5 Ways That Some Nursing Homes Aren't Prepared For an Emergency
The time to prepare for an emergency – whether it is a tornado, hurricane, blizzard or other natural or man-made disease – is well before it actually strikes. Unfortunately, a new report by the Department of Health and Human Services’ Office of Inspector General found some glaring holes in the emergency plans of 24 nursing homes that were selected to be used as case studies in the study.
Here are five key take-aways from the report:
1. Many nursing homes’ emergency plans do not include a well-thought-out map for evacuating residents. All 24 nursing homes hadn’t identified steps to transport adequate food and water supplies. Nineteen homes’ emergency plans also did not have steps to transport critical supplies, equipment, wheelchairs and assistive devices. Twenty-two plans hadn’t considered transporting and protection of medications or medical records. And 23 plans did not include evacuation routes and alternate routes, while 15 plans had not developed evacuate routes.
2. Many nursing homes’ emergency plans do not include critical information about their residents. You’d think that nursing homes would be prepared to have critical information like the name and contact information for the next of kin or the person who has power of attorney ready if an evacuation happens. But that wasn’t the case in 19 of the 24 nursing homes that the OIG studied. Additionally, 17 of the nursing homes didn’t include the resident’s date of birth or diagnosis in the emergency plan while 15 didn’t include current drug/prescription and dietary requirements for individual residents. Eleven didn’t include the names of residents while 10 didn’t have a way to account for residents during and after an evacuation.
3. Some nursing homes’ emergency plans didn’t include plans to communicate with key stakeholders or to collaborate with emergency managers. Based on the earlier findings that key contact information isn’t part of the emergency plans, it’s not too surprising that communication could be an issue. Interestingly, the emergency plans most often didn’t include the ombudsman (missing in 22 emergency plans), residents (missing in 15 plans), and staff (missing in eight plans). The OIG also found that 16 plans did not include a task to collaborate with emergency managers in plan development while 17 plans did not include collaboration with emergency managers in deciding whether to evacuate residents or to shelter in place.
4. Some nursing homes’ emergency plans do not have detailed information about residents’ health needs ready to go in case of an evacuation. Why is this important? Let’s use my mom as an example. She not only had Alzheimer’s, but also suffered from advanced chronic obstructive pulmonary disease. Therefore, if her nursing home was evacuated, she would have needed to have oxygen and medications for both conditions available. In addition, she also was bound to wheelchair during the last few years that she was alive. Therefore, she could not have easily accessed a regular bus or van; instead, Mom would have needed transportation that would allow her to stay in her wheelchair. Those types of details for each nursing home resident need to be included in an emergency plan.
5. Holes in the emergency plan exist even if the nursing home makes the decision not to evacuate residents. You’d think that remaining in place would be really easy, but what if the crisis involves the surrounding community? I’m thinking of Houston right after its most recent hurricane when parts of the city were without electricity for a period of time and some areas were affected by downed trees. Unfortunately, some nursing homes aren’t well prepared for these types of situations. The OIG found that of the 24 emergency plans reviewed, all of them did not have a plan for acquiring an adequate supply of potable water to care for residents for a minimum of seven days. Furthermore, 22 don’t have a plan for getting extra medical supplies and equipment to care for their residents for that week. Nineteen plans didn’t include generator fuel supplies while the same number hasn’t considered getting extra pharmacy stocks of common medications. And 17 of these nursing homes had not developed a plan to have the appropriate amounts and types of food available for that week-long period.
So what should you do if you have a loved one who lives in a nursing home? I’d suggest approaching the facility’s leadership – including the administrator and the director of nursing -- to talk about the facility's emergency plan. Encourage them to give a presentation on the plan to family members at a special meeting. And if you have concerns about the quality of the emergency plan at your loved one's nursing home, contact the ombudsman to express your worries.