State working on disaster planning for nursing homes

Frederick’s Citizens Care and Rehabilitation Center working on several ideas

Thursday, Feb. 9, 2006

Citizens Care and Rehabilitation Center in Frederick, is working to improve its emergency evacuation and response plans for the safety of its 140 residents.

‘‘We’re doing our own internal checklist to see how we can handle a natural or man-made disaster,” said Administrator Nicole Bohrer-Banzhoff.

One of the lessons learned in the aftermath of Hurricane Katrina was about nursing homes. Many New Orleans facilities struggled to evacuate residents, many whom suffered from serious medical conditions.

Maryland is just one state taking lessons from the tragedy and putting new regulations in place.

The state’s Office of Health Care Quality is working to better prepare nursing homes and assisted living and adult day care facilities throughout the state for natural disasters, terrorist attacks and flu outbreaks.

‘‘Our biggest concern is to revise our regulations,” said Wendy Kronmiller, acting director of the Office of Health Care Quality. ‘‘When the regulations were established 15 years ago the worst thing we could think about is a fire. Sadly, times have changed.”

In November, Kronmiller and her office met with several Maryland long-term care associations to better prepare nursing homes for the worst possible disasters. Included in the discussions were agencies such as the Maryland Emergency Management Agency and the Office of Homeland Security.

‘‘What we’ve done is we’ve tried to see where nursing homes, assisted living facilities and day cares sit with other emergency preparedness agencies,” Kronmiller said. ‘‘We did see with nursing homes that they need to enhance their planning and try to accumulate the best practices... We’ll be working with them to ensure nursing homes have a plan on the table. But if they are not integrated with other agencies it’s just a paper plan.”

To better move the process along, the Office of Health Care Quality recently sent out an emergency preparedness checklist to nursing homes, group homes and assisted living facilities throughout the state. The checklist was prepared by the Montgomery County Advanced Practice Center for Public Health Emergency Preparedness and Response and is designed to ensure that health care facilities can safely handle a disaster.

The checklist includes questions such as whether the facility maintains a five-day food and water supply, and whether emergency generators are on hand.

In preparing a nursing home for a major emergency many conditions must be taken into consideration, Bohrer-Banzhoff said.

Residents who are frail, suffer from conditions such as dementia or are dependent on large pieces of medical equipment make evacuations during a disaster much more difficult and complicated.

‘‘It’s very disruptive to individuals in this environment,” she said. ‘‘An evacuation is very significant. You’re uprooting them and it’s something we have to prepare for.”

Emergency preparedness plans are taking shape at Citizens.

Special chains with tags indicating a resident’s medication is under consideration. In the event of an evacuation, the chain would be placed around the neck of the resident.

The county-owned nursing home is also partnering with other Frederick County government agencies for help during an emergency. They have agreements with other nursing homes in the county if residents need to be transferred to their facilities in an evacuation.

A forum with family members will also take place regarding what they can do during an emergency, Bohrer-Banzhoff said.

The 200-plus employees at the home will also be briefed.

But most important, said Bohrer-Banzhoff, is the need for community volunteers, for example in the event of a major snowstorm or hurricane when an evacuation is needed.

‘‘In an emergency things can deteriorate rapidly,” Bohrer-Banzhoff said. ‘‘We truly need to make sure the community is aware if there is a disaster.”