Hundreds of deaths of Florida nursing home residents due to Hurricane Irma were not accounted for — by more than 400 when compared to what was reported by the Centers for Disease Control and Prevention — according to new research published Tuesday in JAMA.

Researchers argue that the findings expose cracks in the elder care system, especially during disaster situations.

There were an additional 139 resident deaths linked to Hurricane Irma 30 days after the storm, a study led by Brown University researchers found. In addition, there were an additional 433 storm-related deaths when the timeframe was extended to 90 days after the hurricane. 

The CDC reported there were 123 total resident deaths statewide of residents during the storm, according to the analysis. Hurricane Irma hit in September 2017. 

“We tend to underestimate nursing home deaths for a variety of different reasons, because these are frail, older adults who are likely to die with heart failure, COPD and dementia among other causes of death,” study author David M. Dosa, MD, MPH, said.

“When they die, we attribute their deaths to natural causes rather than taking into account the near-term impact of the disaster,” he added. 

Investigators added the same faults have been on display during the coronavirus pandemic as nursing homes have struggled to get reliable access to personal protective equipment during early stages of the crisis. 

“One would hope that this sort of research allows us to focus on populations at risk during disaster situations,” Dosa said.

“We need to prioritize nursing homes,” he added. “I hope that this work adds to the idea that nursing homes need to be front and center in disaster management.”