Nearly seven years after the devastation of Hurricane Katrina, the inspector general’s office of the Health and Human Services Department identifies major gaps in emergency preparedness and response of nursing homes across the country. Natural disasters, be it tornados, hurricanes or floods, leave the nearly 3 million elderly and medically frail living in nursing homes across the United States particularly vulnerable.

“We identified many of the same gaps in nursing home preparedness and response,” the inspector general’s office wrote in a recent report. “Nursing homes faced challenges with unreliable transportation contracts, lack of collaboration with local emergency management, and residents who developed health problems.”

Recommendations have been made that Medicare and Medicaid add training plans and emergency planning to the federally required disaster plan. Investigators took a closer look at 210 facilities that were affected by floods, hurricanes and wildfires. On paper, the facilities appeared to be in good shape, but the truth came out when the inspectors showed up at 24 nursing homes in California, Louisiana, Minnesota, North Carolina, North Dakota Tennessee and Texas, and began interviewing staff and looking at files. Some surprising findings included:

  • Of the 24 plans, 23 had no details on how to handle a resident’s illness or death during evacuations.
  • None of the 24 had the recommended 7 day supply of fresh water in the facility
  • 22 of the 24 plans had no backup plan in place to replace staff members unable to report for work due to the disaster
  • At one facility, the disaster plan was in several boxes. In another, it was on a legal pad
  • 17 of the 24 had no plan for working with government or emergency coordinators to determine whether to evacuate or shelter in place
  • 7 facilities  had no plan in place to identify patients, such as name tags or arm bands.
  • 15 of the 24 had no medication list in place, meaning patients would likely go without their medications in the event of an evacuation
  • Employees of nursing homes shared information regarding transportation contracts not honored during evacuation
  • One facility’s employees that chose not to evacuate temporarily lost patients during the emergency.