in nursing home preparedness and response that we found in our 2006 report,” wrote authors in the latest report, released last week. “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.”

Even more disturbing is the fact that the 24 facilities visited were culled from 210 organizations that had already experienced flood, hurricane, or wildfire between 2007 and 2010, according to an Associated Press article.

“Of the 24 emergency plans, 23 did not describe how to handle a resident’s illness or death during an evacuation,” the article stated. “Also, 15 had no information about specific medical needs of patients, such as feeding tubes and breathing equipment. Seven plans were silent on how to identify residents in an evacuation [and] 15 made no provision for including medication lists.

“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.”

Investigators also found that transportation contracts were often not honored during disasters and only covered patients—not food, supplies, and medical equipment—when they were, according to the 2012 report.

Regulations require all nursing homes have to have a disaster plan, but many elements of that plan are optional. In fact, 92 percent of the 16,000 nursing home facilities met the letter of federal requirements for emergency planning and 72 percent met training requirements, according to the Associated Press.

Report authors recommended that those regulations be strengthened to include specific plan and training requirements, guidance be given on compliance, and nursing homes compelled to use existing planning checklists.