Nursing home investigated over Hurricane Sandy preparations

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December 18, 2012

Nursing home investigated over Hurricane Sandy preparations 

Courtney L. Davenport

New York City health officials are investigating whether a nursing home in an area hard-hit by Hurricane Sandy was inadequately prepared for the storm and put its residents in danger, according to a report by the New York Times.

Promenade Rehabilitation and Health Care Center is in the Rockaway Park area of Queens, N.Y. During the hurricane, water inundated the area, knocking out power for days and leaving many buildings with ground floors flooded to the ceiling. Like most nursing homes, Promenade did not evacuate because city officials recommended that they ride out the storm. But employees, hospital officials, and shelter directors interviewed by the Times said that Promenade’s administrator and nursing director left the facility without ensuring any storm preparations were undertaken, such as stocking up on extra food and flashlights, adding more staff, ensuring that generators were high enough off the ground, and gathering medical charts in the event of an evacuation after the storm.

When water rushed through the windows and into the first floor, it short-circuited the generator, which was only slightly higher than ground level. There were no emergency lights, so a short staff of nurses and aides cared for residents in the dark and cold. After water flooded the kitchen, the facility was also short on food. A nearby nursing home made sandwiches.

When emergency personnel evacuated the nursing home more than a day later, few patients had their medical records and none were accompanied by staff to other locations. They were evacuated to shelters and nursing homes across the city—often without their families being notified—and shelters frequently did not know their health conditions or what medications they required.

Although Promenade is being highlighted as the worst offender, the families of residents in several other nursing homes in the Rockaway Park area have complained that they were unable to find their loved ones for days, sometimes weeks, after the storm. Emergency personnel evacuated about 4,000 nursing home and 1,500 adult home residents, creating chaos at shelters and other nursing homes that took in the residents. Despite regulations requiring nursing homes to notify relatives if residents are evacuated, staff often could call only from cell phones because the facilities’ phone systems were down, limiting the number of people they could call before their phone batteries died.

Trial lawyers said these problems are reminiscent of Hurricane Katrina, when 140 nursing home residents drowned in their facilities and several nursing homes were sued.

“It does surprise me that some nursing homes weren’t prepared [for Hurricane Sandy],” said Pittsburgh attorney Robert Daley, who frequently represents nursing home residents or their families. “There were some major issues with nursing homes when Hurricane Katrina occurred in 2005, and I would have hoped that nursing homes would have been more adequately prepared after that.”

Last April, the inspector general of the Department of Health and Human Services released a report finding that many of the “gaps in nursing home preparedness and response” it identified after Hurricane Katrina are still lacking six years later. Of 24 nursing homes that experienced disasters between 2007 and 2010, none had emergency plans that included all of the government-recommended tasks. Most plans lacked information about staffing requirements. Only one nursing home had a plan for how to handle resident illness or death during an evacuation, and 15 plans did not contain information regarding the patients’ specific needs, diagnoses, and drug requirements. Half of the nursing homes had no plan for staying in the facility during an emergency, and only two had plans for how to transport and protect medical records during an evacuation.

“Though the tasks in the checklist exceeded federal regulatory requirements for nursing home emergency plans, their omission could compromise resident health and safety and jeopardize effective nursing home response to disasters,” the report concluded.

David Cohen, a trial lawyer in Princeton, N.J., who often represents nursing home patients, said that he is not surprised that some of the homes weren’t prepared for Sandy because “they are not going to spend money unless and until they have to do it.” However, nursing homes should actually be better equipped to deal with emergencies than many other health care facilities, he said.

“These are organizations that deliver health care that are not run by health care providers; they’re run by administrators. They should be good at making sure the administrative tasks are met—enough food, backup generators, and ensuring people are not stranded,” said Cohen. “When you’re dealing with the weakest, most vulnerable population, you have a responsibility to be prepared, and that should be exactly what administrators at nursing homes are good at.”

Although Cohen is in an area struck by Sandy, he hasn’t received any calls from families whose loved ones were residents in ill-prepared nursing homes, and that barring physical injuries, Cohen and Daley agreed that poor preparation alone may not be strong grounds for liability.

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