It takes a community. It takes a plan. And it takes leadership in emergency life-threatening incidents.

Everyone watched for the days leading up to the arrival of Hurricane Harvey; on Friday night, August 25 Harvey came ashore. The Texas Department of Emergency Management issued an initial Situation Report (SITREP) about Hurricane Harvey on August 23. The SITREPS continued each day.

The Federal Emergency Management Agency’s (FEMA) weather briefing on August 21 contained this projection: “Heavy rain/flash flooding possible.” Subsequent daily reports confirmed the inevitable.

Everyone knew what was probably going to happen! So why … did this happen?

nursing home

Why did an assisted living facility in this Texas community not have an emergency plan to evacuate its residents? If it did have a plan, why did the facility not activate its plan to evacuate its residents?

Failure to anticipate the consequences of Hurricane Harvey or any other critical incident is a failure of leadership. Failure of leadership can result in death, injury, likely lawsuits, but certainly, comments as these following the Galveston County Daily News article:

“This is horrific treatment to our seniors. They should have been moved before the storm got here. Poor planning on managements part. I would not want to sit in that water (hypothermia) especially with thin clothing and diapers soaking up water. Just use common sense and have an evacuation plan. God bless them to endure such treatment.

“Poor planning, true. But to be clear, part of whatever plan they had obviously gave little to no consideration for these seniors.

“This is a privately owned assisted living facility (not cheap) and they do have an evacuation plan but obviously did not evacuate. Regardless of what Dickinson Emergency Mgmt. advised, the owner is responsible for the welfare of the residents. It rained ALL night! Why wasn’t a better decision made sooner to get these disabled seniors out of harms way? In good circumstances, most of these residents are usually cold but to see them like this is appalling. They deserve so much better!”

Flooding can happen along any body of water. “Flooding is the most frequent and damaging natural disaster that occurs throughout the Commonwealth. Many of Pennsylvania’s communities are located along waterways,” according to Pennsylvania’s Hazard Vulnerability Analysis.

Assisted living facilities, nursing homes, hospitals and a complement of health services providers are required to have emergency preparedness and response plans for all types of hazards. They’re mandated to understand, institutionalize, rehearse and implement the National Incident Management System’s Incident Command System.

nursing home icsTemplates, forms and the Incident Command System are easily available online at multiple sites; this is one.

“The Centers for Medicare & Medicaid Services (CMS) issued the Emergency Preparedness Requirements for Medicare and Medicaid Participating Providers and Suppliers Final Rule to establish consistent emergency preparedness requirements for healthcare providers participating in Medicare and Medicaid, increase patient safety during emergencies, and establish a more coordinated response to natural and human-caused disasters.

“This rule applies to 17 provider and supplier types as a condition of participation for CMS. The providers/suppliers are required to meet four core elements (with specific requirements adjusted based on the individual characteristics of each provider and supplier):

  1. Emergency plan — Develop an emergency plan based on a risk assessment and using an “all-hazards” approach, which will provide an integrated system for emergency planning that focuses on capacities and capabilities.
  2. Policies and procedures — Develop and implement policies and procedures based on the emergency plan and risk assessment that are reviewed and updated at least annually. For hospitals, Critical Access Hospitals (CAHs), and Long-Term Care (LTC) facilities, the policies and procedures must address the provision of subsistence needs, such as food, water and medical supplies, for staff and residents, whether they evacuate or shelter in place.
  3. Communication plan — Develop and maintain an emergency preparedness communication plan that complies with federal, state and local laws. Patient care must be coordinated within the facility, across healthcare providers, and with state and local public health departments and emergency management systems to protect patient health and safety in the event of a disaster.
  4. A training and testing program — Develop and maintain training and testing programs, including initial training in policies and procedures. Facility staff will have to demonstrate knowledge of emergency procedures and provide training at least annually. Facilities must conduct drills and exercises to test the emergency plan or participate in an actual incident that tests the plan.”

Click here to read the complete document: “CMS Emergency Preparedness Rule: Resources at Your Fingertips.”


One comment

  1. I worked in a long-term care facility for 34 years and in the 1980s while I was working night shift, a storm came through and dumped an excessive amount of rain. The building flooded severely. In some parts of the ground floor where residents were living it was 28 inches deep. Prior to this depth of water accumulating I was responsible to evacuate residents and there was some concern over electric outlets that were located near the floor and the use of elevators. We knew nothing about how to proceed because all we were ever trained for was fire, never flooding. The facility is located next to a creek and some flooding on the property was typical, but not inside the building. Many residents did not want to leave, did not want to lose belongings that were stored under beds, on closet floors, they were getting saturated. Bath blankets and towels were thrown all over the floors near where the water was gushing through the radiators. The force and weight of the water pressed on automatic doors and opened them gushing through. It was a learning experience of how destructive and devastating water and flooding can be. There is an amazing amount of power in water. After the water receded, tables were set up in common areas and resident’s muddy, wet belongings were put out for them to claim. Even after this experience, I do not recall any flood evacuation training taking place.

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