You may have read about the 11 residents of a Hollywood, Florida, nursing home who died from the heat after Hurricane Irma hit in September 2017 and power was lost. What you might not know is that regulations are in place that might have prevented the deaths. Ever since 2005’s Hurricane Katrina, which caused more than 200 hospital and nursing home residents to die, federal regulators have required that details of emergency preparedness plans for the more than 15,600 nursing homes in our country be specified, including how to evacuate residents if necessary.
So why did 11 elderly people die?
New Rules Post-Katrina, But…
One of the problems is that the rules are good, but enforcement can be lacking. Often, the government gives nursing homes and other long-term care centers several years to implement changes needed for safe operations. And sometimes, if a nursing home can’t meet a multi-year deadline, they are given yet another extension.
One example is requiring automatic sprinkler systems, which have been mandatory since 2008. Nursing homes were given five years to install such life-saving systems, and yet, in 2014, extensions were granted to those homes which had not met the deadline six years after the rule was put in place. As of October 2017, some facilities still haven’t installed automatic sprinkler systems, nearly 10 years later.
But actual disasters have a way of revealing flaws in the regulatory system. Here are examples of nursing homes which failed to plan and prepare for even the most basic of emergencies:
- When a fire broke out at a Chicago nursing home, residents were evacuated in the wrong order. Instead of removing those closest to the blaze first, staff evacuated those farthest from the flames first.
- In May 2016, federal inspectors discovered that a nursing home in El Paso, Texas, had no plan and no idea how to evacuate wheelchair-bound residents down a flight of stairs.
- Records show that employees did not know the combination to unlock their Colorado nursing home’s courtyard gate in case of emergency, according to inspectors.
When it comes specifically to the question of generators for emergency power, one-third of nursing homes have been written up for not inspecting their generators weekly or testing them monthly. Yet none of these violations was considered a “major deficiency” that would put residents at risk of death, not even at the 1,373 facilities who received more than one citation.
As Toby Edelman, a senior policy attorney with the Center for Medicare Advocacy, commented, “It’s always the same story: We have some pretty good standards and we don’t enforce them.”
One Big Problem: Staffing
A 2016 review of various studies showed that at least one-fourth of U.S. nursing homes could be considered “dangerously” understaffed. Around half of our country’s facilities are chronically understaffed, meaning that evacuations and care during emergencies become much more difficult. Compounding the problem is that some staffers may not be able to get to work during a natural disaster like a hurricane. But we have no regulations that mandate a minimum level of staffing.
What’s Happening in Florida?
Since the horrible situation in Hollywood, new rules have been announced for Florida by Gov. Rick Scott. Nursing homes now need generators to produce power to run essential services for at least 96 hours at each nursing home. One state legislator’s bill would extend the time period to 120 hours.
In 2006, nursing home industry lobbyists in Florida managed to kill a bill that would have required generators on-site for facilities. At the federal level, a proposal to increase nursing home staffing requirements also died due to lobbyists.
It often seems that a real tragedy has to occur before the proper regulations are put into place and, just as importantly, enforced. The executive director of the Long Term Care Community Coalition, Richard Mollot, said, “This should be a wake-up call… that every nursing home in our country should be held accountable before ― not after ― the next tragedy takes place.”