- Associated Press - Thursday, February 7, 2013

NEW YORK (AP) - In Superstorm Sandy’s wake, health experts and regulators are warning that thousands of nursing homes nationwide are still ill-prepared for a natural disaster.

The late October storm was the latest in a string of disasters to reveal gaps in emergency planning, despite an industry-wide effort to improve preparedness in the years since Hurricane Katrina.

Even in New York City, where disaster readiness has been a way of life since 9/11, seaside nursing homes and assisted living centers struggled to evacuate 6,300 residents from their flooded or powerless buildings in the days after the storm.

Some changes could be in the works. The federal Centers for Medicare and Medicaid Services said it expects to issue new disaster planning requirements for nursing homes this year, with an aim toward avoiding the types of problems seen in Sandy.

“They seem to do quite well with food, water, transportation, but once you get beyond that, they aren’t so great,” said University of Pittsburgh researcher Nicholas Castle, who published a study of more than 2,000 nursing home evacuation plans in 2008.

In New York, there was confusion at many homes about where patients should be sent. Some sat for hours aboard unmoving ambulances as the drivers waited for orders, only to be taken to the wrong place. Some facilities accepting evacuees wound up overloaded with more patients than they were prepared to handle. With the phones knocked out, relatives struggled to learn where loved ones had been taken. Medical records that were supposed to accompany displaced residents never arrived.

State and city health officials say that, by one important measure, the evacuations were a success because no patient died during transport. But that statistic doesn’t include patients like Grigoriy Grodzenskiy.

The 95-year-old was on the fifth floor of the Sea Crest Health Care Center, in Brooklyn, when Sandy’s surge swept over the beach at Coney Island and inundated the nursing home’s ground floor.

Grodzenskiy, a retired scientist who fought for Russia in World War II, spent a frigid day in the heatless building, then nearly six hours aboard ambulances before he was taken to a nursing home in the Bronx _ a facility so overcrowded with evacuees that he was soon moved again. After that second trip, Grodzenskiy’s health deteriorated. He died eight days after the storm.

“His final days were so difficult for him,” said his daughter, Tatiana Vishnepolsky.

Experts have been warning for years that the evacuation plans at many nursing homes need improvement.

The inspector general of the U.S. Department of Health and Human Services said in a report last year that while most facilities had evacuation plans that complied with federal law, they were often woefully insufficient.

Many had no plan for how to communicate if their phones went down. They lacked procedures for making sure records and medications accompanied patients. They often hadn’t worked out a system with local authorities to determine when to have patients shelter in place, rather than evacuate.

After that report, Medicare and Medicaid officials pledged changes. One possibility is a new requirement that nursing homes to model their evacuation plans around a federally authored checklist.

“We have been actively soliciting input to determine appropriate ways for nursing home facilities to be adequately prepared for disasters and coordinate with other local and national emergency preparedness systems,” the agency said in a statement.

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