Florida’s Efforts to Protect Nursing Home Residents From Hurricane Ian May Have Worked

As the storm moved east, dumping water in unexpected parts of central Florida and the east coast, some additional long-term care facilities were also forced to evacuate. In Orlando, Orange County Fire Rescue evacuated some 300 residents from three long-term care facilities through rising floodwaters, ferrying residents to paratransit buses and ambulances with stretchers and wheelchairs.

Most displaced nursing home residents were transferred to sister facilities or other nursing homes with spare beds outside the storm’s path. Ahead of the storm, Florida’s Agency for Health Care Administration, which regulates nursing homes and assisted living facilities, activated a statewide reporting network that requires all health care providers to report available beds, evacuation status and other essential information daily. A partnership between the state government, hospitals and long-term care organizations used the data to place residents in suitable facilities.

“It’s all hands on deck,” said Agency for Health Care Administration Secretary Simone Marstiller in a recent briefing with long-term care organizations. “We need to continue to work as well together as we have been up to now.”

Most of the nursing homes that evacuated have returned to their buildings, after getting approval from their county emergency management offices. Around 10 nursing homes across the areas of Port Charlotte, Cape Coral, Winter Park, Daytona Beach and Englewood were out of service as of Oct. 10 due to storm damage or flooding in the area, according to the Florida Health Care Association. Those residents are in other health care facilities.

New generator rule

Around 80 nursing homes lost power due to the storm, the Florida Health Care Association says. But Florida law requires all nursing homes and assisted living facilities to have a backup power supply to keep temperatures at or below 81 degrees Fahrenheit for at least 96 hours in such situations. The law passed after Hurricane Irma knocked out power in Florida in 2017 and a dozen residents in a Hollywood Hills nursing home that lost air-conditioning died from exposure to extreme heat.

Florida’s Agency for Health Care Administration reported that 100 percent of facilities across the state self-reported compliance ahead of Ian — and the agency visited more than 300 facilities across the state to verify compliance. The generator law, which AARP fought for, “may have really helped us in this case,” says AARP’s Johnson. All of the roughly 80 long-term care facilities that lost power after Ian reported activating their generators.

Power had been restored to the majority of nursing homes that lost it by Oct. 4, six days after the storm’s landfall on Florida, according to the Florida Health Care Association. Spokesperson Kristen Knapp wrote in an email that Florida Power & Light, Duke Energy and other utilities “have done amazing to help prioritize our care centers for power.”

Nursing homes should be closely monitored in days ahead, says AARP’s Johnson. “Remember: The Irma disaster in Hollywood was days [after the storm],” he says. Power has generally been restored much quicker this time around, he notes, but “problems could still pop up.”

Florida’s Long-Term Care Ombudsman Program, which advocates for long-term care residents, had received six storm-related inquiries from assisted living residents by early this week, including reports of lack of staff and mold and water damage. “Historically, we see increases in complaints over time as residents return to evacuated facilities,” spokesperson Audra Peoples wrote in an email.

The stress or deterioration that a person can experience when changing living environments — known as transfer trauma and often affecting those with dementia — will likely be an issue that comes to light later on, says Johnson, particularly given the volume of evacuations performed.

Staffing shortages, a long-standing issue in U.S. nursing homes, may also worsen as workers are forced to deal with their own losses from the storm. But the state reports that it’s moved 400 additional nurses into southwest Florida. An Emergency Order allowing health care facilities to deploy out-of-state health care workers to the same roles in Florida during the emergency has also been activated.

For now, those who advocate for nursing home residents are optimistic. “The nursing home system seems to have found ways to be better prepared for storms like this,” Johnson says. “And it makes me wonder: How do we bring that attention and planning to those who are aging in place at home so we can ensure they are safe too? There’s an opportunity for us as a state to really lean into that.”

If you’re concerned about any long-term care residents impacted by Hurricane Ian, contact Florida’s Long-Term Care Ombudsman Program at 1-888-831-0404 or ltcopinformer@elderaffairs.org.