Hurricanes are not rare, unexpected events. They are a common occurrence that climate scientists expect will increase in frequency and intensity as ocean temperatures continue rising, along with more extreme droughts and heat.
Hurricane season often brings destructive winds, catastrophic storm surges, and widespread flooding. These storms and floods affect the elderly, the infirm and the poor most of all because they are less mobile and generally must shelter-in-place.
Coastal areas in the U.S. have dealt with several major hurricanes in the past few years that have cost too many lives and billions in property damage. The effects from these storms, including flooding, is sometimes felt miles inland from the coasts.
In 2005, hundreds of nursing home residents drowned in Hurricane Katrina’s floodwaters. Despite the harsh lessons of Katrina, a lack of preparation by nursing homes was evident during the hurricanes of 2017 and 2018. The owners and operators of such facilities need to better protect their residents from storms, floods and power failures.
About 1.5 million people live in nursing homes in the U.S. And, more than 10 million Americans — mostly people 65 or older — need long-term services and support.
The U.S. Government estimates that there are 22,200 assisted living facilities in the U.S. and 15,700 nursing homes. Of the 877 direct fatalities from Hurricanes Katrina and Rita, 12 percent were nursing facility residents. Almost half of the adults living in nursing facilities in the U.S. reside in the hurricane-prone, Gulf and Atlantic Coast states.
Most nursing facility patients have significant limitations. Many have dementia, vision and hearing impairments, or other conditions that compromise their ability to respond during emergencies.
A year after Hurricane Irma and the tragic nursing home deaths at the Hollywood Hills Rehabilitation Center, the minority staff of the U.S. Senate Committee on Finance released a report: “Sheltering in Danger, How Poor Emergency Planning and Response Put Nursing Home Residents at Risk During Hurricanes Harvey and Irma.”
In addition to the people who died at Hollywood Hills, more than 100 residents had to be evacuated, evaluated and treated, underscoring that the facility’s missteps put many more people at risk.
According to data collected by the Florida Agency for Health Care Administration, just 88 of the state’s 683 active nursing homes evacuated during Hurricane Irma, while 635 of the 3,109 assisted living facilities licensed by the state evacuated.
If most long-term care facilities don’t evacuate, and most facilities have not invested in any flood-risk assessments or defenses, then there’s a substantial risk that patients could be injured or even drown in the next tropical cyclone.
Most nursing homes, assisted living facilities and homeless shelter owners and operators know little more about their risks of flooding other than their location relative to a FEMA-designated flood zone, if that.
But, there are serious problems with the accuracy and comprehensiveness of FEMA flood maps. They do not include heavy rainfall flooding, which was a huge problem in Hurricane Harvey in the Houston area.
In the coastal areas, FEMA’s Base Flood Elevations are typically lower, and in most cases substantially lower, than NOAA storm surge models. This means that relying on FEMA flood maps can put the facilities in unrecognized danger.
In the case of the storm surge damages at Mexico Beach in Florida’s Panhandle from Hurricane Michael, hundreds of homes in the FEMA X-zone (500-year risk) were destroyed and hundreds of nursing home patients had to be evacuated.
In addition to installing backup generators to keep inside temperatures within a safe range, facilities housing the elderly, infirm, and the poor need to comprehensively evaluate their flood risks and investigate appropriate and cost-effective investments to mitigate those risks, including permanent and/or removable flood barrier systems.
Albert Slap is the President of Coastal Risk Consulting, a flood, natural hazard and climate impact tech firm in Plantation, FL.
“The Invading Sea” is a collaboration of four South Florida media organizations — the South Florida Sun Sentinel, Miami Herald, Palm Beach Post and WLRN Public Media.