We were all shocked when elderly residents died in the heat as Hurricane Irma knocked out a transformer in the air-conditioning system of a Florida nursing home. Management at The Rehabilitation Center at Hollywood Hills said it made phone calls for help and received no response. Still, they did not take patients to a hospital right across the street even as temperatures mounted and residents reached critical states. A total of 14 people died.
How did this happen? Hurricane Irma hit 12 years after Hurricane Katrina, when many nursing home residents died due to heat and flooding. How have lessons not been learned? Why aren’t nursing homes better prepared for natural disasters?
The tragedy in Florida has left many local people here in Ohio wondering what kinds of precautions our nursing homes have in place. We may not face hurricanes, but we are at risk for natural disasters such as tornadoes, blizzards, and floods as well as manmade disasters.
Ohio Nursing Home Disaster Preparation
Though Cleveland ranks as the second-safest city in the country when it comes to natural disasters, that doesn’t make us immune to them. Ohio nursing homes were surveyed a few years ago to determine their level of preparedness for natural disasters, evacuations, and other emergencies. More than 90% responded.
The good news is that most facilities seem to be prepared. All who responded to the survey reported that they have an emergency plan in place; however, only half had coordinated with local resources such as hospitals, public health officials, and emergency responders.
For disaster management to be effective, there must be a great deal of pre-planning and coordination. Good disaster management includes:
- Disaster planning that can prevent or mitigate a disaster;
- Risk identification and analysis;
- Response that is structured and collaborative; and
- Recovery actions to repair, rebuild, and get back to normal as soon as possible.
New Federal Legislation to Improve Safety Requirements
Until recently, nursing homes that accept Medicare and Medicaid — that is, most nursing homes — have been bound by federal regulations that required them to be “designed, constructed, equipped, and maintained to protect the health and safety of residents, personnel and the public.” That ought to be enough for facilities to put temperature-control back-ups into place, but clearly, this regulation did not protect nursing home residents in Florida. So, even though Ohio nursing homes seem to be prepared, there has not been enough oversight of the details on a federal level.
But change is coming. As of November 15, 2017, health care providers and suppliers must implement all regulations contained in final rule Emergency Preparedness Requirements for Medicare and Medicaid Participating Providers and Suppliers. This rule impacts all facilities that take Medicare and Medicaid payments, including nursing homes.
The new regulations are more specific than the old, and they require steps be taken related to natural, manmade, and facility-based disasters. These requirements include:
- Facilities must develop and implement emergency preparedness policies and procedures. Emergencies include power and communications failures, cyberattack, and interruption in delivery of supplies. Facilities must coordinate with state and local officials and test their plans.
- Facilities must be able to provide for adequate subsistence for all patients and staff for the duration of an emergency or until all its patients have been evacuated and its operations cease. This includes:
- Medical and pharmaceutical supplies; and
- Alternate sources of energy to maintain the following:
- Temperatures to protect patient health and safety and for the safe and sanitary storage of provisions;
- Emergency lighting;
- Fire detection, extinguishing, and alarm systems; and
- Sewage and waste disposal.
It is up to each individual facility, based on its risk assessment, to determine the most appropriate alternate energy sources in accordance with local and state laws. Only facilities with life-saving equipment that requires power such as ventilators will be required to have generators. If a facility determines the best way to maintain temperatures, emergency lighting, etc. is a generator, the generator must be properly tested and maintained.
However, the new rule does not require backup generators for air-conditioning systems. Due to the tragedy in Florida, in which the Rehabilitation Center at Hollywood Hills did not have a generator, some wonder if it should be required. Advocates in Ohio, at the least, say that the requirements for generators should be increased.
How do I know my nursing home is safe?
Ohio has almost 1,000 nursing homes to choose from and you want to pick the best for you and your family. If you are searching for a nursing home that complies with safety standards, the Ohio Long-term Care Consumer Guide offers comprehensive information on services, location, quality indicators, and costs of nursing homes in our state.
The new federal regulations, of course, are much more involved and lengthy than what we have included here. If your family member is a resident of a skilled nursing facility and you’re concerned with their safety, don’t hesitate to call our office. The experienced attorneys of Plevin & Gallucci will be happy to consult with you. We cannot be overly prepared in keeping our seniors safe in the face of disaster.
For our latest blog posts on nursing homes and nursing home abuse in Ohio, see: