Nursing home administrators can rise to 'unrealistic expectations' with disaster management, expert says in aftermath of Oklahoma tornado

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One day after a powerful tornado destroyed a hospital and devastated an Oklahoma town, long-term care stakeholders gathered at a disaster preparedness conference organized by the Center for Preparedness Education, a joint endeavor of the Creighton University School of Medicine and the University of Nebraska Medical Center.

“The majority of long-term care facilities have planned for the hazards in their areas to include tornadoes,” said Sharon Medcalf, R.N., M.Ed., associate director of the Center for Preparedness Education (CPE).  She was referring to a participant poll at Tuesday's Long-Term and Residential Care Disaster Preparedness Conference in Omaha, NE. “The overwhelming attendance at today's conference is testimony to the increased activity in disaster planning for our nation's vulnerable seniors.”

The Oklahoma tornado is only the most recent event to underscore the importance of disaster planning for long-term care facilities. Last month's fertilizer plant explosion in West, TX, damaged a nearby nursing home; one resident died shortly after the blast. Last October, Hurricane Sandy caused nursing home evacuations along the East Coast. A speaker at the Omaha conference said at least two facilities still are not open and may not reopen due to damage from that storm, said CPE Assistant Director Keith F. Hansen.

“We would never expect an R.N. to walk into a job and nurse without any practice, but we do expect administrators and shift supervisors to be disaster managers with no training and one two-hour drill a year,” Hansen told McKnight's.

Although long-term care leaders face such “unrealistic expectations,” they can become good at this aspect of their jobs by focusing on the three components of planning, training and exercising, Hansen said.

First, get out the disaster plan that has been put together per Centers for Medicare & Medicaid Services or Joint Commission regulations, Hansen advised. Review the plan, train the staff on it and practice it multiple times, going back to revise the plan with changes as necessary. Then, practice the new plan.

“What you'll find is, the plan says we're all going out ‘this door,'” Hansen said. “But what if you can't? What's plan B? The three components have to be repeated over and over and over.”

Long-term care facilities must not only have a plan for when a disaster strikes, but also for the recovery period afterward, which according to Hansen, can take as long as three years. There are two main areas to focus on here: business continuity and behavioral health. The business continuity plan will address the basic operational issues that will allow a provider to keep customers, rebuild a customer base and stay in business. The behavioral health issue is a matter of resident care.

“There's lots of psychological trauma that occurs in a disaster, especially if your facility has people with mental health or behavioral health issues,” Hansen noted. “Disrupting that schedule can be very hard on people, so mental health is very important.”

The preparedness conference wraps up today.