Disaster Preparedness at Health Facilities in Spotlight

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By Mike Stankiewicz

A bipartisan group of senators is taking a closer look at emergency preparedness and care for seniors after disasters like Hurricanes Harvey and Irma.

Committee members and witnesses during a Special Committee on Aging hearing Sept. 20 made it clear that changes, including ensuring emergency equipment is available, are needed to protect elderly patients when disasters strike.

“As these recent disasters made clear, older Americans are more vulnerable before, during, and after these storms,” Sen. Susan Collins (R-Maine) said during the hearing. There seems to be “a very troubling lack of preparedness in some health-care centers.”

Collins, along with fellow committee members Sens. Bill Nelson (D-Fla.), Marco Rubio (R-Fla.), and Bob Casey (D-Pa.), has also introduced legislation that would require the Department of Health and Human Services to establish a national advisory committee to improve care for seniors during a disaster. This follows the deaths of eight people in a Hollywood, Fla., nursing home in the wake of Hurricane Irma.

“Not only has the tragedy in Hollywood left wounds across the state of Florida, but it has exposed other examples of potential mismanagement at assisted living facilities in the state,” Rubio said in a press release. “This bill is a necessary step in preventing similar tragedies in the future and ensuring Florida’s seniors are taken care of during natural disasters.”


Under the bill, members of the advisory committee would be appointed by HHS Secretary Tom Price and comprise both federal and local agency officials, and nonfederal health-care professionals who specialize in disaster response.

The panel would be tasked with providing guidance to local, state, and federal officials on how to better prepare seniors for an emergency, how to better evaluate their health needs during an emergency, and what activities should be carried out when an emergency is declared.

The legislation now heads to the Senate Committee on Health, Education, Labor and Pensions for consideration.

Evacuations and Safety

Karen DeSalvo, the former health commissioner of New Orleans, said during the hearing that the Centers for Medicare & Medicaid Services’ emergency preparedness rule, finalized last year, is a step forward, but requires robust implementation.

“It’s not pieces of paper and checklists, it’s actually really drilling down and paying attention in an ongoing fashion for things like fuel supplies for generators,” she said. “The administration should think about creating best practices and tools that can help guild policy and regulation and local ordinances that can support areas that sometimes we forget about in emergency preparedness, like building codes.” DeSalvo was also national coordinator for health information technology at the Department of Health and Human Services in the Obama administration.

Collins cited the lack of reliable electrical power as a contributor to the death of the seniors in the Florida nursing home.

Kathryn Hyer, professor at the University of South Florida’s School of Aging Studies, said a nursing home’s decision to evacuate is difficult and sometimes dangerous.

“Following Katrina, nursing home administrations said they wrestled with the decision of whether to evacuate their residents prior to the storm,” she said. “They cited pressure from emergency managers urging them to evacuate despite the difficulty including having them evacuate to gyms without supplies and adequate materials. These patients declined to want to move, and staff was having difficulty trying to help and move residents, and the administrations believed they’d be better served by staying.”

Hyer also said nursing homes need generators to support medical needs during disasters, as well as fuel and proper planning.

“Emergency plans for nursing homes and assisted living must be publicly and easily available for residents and families to understand before they enter the home,” she said. “We know that disasters will continue to occur, and we must be prepared.”

Hyer also said nursing homes should be built in locations that aren’t susceptible to frequent natural disasters and should be built to stand strong storms.

To contact the reporter on this story: Mike Stankiewicz in Washington at mstankiewicz@bna.com

To contact the editor responsible for this story: Brian Broderick at bbroderick@bna.com

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