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U.S. Senate Report On Nursing Home Disaster Oversight

A U.S. Senate report on nursing home disaster oversight revealed that facilities are often not equipped to handle basic safety matters when natural disasters strike.

“Sheltering in Danger,” an investigative report by the minority staff on the U.S. Senate Committee on Finance released in November 2018, depicts a horrific picture of fatal heat strokes and chaotic evacuations during Hurricanes Harvey and Irma in 2017. The scathing report showed that a lack of state and federal oversight, poor emergency planning, faulty communication strategies, and questionable decision making by nursing home administrators contributed to the preventable deaths of nursing home residents.

The report triggered the Senate to call for stricter disaster preparedness and response standards. Without changes at all government levels, senators said nursing home residents will remain at risk during emergencies and disasters.

In response, the U.S. Centers for Medicare and Medicaid Services (CMS), a federal agency that was one of the major targets of the inquiry, agreed to clarify expectations for how nursing homes must maintain safe temperatures during emergencies.

What Sparked the Report

The most significant tragedy occurred when 12 residents died in a nursing home in Hollywood Hills, FL during Hurricane Irma. The storm knocked the power out to the building’s air conditioning system, causing the temperature to rise up to 99 degrees in some areas. Florida regulations now require nursing home officials to fix the problem or relocate residents if temperatures exceed 81 degrees.

Residents sat in the sweltering heat for three days; nursing home staff began evacuating residents after several passed away from heat-related complications. The residents did not receive proper care and were not kept hydrated. The Broward County Medical Examiner ruled the deaths homicides.

Key Report Recommendations

The report makes several recommendations, so government officials and nursing home providers can be better prepared in the future. The report lists the following eight key recommendations:

  1. Revising the “Safe and Comfortable” Temperature Standard: CMS should tweak its temperature standards to incorporate modern heat index guidelines and show the health and evidence-based risks that rising temperatures pose to nursing home residents.
  2. Clearly Communicate that the Temperature Standard Applies in Emergencies:

CMS should ensure that the state and nursing home providers know that the temperature standard applies during emergencies, including natural disasters like hurricanes.

  1. Install Emergency Power to Maintain Safe Temperatures: CMS should require nursing homes to install emergency power that can maintain the temperature standard.
  2. Issue Warnings About Alternative Temperature Devices: CMS, as well as state and local officials, should warn nursing homes of the improper use of alternative temperature devices, such as portable air conditioners. If not used properly, spot coolers can make conditions worse, like they did in Hollywood Hills. The portable air conditioners used in Hollywood Hills were not vented properly, causing the space to become even hotter.
  3. Shed Light on the Elderly’s Vulnerability in Heat Emergencies: CMS should highlight seniors’ vulnerabilities to heat emergencies and require facilities that care for them to prepare accordingly.
  4. Coordinate With Providers of Electricity: CMS and state and local officials should coordinate with electricity providers to ensure that their facilities are given higher priority in terms of restoring service due their senior population. Plans should include alternative actions that homes will take if power cannot be restored promptly.
  5. Evaluate, Review, Revise, Approve Emergency Plans: CMS and state and local governments must re-examine their processes for reviewing and approving long-term care facilities’ emergency plans to ensure that they are complete, accurate, and protect residents.
  6. Shelter-in-Place/Evacuation Warnings: CMS and state and local governments need to better define what it means to issue mandatory orders to shelter-in-place or to evacuate. Nursing homes must be clear about their responsibilities. When homes shelter-in-place, trained staff and equipment must be on-site to ensure resident safety. Also, homes must continually reassess their decisions and the level of safety they are providing.

Legal Help for Nursing Home Injuries

If your loved one suffered injuries or passed away due to a nursing home’s lack of emergency preparedness and response planning, contact a nursing home abuse lawyer to discuss your case: 1-800-516-4783.