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Another lesson from this hurricane season: Better plans are needed to ensure the safety of elderly nursing home residents during a disaster and evacuation.

At least two-thirds of the documented deaths in one Texas coastal county amid Hurricane Rita’s carnage involved elderly residents of nursing homes. These deaths do not even include the much-publicized bus fire deaths.

“Rita underscored that we have some holes in hurricane preparedness,” said Diane Persson, an expert on aging at the University of Texas Health Science Center at Houston. “It showed, for instance, it isn’t realistic to put a lot of frail seniors on buses and haul them around.”

In an effort to improve preparedness and safety for nursing home residents, several experts on aging and a consortium of providers are preparing a report for county, state and national officials.

While the U.S. Department of Health and Human Services requires nursing homes to have disaster plans that include education of employees, unannounced drills and evacuation plans, no medical component has been established to determine whether certain residents might be better off staying because they night not survive if moved.