Tornado shelters should be installed in nursing homes, government agency recommends in report on Joplin disaster

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A tornado totally destroyed the Greenbriar Nursing Home
A tornado totally destroyed the Greenbriar Nursing Home

The deadly tornado that destroyed a Missouri nursing home three years ago showed that long-term care facilities need to have specially designed shelter areas, says a recently released government report.

The Greenbriar Nursing Home was directly in the path of the tornado that tore through the town of Joplin, MO, on May 22, 2011. Of 95 occupants, 19 died. The nursing home was the structure with the highest number of fatalities in the tornado, which claimed a total of 161 people in Joplin, according to the new report from the National Institute of Standards and Technology.

The one-story, wood-frame Greenbriar structure — built in the mid-1960s — was totally leveled, the report states. Workers and residents followed protocol by sheltering in inner hallways to avoid flying glass, the NIST found. However, the attempt to remain safe was futile.

“The damage survey indicated that there were no areas in the interior of the facility that were structurally hardened and therefore more suitable than other areas for use as designated safe or refuge areas,” the report states.

Specifications for tornado shelters for existing buildings should be developed, and these shelters should be installed both in new and existing nursing homes and similar buildings in tornado hazard zones, the NIST recommends.

As an interim measure, nursing home operators and other building owners should locate the best available tornado shelter areas in their structures, the report urges. The NIST says standards should be developed to help people identify these areas. While there apparently were not any “hardened” areas in Greenbriar, other structures did have features that stood up to the tornado. For example, investigators found that walls with “fixed-end” construction for bracing against “accidental truck impacts” remained intact, suggesting they would have provided good protection.

The NIST, part of the Commerce Department, does not set regulations but provides recommendations regarding infrastructure. It released the draft of its final report on the Joplin tornado on March 28.

In response to the Joplin tornado and other disasters, the Centers for Medicare & Medicaid Services has proposed comprehensive emergency preparedness requirements for healthcare facilities. Some provider associations have pushed back, saying that compliance could be too costly for facilities that would have to make substantial physical plant updates.

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