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Are California Nursing Homes Prepared for Emergencies?

If the recent tragedies that unfolded following hurricanes Irma and Harvey are any indication, the answer is undoubtedly no.

In Florida, eleven residents of The Rehabilitation Center at Hollywood Hills died shortly after Hurricane Irma swept through the state, knocking out a transformer that powered the nursing home’s air conditioning system. On September 13, eight residents died after suffering there in sweltering conditions, with body temperatures reaching as high as 109.9 degrees. At least three more residents of the facility died during the following days and many more needed intensive care after emergency responders evacuated over 140 of them to local hospitals. Crime scene tape now drapes the nursing home as investigators ponder why so many critically ill residents were left in extremely dangerous conditions when a fully functioning hospital was just yards away. The nation is justly horrified by this tragedy.

In Texas, a photo of several residents sitting in waist deep water went viral on August 27 after Hurricane Harvey brought record flooding to Southeast Texas.

Why were these facilities and many others not better prepared to keep their residents safe? On September 20, 2017, the Senate Special Committee on Aging held a hearing to consider this question and hear from experts. At the outset of the hearing, Susan Collins, the committee chair, held up a voluminous report that contained recommendations made following Hurricane Katrina in 2005. Lessons have already been learned, over and over again in other disasters, but they are falling on deaf ears in too many nursing homes.

California nursing home and assisted living residents are at high risk from disasters. Although hurricanes are not a threat here, California is prone to wildfires, earthquakes, floods, mudslides and other types of natural disasters. Man-made disasters, such as fire, are another threat, and residents are increasingly at risk from extreme weather. During the recent prolonged heat wave, CANHR received reports that some nursing home residents were evacuated to San Francisco hospitals due to temperatures reaching 100 degrees inside of a facility. Not all California nursing homes have air conditioning.

On September 19, NPR published an article titled, Many Nursing Homes Aren’t Prepared For Even Basic Emergencies. It reported that 53 percent of California nursing homes have been cited in the last four years for at least one of two deficiencies related to emergency preparation: training employees what to do in an emergency and carrying out unannounced staff drills; or having a detailed written plan for disasters and emergencies, such as fire, severe weather and missing residents. A third of U.S nursing homes have been cited for failing to inspect their generators each week or to test them monthly. Nursing homes usually face no consequences for flaunting these most basic safety requirements because inspectors treat the violations as minor deficiencies.

Regulations will not help residents in facilities that pay no heed to them or if state officials do not enforce them, but there are regulatory changes that should be made. In the wake of Hurricane Irma, Florida’s Governor rushed to establish emergency rules that require each nursing home and assisted living facility to have sufficient generator capacity and fuel to cool the facility to 80 degree or less for at least four days if electrical power is lost. The Florida nursing home industry helped kill proposed legislation following a 2005 hurricane that would have established similar requirements.

California officials should review and strengthen its emergency preparedness requirements and oversight now, rather than wait for disaster to strike. CANHR has called on the Department of Public Health to establish comparable regulations on generator capacity and emergency preparedness for California nursing homes and to reexamine its methods of ensuring compliance with State and federal requirements.

Nursing homes and assisted living facilities should not become death traps during emergencies. The time to act is now.