​Emergency preparedness in senior care facilities often focuses on what’s inside the walls: evacuation procedures, emergency food and water, medical protocols, staff readiness, and more. However, there’s a critical vulnerability that often goes overlooked—the local infrastructure these plans depend on.

Local infrastructure risks may include aging water systems, deteriorating roads, crumbling bridges, and outdated drainage networks, which could undermine even the most carefully developed emergency plans. When the water stops flowing or the evacuation route becomes impassable, your facility may find itself isolated and unsupported.

Recent hurricanes, fires, and floods have shown something important: even a well run facility can be disrupted by problems far outside their control.

The Infrastructure Problem: A National Weakness

The American Society of Civil Engineers (ASCE) recently gave U.S. infrastructure a C- grade on its national report card. Among the most concerning findings:

• 43% of U.S. public roadways are in poor or mediocre condition.
• Over 46,000 bridges are considered structurally deficient.
• The average U.S. drinking water treatment plant is 50 years old—many are operating beyond their intended lifespan.
• The U.S. currently has a $125 billion shortfall in stormwater infrastructure upgrades.

These breakdowns have immediate consequences during disasters. Flooded roads delay emergency responders. “Do not drink” alerts leave facilities without safe water. Sewer backups can cause costly property damage and increase the risk of illness.

Threat #1: Water System Failures

Water is often the most overlooked necessity—until it’s unavailable. Cities like Jackson, Mississippi, and Houston, Texas, have issued boil advisories, experienced water pressure loss, or even had complete shutoffs during major storms and infrastructure failures.

For senior care facilities, this means every aspect of care, such as hydration, hygiene, food prep and medication, may be impacted. 

Best practices:

• Store at least three days of potable water on-site—1 gallon per person, per day (residents and staff).
• Keep documentation of how much water is stored and the expiration dates to meet compliance requirements.
• Understand shelf life: bottled water typically lasts 12–18 months; canned water lasts up to 10 years; large tank storage should be treated and cycled every 6 months.
• Reevaluate your water needs annually, especially if census or staffing levels change.

Threat #2: Impassable Evacuation Routes

During Hurricane Ian in 2022, dozens of Florida senior care communities experienced evacuation delays—not due to internal disorganization, but because of washed-out roads and closed bridges.

If your evacuation plan relies on a single bridge, low-lying roadway, or local highway, that route could become a choke point during a major weather event.

Best practices:

• Contact local emergency managers to map alternate evacuation routes.
• Conduct mock evacuations using multiple evacuation routes.
• Prepare to shelter-in-place (enough food, water, medical, and power continuity) in case an evacuation is impossible.
• Use real-time traffic apps to verify road conditions during severe weather events.

Threat #3: Overloaded Drainage and Flooding

It doesn’t take a hurricane to flood a facility. Drainage systems that were built decades ago are often under-equipped for today’s rainfall levels and urban density. Routine storms can now overwhelm sewers and storm drains, causing significant damage to senior care communities.

Flooded basements, elevator shafts, and electrical rooms can create life-threatening hazards—and result in lengthy closures.

Best practices:

• Know your facility’s proximity to flood-prone areas or outdated storm drains.
• Elevate critical systems off the floor (generators, electrical panels, supply storage).
• Use waterproof containers for essential emergency gear.
• Have absorbent barriers or sandbags ready in known leak-prone areas.

Focus on What You Can Control

Senior care operators can’t fix bridges or modernize sewer systems, but they can strengthen internal resilience. Facilities that build self-sufficiency—especially for 72+ hours—are better equipped to maintain care continuity when outside systems fail.

Key investments include:

• Evacuation kits stocked with essentials: water, masks, name tags, hygiene items.
• Backup lighting, flashlights, battery-powered medical devices, and mobile charging banks.
• Shelf-stable food bars or MREs that don’t require water, heat, or preparation.
• Portable hygiene supplies: wet wipes, sanitizers, disposable bed pads, etc.

These strategies protect resident health and dignity, support compliance with CMS and state emergency preparedness requirements, and reduce the stress on frontline staff during emergencies.

External Infrastructure Audits

Emergency preparedness should extend beyond your property line. Adding an external infrastructure audit to your facility’s planning cycle can help to expose hidden vulnerabilities.

Consider: 

• Are the roads in and out of the facility in good condition year-round?
• Has the city updated its flood zone or stormwater maps?
• How frequent are boil water advisories in your area?
• If power, water, or access failed, how long could you sustain operations?
• How many alternative evacuation routes do you have if the main route is not passable? 

Emergency Planning Doesn’t Stop at the Property Line

Infrastructure failure can have a meaningful impact on senior care facilities. These failures can escalate quickly, especially for vulnerable residents with mobility or medical needs.

By planning beyond your walls and by preparing for infrastructure failures, operators can better protect residents, reduce operational risk, and build a reputation for true emergency readiness.

Byron Walker is the founder and CEO of Peak 10 Emergency, a Colorado-based company specializing in emergency preparedness solutions tailored to the senior care industry. He can be reached at byron.walker@peak10emergency.com.

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