Two new studies on wildfire and hurricane-related flooding threats to nursing homes demonstrate a need to bolster emergency preparedness in a sector where many leaders may be unaware of evolving weather-related risks.

The latest study from the Yale School of Medicine found approximately 10% of the nearly 6,000 nursing homes along the Atlantic and Gulf coasts involved in the study were at risk of inundation, while approximately 30% exhibited emergency preparedness deficiencies. 

 “In our analysis, we found that nursing homes in the western Gulf Coast seem to be responsive to local environmental risks,” said Natalia Festa, MD, research fellow with the National Clinician Scholars Program and Yale Program on Aging, who led the research, in a press release announcing the study.

The study, which found that 1 in 10 nursing homes are at risk for “severe” hurricane-related flooding, analyzed emergency preparedness deficiencies based on inspections from Jan. 1, 2017, to Dec. 31, 2019. They defined exposure as facilities at risk of receiving at least 2 feet of flooding during a hurricane.

The study is part of a broader series of projects focused on environmental gerontology and the relationship between nursing home emergency preparedness and surrounding environmental risks. It is supported by the Yale Pepper Older Americans Independence Center and Yale National Clinician Scholars Program. 

“We’re trying to understand how nursing homes are responding to various climate threats through using fully open data,” said Kaitlin Throgmorton, data librarian for the health sciences at Cushing/Whitney Medical Library and collaborator on the study. 

The “paucity of information” available regarding facility preparedness could be due to the difficulty in determining environmental exposure, which can vary from community to community. CMS has “advised an all-hazards approach,” the researchers noted. 

“This requires that facility administrators and staff assess, document, and plan for potential hazards, including severe weather events, that are expected to impact their geographical region,” study authors noted, adding that CMS encourages partnerships with local and regional municipalities and emergency service agencies to ensure nursing homes are part of planned responses. 

The hurricane study was published last week in JAMA Network Open.

Burning questions

In late December, Festa also published a separate paper in the Journal of the American Geriatrics Society examining how well facilities in areas at high-risk for wildfires were prepared for them.

She found that a higher share of “exposed” facilities had at least one emergency preparedness deficiency compared to those in less-prone areas.

“These findings suggest that nursing home management and staff may be unaware of important environmental risks to which their facilities are exposed,” she and Yale colleagues reported. “Improved integration of nursing homes into community disaster planning may better align facility preparedness with surrounding wildfire risk.”

While that study looked exclusively at California, climate change is rapidly making more of the US and its healthcare facilities vulnerable to wildfire threats. A 2022 Washington Post analysis found 80 million properties in the United States stand a significant chance of exposure to fire, with about 16% of the population living in potential fire zones. But over the next three decades, the newspaper’s research projected that would increase to 21% and that much of the South would be at high risk for a fire event.

The World Health Organization has said climate-informed preparedness plans and emergency systems are essential for building climate resilience. WHO officials promote strategies that better intertwine community and health system emergency planning, noting that emergency responses are often “delayed, resource intensive, and not effective in building long-term resilience.”