Call for reforms in nursing homes following deaths in Miami

The state agency that regulates nursing homes in Texas was consolidated into the Department of Health and Human Services earlier this year. The move was done to streamline to be more responsive to the needs of the elderly. That reorganization is now getting its first big test.

115 residents were evacuated Wednesday morning from the Rehabilitation Center at Hollywood Hills. Company officials claim the building's air conditioning system was off because of a prolonged power failure caused by Hurricane Irma. 

The deaths at the center triggered welfare checks at other nursing homes in the Miami area.

"It’s a sad as a precautionary measure we've assigned police officers to go check all of the other 42 assisted living facilities and nursing homes throughout the city to make sure they are in sufficient care of the elderly,” said Hollywood police Chief Tom Sanchez

In Texas, reviews are also planned for several nursing homes which were flooded by Hurricane Harvey.

Nursing home residents had to be rescued in La Grange when the Colorado River poured into that town. In Port Arthur, flood waters poured into another nursing home residents there were rescue by people who arrived in bass boats. They were airlifted out by the National Guard and relocated in a facility near Conroe.

Officials at the Texas Department of Health and Human Services say they do not order evacuations because that is done on the local level. The state does require nursing homes to have written emergency plans on how to handle an evacuation.

"If there is any indication residents were put into Harm’s way, or the facility was not protecting the health and safety of its residents, we will take a look at that and we will investigate,” said Christine Mann with Texas Health and Human Services.

If a when a regulatory review takes place, the challenge will be trying to avoid a knee jerk reaction.

Sometimes an evacuation can put you into harm’s way. A case in point occurred in 2005. It was a chaotic scene as residents of Houston tried to leave before Hurricane Rita hit. "We had folks who died on a bus trying to evacuate, we had people die of heat stroke, spending multiple hours on a bus without air-conditioning,” said George Linial  with Leading Age Texas.

Linial said his organization has a member, who has been in existence for 54 years, and they had never flooded, but with Harvey, the facility was inundated this time.

As an advocate for seniors, Linial says he expects there will be meeting with state leaders to review state regulations. In the aftermath of Hurricane Katrina new rules were put in place requiring Texas nursing homes to have backup generators.

That was to make sure life sustaining equipment stays on during power outages.

Reports out of Miami say the nursing home there had generators. Investigators are checking to see if they were working or if the deaths were caused by carbon monoxide poisoning from the generators

"The answer is all in coordination, and better preparedness, I mean no matter how many plans you have in place, there are always ways to improve them,” said Linial.

In the coming days, House Speaker Joe Straus is expected to issue a list of Hurricane Harvey-related issues he wants lawmakers to study before the regular session.

What happened with the nursing homes is a concern but a spokesman for Straus tells FOX 7 that financing, infrastructure and schools repair are currently at the top of the list.

A spokesman for State Representative Garnet Coleman told FOX 7 the Houston Democrat will call for hearings on hurricane response including why nursing home residents were stranded.

Representative Carol Alvarado has already held a hearing on housing concerns.

State Rules for Nursing Home Emergencies
From: Christine Mann, Press Officer Texas Health & Human Services Commission

Rules require nursing facilities to develop and implement a written emergency preparedness and response plan for emergency situations that interfere with normal activities of a facility and its residents and may cause injury or death to a facility resident or staff member or cause damage to facility property such that it requires the facility to respond immediately to alleviate or avoid the injury, death, damage or interference. 

A facility's plan must include a:

1) risk assessment of all potential internal and external emergency situations relevant to the facility's operations and geographical area, such as a fire, failure of heating and cooling systems, power outage, bomb threat, an explosion, a wildfire, terrorism, a hazardous materials accident, and weather-related emergencies such as a hurricane, a tornado, a flood, extreme snow and ice conditions for the area, or a thunderstorm with a risk for harm to persons or property;

2) description of the facility's resident population;

3) section for each core function of emergency management, as described in 40 Texas Administrative Code (TAC) §19.1914(d), that is based on a facility's decision to either shelter-in-place or evacuate during an emergency situation;

4) section for a fire safety plan that complies with 40 TAC §19.326 of this chapter (relating to Safety Operations); and

5) section for self-reporting incidents that complies with 40 TAC §19.1914(f).

Plan requirements regarding Eight Core Functions of Emergency Management include:

1) direction and control;

2) warning;

3) communication;

4) sheltering arrangements;

5) evacuation;

6) transportation;

7) health and medical needs; and

8) resource management.

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