News Analysis: Disasters teach again -- prep even more

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'Plan B' may be the most important tool in planning for catastrophes. If history serves as any guide, there will be many lessons learned about emergency planning in the wake of hurricane season in the Gulf Coast region.

History also promises there will be many more lessons that should have been learned but won't be until after the next disaster strikes.
Chris Johnson is a provider who is not taking any chances. The director of operations for 20 Community Eldercare Services facilities in Tennessee, Louisiana and Mississippi, Johnson figures his residents and facilities -- including three on the Mississippi Gulf Coast -- came through the deadly Hurricane Katrina storm in relatively good shape.
But he wants to do even better next time. That's "better" with a capital "B" because Plan B is what he thinks he and others, including public officials, need to concentrate on more.
It's a concept heralded by emergency preparedness experts around the country. They are quick to point out that  the overwhelming majority of nursing  home providers took care of their facilities and residents valiantly during hurricanes Katrina and Rita.
But there's always another disaster around the corner someplace, ready to unload danger and grief on those in its way, particularly the  unprepared.

No evacuation ordered
There was no mandatory evacuation order of Johnson's Mississippi coastline facilities in Biloxi, Pascagoula and Ocean Springs, so residents and staff hunkered down where they were for the most part. It might have been a stroke of luck they did, even though facilities nearer the beach were destroyed.
"My potential site to be evacuated to (175 miles away in Jackson, MS) would have been without power and did not have a generator," Johnson said. He added that the worst damage among his facilities  occurred 90 miles inland. Part of a roof peeled off.
Still, next time, Johnson says he would evacuate. He's already refined plans with better contingencies.
"We'll have comfortable places to go -- mattresses on floors in gymnasiums are not the best place for people in skilled nursing facilities -- and the transportation has been arranged better," he explained.
He reconfirmed with private transportation companies that enough ambulances and wheelchair vans would be used to transport the many fragile, elderly frames under his umbrella. He also hooked up with an emergency generator company from North Carolina that will deliver its goods wherever needed, including "Plan B" facilities, such as gyms, that may not have air-conditioning.
Transportation was one of the most analyzed aspects of nursing-home evacuation preparedness in the wake of hurricanes Katrina and Rita. Even when they were comfortable enough or weren't inadvertently double-booked, buses sometimes were commandeered right out of nursing facilities' hands.
Many well-thought plans were undermined, the head of the nation's largest nursing home chain told the Senate Special Committee on Aging in October.

Most at risk
Nearly two months after Katrina, many residents and long-term care workers were still a long way from returning to anything that resembles their previous lives and surroundings.
The elderly clearly were the hardest hit population. A study of the dead in Katrina's wake showed that the majority were seniors, whether they lived in  nursing homes, hospitals or personal residences.
With Hurricane Rita, at least two-thirds of the documented deaths in one Texas coastal county involved elderly residents of nursing homes – and those do not include highly publicized burning-bus victims.
That explosive incident occurred when a facility was by all appeaancesdoing the right thing – trying to clear its residents from the potential path of Hurricane Rita. Coming less than a month after 34 abandoned nursing-home residents were found drowned in a Louisiana nursing home after Katrina, no one could have criticized the move to evacuate. And then the bus caught fire, oxygen tanks exploded and 24 residents burned to death.
Providers found themselves in a familiar position of second-guessing the move of often fragile individuals, though this time for a totally unexpected reason.

Next time
One thing Johnson and other