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 Providers Take Action as Hurricane Dorian Pushes up Eastern Seaboard

Long term and post-acute care facilities along the eastern seaboard are instituting emergency preparedness plans as Hurricane Dorian charts its path north after having spared Florida from the devastation that left many parts of the Bahamas in ruins.
 
As of Sept. 5, Dorian is a Category 3 hurricane and has started to bring high winds and ocean swell to stretches of seaboard from Georgia to the Carolinas, with the outer band of the storm starting to be felt in Virginia’s coastal areas, according to media reports. 
 
Leaders of the skilled nursing and assisted living sectors in the states being impacted by Dorian say precautions are in place as facilities prepare for the worst, and hope for the best. 
 
Adam Sholar, president and chief executive officer of the North Carolina Health Care Facilities Association (NCHCFA), an affiliate of the American Health Care Association, tells Provider the focus is clearly on Dorian.
 
"The NCHCFA and its members take emergency preparedness seriously,” he says. “In the past year, NCHCFA has conducted numerous training sessions on this topic, including an after-action review last fall following Hurricane Florence. These events have been well-attended and seek to build on the outstanding work countless North Carolina nursing home operators and staff members performed during recent hurricanes.”
 
Sholar says the NCHCFA supplements the work of North Carolina nursing facilities and emergency management officials as needed by facilitating the flow of information, but communications about evacuations and transfers occur directly between nursing centers and state and local officials.
 
“We are, however, aware that some nursing home residents near the coast have been temporarily relocated,” he says.
 
Further, Sholar stresses that it is important to remember that nursing facilities have emergency plans for events such as Hurricane Dorian. Those emergency plans are based on and include a documented, facility-based and community-based risk assessment, utilizing an all-hazards approach, he adds.  
 
“Strategies for addressing emergency events identified by the risk assessment, resident population, the type of services the nursing home has the ability to provide in an emergency, and continuity of operations are included in the plan,” Sholar says.
 
Nursing centers also have processes for cooperation and collaboration with emergency management officials and plans for backup power.
 
“Nursing homes make decisions regarding whether to evacuate or to shelter-in-place in accordance with their emergency plans and decisions by local emergency management officials,” he says. “Evacuating a nursing home is a serious undertaking and not without risk given the care needs of the residents, many of whom are wheelchair or stretcher dependent for transportation.”
 
This, any decision to evacuate is facts-and-circumstances based, depending on the needs of the residents and conditions at the nursing facility, Sholar says. “Individual nursing homes are in the best position to make this determination in accordance with their emergency plans and decisions from local emergency management officials,” he says.
 
In Georgia, Devon Barill, director of communications for the Georgia Health Care Association (GHCA) and Georgia Center for Assisted Living, says, “Our members’ highest priority is the safety and wellbeing of their residents.”
 
She notes that once they became aware of the impending nature of Dorian, centers on or near the coast activated their emergency plans and began preparing by reviewing disaster supplies and augmenting as needed, ensuring emergency vehicles and equipment were fueled, reviewing vendor contracts, and contacting sisters facilities in the event an evacuation became necessary.
 
“Once Gov. Brian Kemp ordered a mandatory evacuation for six coastal Georgia counties, members in those areas began evacuation processes while maintaining ongoing contact with their local Healthcare Coalitions and Emergency Management Agencies regarding their status,” Barill says. 
 
Centers that were not located in the six counties included in Kemp’s order kept the state informed of their bed availability to assist with emergency placement of evacuating residents.
 
“As always, GHCA is dedicated to assisting our members in their efforts to ensure the safety and happiness of their residents,” he says. “We have continuously monitored the storm and sent daily updates to members with important information to help them ensure preparedness.”
 
The organization has also been in direct contact with its evacuating member centers and GHCA Emergency Preparedness Coordinator Hannah Byers is present at the Emergency Support Function 8 Transportation Desk at the Georgia State Operations Center to provide timely assistance and coordination.
 
Much the same preparation is happening in Virginia, says Amy Hewett, a spokesperson for the Virginia Health Care Association. She says the state has a web-based system that hospitals, nursing facilities, and assisted living communities use to share emergency management information and can communicate that to emergency officials. 
 
“It’s called the Virginia Healthcare Alerting and Status System. Virginia also has a LTC Mutual Aid Plan, which provides a method to coordinate and manage requests for assistance when one or more LTC facilities are faced with an incident that exceeds their ability to manage the event independently,” Hewett says.
 
The precautions for Dorian have come and gone for one state previously in the storm’s path as Florida providers along the coast get back to normal operations, says Kristen Knapp, director of communications, Florida Health Care Association.
 
“So, basically we are out of woods,” she told Provider on Sept. 4, noting that member facilities in affected areas had activated emergency preparedness plans well ahead of any possible trouble from Dorian.
 
“We activated emergency operations last Friday, since it was so hard to tell what would happen [path of the storm],” Knapp says. Some 19 skilled nursing facilities and 87 assisted living facilities were evacuated before mid-week this week primarily along the coast and in areas prone to flooding.
 
Since Dorian did not hit Florida as was feared, those facilities that evacuated were in the process or, or already, returning residents to their homes, she says.
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