Are Nursing Homes Prepared for Hurricane Season?

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Who could forget the chilling images of nursing homes flooded, residents sitting in waist-deep water after Hurricane Harvey in 2017?  A few weeks later, 12 patients died without air conditioning in a South Florida nursing home when Hurricane Irma knocked out power for several days.

The horrific images from the last few hurricane seasons indicate surviving the storm is only the first hurdle nursing home residents face.  To protect vulnerable residents, nursing homes in hurricane-prone areas must be prepared for the aftermath of flood waters, extreme heat, and blocked supply routes.  The sad truth is that the majority of nursing homes are not prepared.  Even worse, many have ignored new laws mandating emergency preparedness.

Florida Tragedy Highlights Lack of Nursing Home Preparedness

The events that took place in the Rehabilitation Center at Hollywood Hills Florida in September 2017 defy logic.  To weather a severe storm like Hurricane Irma, law enforcement most often advises citizens to shelter in place.  Truly, for nursing home residents, this is often the safest scenario.

By sheltering in place, the residents in fragile health will have continued access to their medical devices, medications, and familiar surroundings.  Sheltering in place is a wise idea in most circumstances, but it is a deadly scenario in sweltering September temperatures in Florida in a facility that did not have a back-up generator.

That is exactly what took place at Rehabilitation Center and resulted in the tragic and needless deaths of 12 seniors.  The hurricane knocked out power on September 10, 2017.  The employees managing residents through the storm were reportedly unwilling to call 911.  It seems they were also unwilling to transport the residents to a hospital within walking distance – a hospital with a back-up generator and air conditioning.

Rather, the nursing home workers allowed three sweltering days to pass before calling, not 911, but the nursing home director at home.  In the meantime, more than a dozen patients were in distress from the extreme heat in an non-ventilated 2nd floor room.  Twelve patients died in these conditions.  Some of them had body temperatures of 107-109 degrees when they died.

Unable to plumb the apathy or malice that would enable these horrible deaths when a single 911 call may have prevented the tragedy, the Florida state legislature passed a back-up generator law.

The Generator Law

The generator law requires nursing homes to have a backup source of power capable of keeping patient areas at 81-degrees or cooler for 96 consecutive hours after a power outage.  The law seems simple and straightforward.  In a climate like Florida’s, keeping fragile nursing home residents cool in the heat of hurricane season seems like a no-brainer.  This is the case in most coastal areas where hurricanes are most common.

Sadly, the deadline for complying with the law has come and gone, and an unbelievable 65 percent of nursing homes have failed to install a source of back up source of power.  That means more than 400 nursing homes in Florida are headed into hurricane season with no way prevent heat-related deaths in a power outage.  Of these, some have submitted paperwork seeking exemption from the generator law and some have ignored the law altogether.

This is a sad example of an industry failing to comply with legal guidelines designed to protect residents and prevent injury or death.  It is likely that other states passing similar laws or guidelines are also facing difficulty with compliance and enforcement. 

Saving Money Should Not Cost Lives

The complaint of most nursing home administrations about the generator law is the cost of installing the back-up power systems.  Admittedly, the systems will cost each facility about $50,000 to install.  Contrast that cost to the annual sales of Avante, a group of for-profit nursing homes who have ignored the generator law.  Avante has yearly gross receipts estimated to top $101 million.  The group’s assets are worth about $39 million.  A $50,000 investment is not a significant expense to a company that size.  Even if it was, isn’t a single human life worth more than that? 

The deadline for complying with the generator law was June 1, 2018, and lawmakers and regulatory agencies have yet to get stern with nursing homes who fail to take disaster preparedness seriously.  Perhaps if faced with severe consequences, nursing homes would make backup power a priority. 

Off-grid Emergency Preparedness in Nursing Homes

Being truly prepared for a natural disaster like a hurricane means being able to:

  • Survive the initial disaster safely
  • Cope with the challenges the aftermath will present

Disasters like Hurricanes Katrina, Sandy, Harvey, and Irma have repeatedly revealed that nursing homes in the Gulf area are woefully unprepared to provide for the substantive needs of residents in the aftermath of a disaster.  While it is true that most facilities cannot store enough supplies and other commodities for a prolonged disaster situation, it is also true that every single facility can plan for how to overcome those difficulties when the need arises. 

That is the crux of the generator law – it is the State of Florida’s plan to help nursing homes cope with power outages after a disaster.  Other state governments have offered similar support for their nursing homes.

Back-up power sources work by automatically kicking on when traditional power sources go out.  These machines rely on underground stores of propane or natural gas to make the power needed to cool the air, pump water, or keep medical devices running.  It’s not a complete disaster solution, but it is a plan. 

Disaster Preparedness Tips

Apart from power outages, nursing homes face unique challenges because of the vulnerable state of health of their residents.  Other aspects of responsible disaster preparedness should include:

  • Shelter in place drills – Especially for residents with cognitive difficulties like dementia or Alzheimer’s, it is important that residents are familiar with shelter-in-place procedures.  It is also important that staff members know how to help these residents through difficult situations.
  • Communication – Whether in an urban or rural setting, nursing homes are fairly likely to need assistance in the aftermath of a storm and should have several means of communication prepared.
  • Anticipating the unexpected – The unpredictable nature of catastrophic storms is a particular challenge for any healthcare setting where routine and sanitation are matters of life and death.  Nursing homes should prepare for the difficulties they know to anticipate, like the extreme Florida heat, but must also train their staff to adapt and minimize the damage when the expected inevitably happens.

Thinking back on the tragedy at Rehabilitation Center raises several questions.  Were the staff members simply untrained and unprepared for the disaster?  What prevented the staff there from seeking help from the hospital literally across the street? 

Concerned about Hurricane Season and Your Loved One’s Safety? Talk to a Nursing Home Abuse Lawyer

Though these events took place in Florida, the Centers for Medicaid and Medicare Services (CMS) have concerns about the ability of all elder-care facilities in the Gulf region to keep nursing home residents safe during hurricane season. 

Surviving a storm is one thing, but injuries or deaths that result from poor preparation for emergencies should never happen.  Nursing homes have a responsibility to provide a safe living environment for their residents, and that includes keeping them safe during extreme weather events.  

Hurricanes are not rare.  Power outages after storms are also common.  Nursing homes must be aware of, and prepared to overcome, these challenges.  If someone you love has experienced injury in a nursing home that was ill-equipped for disaster, Nursing Home Abuse Center can help.  Contact us by calling 1-800-516-4783 or contact us online.


meagan cline

Written By Meagan Cline

Meagan Cline is a professional legal researcher and writer. She lends her expertise to FNHA and our websites, including Birth Injury Guide and