As climate change increases the scope and severity of hurricanes and storms, nursing homes in hurricane risk zones may need to re-evaluate their emergency preparedness status.
A study published in JAMA Geriatrics found that the association between exposure to hurricane-related inundation and nursing home emergency preparedness differs considerably across the Coastal Atlantic and Gulf regulatory regions, with a higher prevalence of emergency preparedness deficiencies among nursing homes in the Mid-Atlantic region.
Data in the cross-sectional study included information from CMS-certified nursing homes in Coastal Atlantic and Gulf Coast states from January 1, 2017, to December 31, 2019.
Of the 5,914 nursing homes studied, more than 10%, or 617, were at risk of inundation exposure, while almost 30%, or 1,763, had a critical emergency preparedness deficiency.
“Exposed facilities were less likely to be rural, were larger, and had similar CMS health inspection, quality, and staffing ratings compared with unexposed facilities,” JAMA researchers wrote. “Exposure was positively associated with the presence and number of emergency preparedness deficiencies for the nursing homes within the Mid-Atlantic region.”
Centers for Medicare & Medicaid Services (CMS) advises an all-hazards approach to emergency preparedness, although environmental exposures vary across communities.
“Despite the risks borne by nursing home residents, variation in their exposure to potential environmental hazards is not well characterized,” JAMA researchers wrote. “It is also uncertain whether nursing homes at increased risk of exposure are adequately prepared to safeguard residents upon encountering environmental hazards.”
During Hurricane Katrina in 2005, 35 nursing home residents drowned due to their facility not evacuating as the storm approached. In 2007, the involved nursing home operators were acquitted for negligent homicide and cruelty charges. And in 2021, the owner of a Louisiana nursing home was arrested for Medicaid fraud and two felony counts of obstruction of justice following the deaths of seven people in his care, prompting CMS to reconsider its emergency preparedness requirements for nursing homes.
Nursing home management and staff may not be well positioned to appraise and prepare for potential environmental hazards given their competing responsibilities, the researchers noted.
And so, in order to make improvements towards emergency preparedness, researchers recommend that nursing homes link up with local emergency planning agencies.
“Based on our findings, CMS regional offices may need to enhance enforcement of nursing home partnerships with local emergency planning agencies, which are better equipped to appraise and address environmental risks.”
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