Nursing homes should be treated like hospitals in preparing for hurricanes and recovering after them, according to a new report.

Otherwise, the frail elderly will remain vulnerable to catastrophes like Hurricane Katrina, said the report, released on Wednesday, the anniversary of the devastating 2005 storm.

National, state and local disaster response agencies should include more help for evacuating nursing homes before hurricanes, concluded the report, sponsored by the nonprofit John A. Hartford Foundation. Local emergency operations centers, as well as state and federal officials, should give nursing homes the same priority as hospitals in restoring electricity and phone service, and providing police protection after storms, it added.

The proposals topped a list of 10 recommendations that emerged from a two-day national nursing home "hurricane summit" held in St. Petersburg last spring. The summit included nursing home administrators, government officials, academic experts and others from across the Southeast.

Participants hope the report will spur government action to improve protection of nursing home residents from storms.

"We are going to continue to push," said LuMarie Polivka-West, vice president of the Florida Health Care Association, an organization representing Florida's long-term care providers. "This report is being distributed widely at all levels of state and federal government."

This year's summit was the second after Katrina and other hurricanes in 2004 and 2005 exposed deep flaws in the systems designed to protect nursing home residents in emergencies.

Funded by the Hartford Foundation and spearheaded by the Florida Health Care Association, the meetings are intended to spur widespread reform.

The elderly in general and nursing home residents in particular suffered heavily in Katrina. An estimated 139 deaths from Katrina were in nursing homes, including 35 in St. Rita's, a New Orleans facility whose owners are on trial on negligent homicide charges for failing to evacuate residents.

Polivka-West said nursing home residents in Florida and other hurricane-prone states are vulnerable to storms because, despite their sometimes serious health conditions, they are treated differently from hospital patients. Many nursing home residents require require close monitoring, oxygen and other equipment.

Yet nursing home operators must fend for themselves, while the government assists in evacuating hospital residents.

Transportation remains a major issue, with facilities having trouble ensuring the availability of buses to evacuate residents before a storm. Summit participants are scheduled to meet in Boston in October with federal transportation officials, private bus companies and others to discuss the issue.

RECOMMENDATIONS

Key recommendations from the 2007 Nursing Home Hurricane Summit:

Disaster response systems at all levels should incorporate nursing homes.

Nursing homes should have priority status for utilities restoration and police protection.

Nursing homes should be hardened and equipped with back-up electrical power to allow sheltering on site in storms when possible.

Long-term care providers must know a facility's vulnerability to flooding and ability to withstand winds to determine when to shelter in place or evacuate.

Providing transportation to evacuate long-term care facilities should be part of local, state and national disaster planning.

Satellite phones or ham radios are needed to maintain communication between facilities and emergency officials.

Good databases are needed to share information and resources for evacuation and emergency response officials.

Long-term care facilities must test disaster plans with drills and identify residents with special needs, including those with cognitive impairment and requirements for medical equipment.

Facilities need plans for communicating with residents, families and staff before, during and after a disaster.

Disaster plans should be flexible and revised frequently.

Source: Caring for Vulnerable Elders During a Disaster: National Findings of the 2007 Nursing Home Hurricane Summit

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