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Nursing Home Self-assessment of Implementation of Emergency Preparedness Standards

Published online by Cambridge University Press:  23 May 2016

Sandi J. Lane  and
Elizabeth McGrady
Sandi J. Lane*
Affiliation:
Nutrition and Health Care Management, Appalachian State University, College of Health Sciences, Boone, North Carolina USA
Elizabeth McGrady
Affiliation:
Nutrition and Health Care Management, Appalachian State University, College of Health Sciences, Boone, North Carolina USA
*
Correspondence: Sandi J. Lane, PhD, FACHE, LHNA Assistant Professor College of Health Sciences ASU Box 32168 Boone, North Carolina 28608 USA Appalachian State University E-mail: [email protected]
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Abstract

Introduction

Disasters often overwhelm a community’s capacity to respond and recover, creating a gap between the needs of the community and the resources available to provide services. In the wake of multiple disasters affecting nursing homes in the last decade, increased focus has shifted to this vital component of the health care system. However, the long-term care sector has often fallen through the cracks in both planning and response.

Problem

Two recent reports (2006 and 2012) published by the US Department of Health and Human Services (DHHS), Office of Inspector General (OIG), elucidate the need for improvements in nursing homes’ comprehensive emergency preparedness and response. The Center for Medicare and Medicaid Services (CMS) has developed an emergency preparedness checklist as a guidance tool and proposed emergency preparedness regulations. The purpose of this study was to evaluate the progress made in nursing home preparedness by determining the level of completion of the 70 tasks noted on the checklist. The study objectives were to: (1) determine the preparedness levels of nursing homes in North and South Carolina (USA), and (2) compare these findings with the 2012 OIG’s report on nursing home preparedness to identify current gaps.

Methods

A survey developed from the checklist of items was emailed to 418 North Carolina and 193 South Carolina nursing home administrators during 2014. One hundred seventeen were returned/“bounced back” as not received. Follow-up emails and phone calls were made to encourage participation. Sixty-three completed surveys and 32 partial surveys were received. Responses were compared to data obtained in a 2010 study to determine progress.

Results

Progress had been made in many of the overall planning and sheltering-in-place tasks, such as having contact information of local emergency managers as well as specifications for availability of potable water. Yet, gaps still persisted, especially in evacuation standards, interfacing with emergency management officials, establishing back-up evacuation sites and evacuation routes, identification of resident care items, and obtaining copies of state and local emergency planning regulations.

Conclusion

Nursing homes have made progress in preparedness tasks, however, gaps persist. Compliance may prove challenging for some nursing homes, but closer integration with emergency management officials certainly is a step in the right direction. Further research that guides evacuation or shelter-in-place decision making is needed in light of persistent challenges in completing these tasks.

LaneSJ , McGradyE . Nursing Home Self-assessment of Implementation of Emergency Preparedness Standards. Prehosp Disaster Med. 2016;31(4):422–431.

Keywords

checklistdisaster planningdisaster preparednesslong-term carenursing home
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 31 , Issue 4 , August 2016 , pp. 422 - 431
Copyright
© World Association for Disaster and Emergency Medicine 2016 

