Gaps Continue To Exist in Nursing Home Emergency Preparedness and Response During Disasters: 2007-2010

U.S. Federal regulations require that Medicare- and Medicaid-certified nursing homes have written emergency plans and provide employees with emergency preparedness training. In a 2006 report about nursing homes that experienced hurricanes, emergency plans lacked many provisions recommended by experts. In response, guidance checklists were issued for emergency planning of health care facilities, long-term care (LTC) ombudsman programs, and State survey agencies (SA). This study was conducted to assess emergency preparedness and response of nursing homes that experienced more recent disasters.

Most nursing homes nationwide met Federal requirements for written emergency plans and preparedness training. However,  many of the same gaps in nursing home preparedness and response were identified that were found in 2006. Emergency plans lacked relevant information – including only about half of the tasks on the CMS checklist. Nursing homes faced challenges with unreliable transportation contracts, lack of collaboration with local emergency management, and residents who developed health problems. LTC ombudsmen were often unable to support nursing home residents during disasters; most had no contact with residents until after the disasters. SAs reported making some efforts to assist nursing homes during disasters, mostly related to nursing home compliance issues and ad hoc needs.

Three recommendations were made to CMS and one recommendation to AoA. CMS agreed with the recommendations to revise Federal regulations to include specific requirements for emergency plans and training, update the State Operations Manual to provide detailed guidance for SAs on nursing home compliance with emergency plans and training, and promote use of the checklists. AoA agreed with our recommendation to develop model policies and procedures for LTC ombudsmen to protect residents during and after disasters. Finally, in a memorandum report (OEI-06-09-00271), guidance was outlined that CMS can consider when revising the checklist for health care facilities.

See Gaps Continue To Exist in Nursing Home Emergency Preparedness and Response During Disasters: 2007-2010 from the U.S. Department of Health & Human Services, Office of the Inspector General.


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