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Disaster Preparedness: Preliminary Observations on the Evacuation of Hospitals and Nursing Homes Due to Hurricanes
Date: February 16, 2006
Author: N/A
Institution: United States Government Accountability Office
Bibliographic Entry: “Disaster Preparedness: Preliminary Observations on the Evacuation of Hospitals and Nursing Homes Due to Hurricanes.” United States Government Accountability Office, GAO-06-443R, February 16, 2006.
Electronic Link: http://frwebgate.access.gpo.gov/cgi-bin/getdoc.cgi?dbname=gao&docid=f:d06443r.pdf
Key Words: disaster preparedness, National Disaster Medical System (NDMS), National Response Plan
Summary of Key Points, Issues, Conclusions:
When disasters strike, health care administrators must make certain operations decisions, such as when and how to evacuate patients if the facility becomes unable to support adequate care, treatment, or services. Hospitals and nursing homes are required to have plans regarding operations during emergencies. Hurricanes Katrina and Rita were national incidents highlighting the challenges with evacuating vulnerable populations. Federal officials used, for the very first time, the National Disaster Management System (NDMS), to evacuate patients during Hurricane Katrina. NDMS was formed in 1984 as a partnership among the Department of Defense (DOD), Department of Health and Human Services (HHS), Department of Homeland Security (DHS) and Department of Veterans Affairs (VA).
Evaluations have begun on assessing the evacuation of hospital and nursing home patients from disasters. In order to conduct the review, information was obtained on 1) who is responsible for deciding to evacuate hospitals and nursing homes, 2) what issues administrators consider when deciding to evacuate hospitals and nursing homes, and 3) what federal response capabilities support the evacuation of hospitals and nursing homes.
The Senate Committee on Health, Education, Labor, and Pensions requested a brief on the preliminary observations. This report documents the preliminary views presented in the briefings. The process used to gather the information involved interviewing officials in Florida in areas experiencing hurricanes in 2004, including officials from three hospitals and three nursing homes that had experienced Hurricane Charley, as well as state officials, and local emergency management officials in two counties. Additional officials were interviewed from national hospital and nursing home associations, Florida hospital and nursing home associations, and Louisiana nursing home associations, along with federal officials from DOD, HHS, DHS, the Department of Transportation (DOT), and VA. Documents were reviewed, including emergency management plans from Florida, Louisiana, Mississippi, local governments, hospitals, and nursing homes; and federal documents, including the National Response Plan.
It was found that hospital and nursing home administrators are often responsible for determining whether to evacuate their patients from facilities due to disasters such as hurricanes. State and local governments can order evacuations of segments of the population during emergencies, but health care facilities may be exempt from the orders. Hospitals and nursing home administrators explained that they evacuate only as a last resort, and that facility plans are designed primarily to provide shelter in place. Administrators do consider several issues before determining whether or not to evacuate, including the availability of adequate resources, risks involved to patients, availability of transportation for moving patients, and destruction of the facility or community infrastructure. Additional factors to consider by nursing home administrators include having residents with no other home and unable to care for themselves, and the need to locate receiving facilities able to accommodate residents for a long time.
Name of Researcher: Alison Stevens
Institution: Integrative Center for Homeland Security, Texas A&M University
Date Posted: May 15, 2008