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References

1. Brunkard, J, Namulanda, G, Ratard, R. Hurricane Katrina deaths, Louisiana, 2005. Disaster Med Public Health Preparedness. 2008;2(4):215-223.Google Scholar
2. Dolan, J. The Joplin Tornado: A Long Term Care Perspective. Presented at the University of Nebraska Medical College 2011 Conference. “Public Health and Medical Disaster Response in Action: The Joplin Story.” https://docs.google.com/viewerng/viewer?url=http:// webmedia.unmc.edu/bioprepare/JoplinConf/Donlan-HO.pdf. Accessed June 18, 2015.Google Scholar
3. US Office of the Inspector General. Gaps continue to exist in nursing home emergency preparedness and response during disasters: 2007-2010. http://oig.hhs.gov/oei/reports/oei-06-09-00270.asp. Published April 2012. Accessed April 2014.Google Scholar
4. Cobb, J. Flood of Lies: The St. Rita’s Nursing Home Tragedy. Gretna, Louisiana USA: Pelican Publishing; 2013.Google Scholar
5. McGrady, E, Blanke, SJ, Swanson, C. Evacuation of Caldwell Hospice–making a case for mitigating patient safety risk by using checklists during disaster response. Am J Hosp Palliat Me. 2014;31(3):260-268.Google Scholar
6. United States. The federal response to Hurricane Katrina: lessons learned. http://www.floods.org/PDF/Katrina_Lessons_Learned_0206.pdf. Published February 2006. Accessed August 27, 2014.Google Scholar
7. Laditka, SB, Laditka, JN, Xirasagar, S, Cornman, CB, Davis, CB, Richter, JV. Providing shelter to nursing home evacuees in disasters: lessons from Hurricane Katrina. Am J Public Health. 2008;98(7):1288-1293.CrossRefGoogle ScholarPubMed
8. Silverman, MA, Weston, M. Lessons learned from Hurricane Andrew: recommendations for care of the elderly in long-term care. South Med J. 1995;88(6):603-615.Google Scholar
9. Saliba, D, Buchanan, J, Kington, RS. Function and response of nursing facilities during community disaster. Health Aff (Millwood). 2004;94(8):1436-1441.Google Scholar
10. Laditka, SB, Laditka, JN, Cornman, CB, Davis, CB, Richter, JV. Resilience and challenges among staff of Gulf Coast nursing homes sheltering frail evacuees following Hurricane Katrina, 2005: implications for planning and training. Prehosp Disaster Med. 2009;24(1):54-62.Google Scholar
11. Hyer, K, Brown, LM, Christensen, JJ, Thomas, K. Weathering the storm: challenges to nurses providing care to nursing home residents during hurricanes. Appl Nurs Res. 2009;22(4):e9-e14.Google Scholar
12. Christensen, JJ, Brown, L, Hyer, K. A haven of last resort: the consequences of evacuating Florida nursing home residents to nonclinical buildings. Geriatr Nurs. 2012;33(5):375-383.Google Scholar
13. Blanchard, G, Dosa, D. A comparison of the nursing home evacuation experience between hurricanes Katrina (2005) and Gustav (2008). J Am Med Dir Assoc. 2009;10(9):639-643.Google Scholar
14. Castro, C, Persson, D, Bergstrom, N, Cron, S. Surviving the storms: emergency preparedness in Texas nursing facilities and assisted living facilities. J Gerontol Nurs. 2008;34(8):9-16.Google Scholar
15. Dosa, D, Grossman, N, Wetle, T, Mor, V. To evacuate or not to evacuate: lessons learned from Louisiana nursing home administrators following Hurricanes Katrina and Rita. J Am Med Dir Assoc. 2007;8(3):142-149.Google Scholar
16. Brown, LM, Dosa, DM, Thomas, K, et al. The effects of evacuation on nursing home residents with dementia. Am J Alzheimer’s Dis Other Demen. 2012;27(6):406-412.Google Scholar
17. Dosa, D, Hyer, K, Thomas, K, et al. To evacuate or shelter-in-place: implications of universal hurricane evacuation policies on nursing home residents. J Am Med Dir Assoc. 2012;12(2):190e1-190e7.Google Scholar
18. Castle, NG, Engberg, JB. The health consequences of relocation for nursing home residents following Hurricane Katrina. Res Aging. 2011;33(6):661-687.Google Scholar
19. Eiring, H, Blake, SC, Howard, DH. Nursing homes’ preparedness plans and capabilities. Am J Disaster Med. 2012;7(2):127-135.Google Scholar
20. Castle, NG. Nursing home evacuation plans. Am J Public Health. 2008;98(7):1235-1240.Google Scholar
21. US Office of Inspector General. Nursing home emergency preparedness and response during recent hurricanes. https://oig.hhs.gov/oei/reports/oei-06-06-00020.pdf. Published August 2006. Accessed February 2013.Google Scholar
22. Centers for Medicare and Medicaid Services. Survey & Certification: Emergency Preparedness Checklist Recommended Tool for Effective Health Care Facility Planning. https://www.cms.gov/medicare/provider-enrollment-and-certification/surveycertemergprep/downloads/sandc_epchecklist_provider.pdf. Published August 2006. Accessed May 17, 2013.Google Scholar
23. Department of Health and Human Services, Centers for Medicare and Medicaid Services. Memorandum to State Survey Agency Directors (February 28, 2014). http://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Downloads/Survey-and-Cert-Letter-14-12.pdf. Published February 28, 2014. Accessed July 27, 2014.Google Scholar
24. Gay, LR, Airasian, P. Educational Research Competencies for Analysis and Applications. 7th Edition. Upper Saddle River, New Jersey USA: Merrill Prentice Hall; 2003.Google Scholar
25. North Carolina General Assembly. G.S. 131E-101. http://www.ncga.state.nc.us/ enactedlegislation/statutes/pdf/bysection/chapter_131e/gs_131e-101.pdf. Accessed December 28, 2015.Google Scholar
26. North Carolina Disability & Elderly Emergency Management Task Force. Report of Recommendations. https://www.ncdps.gov/div/em/documents/DEEM_ Report_of_Recommendations.pdf. Published September 1, 2008. Accessed July 10, 2013.Google Scholar
27. South Carolina Department of Health and Environmental Control. http://www.scdhec.gov/Health/FHPF/HealthFacilityRegulationsLicensing/HealthcareFacilityLicensing/LicensedSCHealthcareFacilitiesLists/. Accessed August 12, 2015.Google Scholar
28. Blanke, SJ, McGrady, E. From hot ashes to a cool recovery - reducing risk by acting on business continuity and disaster recovery lessons learned. Home Health Care Manag Pract. 2012;24(2):73-80.Google Scholar
29. Code of Federal Regulations Title 42: Public Health 483.75(m) F518(1). Public Health Requirements for States and Long-Term Care Facilities: Administration. http://www.ecfr.gov/cgi-bin/text-idx?rgn=div5&node=42:5.0.1.1.2#se42.5.483_175. Published 2001. Accessed August 28, 2015.Google Scholar
30. Dosa, D, Hyer, K, Brown, L, Artenstein, AW, Polivka-West, L, Mor, V. The controversy inherent in managing frail nursing home residents during complex hurricane emergencies. J Am Med Dir Assoc. 2008;9(8):599-604.Google Scholar
31. Stallings, R. Methods of Disaster Research. Bloomington, Indiana USA: Xlibris; 2002.Google Scholar