In a scathing Department of Health and Human Services report that comes on the heels of the GAO report in our last post, the Office of the Inspector General (OIG) found that while self reporting of emergency preparedness by Long Term Care (LTC) facilities showed a 92% compliance in having  an Emergency Response Plan and 72% in compliance with Federal regulations on Staff Training; slightly DOWN from the 2004-2005 (Pre-Katrina) Levels.

Remember that 34%   of the bodies recovered after Katrina were in healthcare facilities – many in nursing homes. 

While 92% sounds good, opening the door to the sausage factory shows a substantially different picture: calling on 24 of these facilities and conducting over 250 individual interviews, OIG surveyors found that critical components of the these self reported emergency plans were missing or diluted. For example, CMS provides a checklist of 70 tasks that should be included in an Emergency Preparedness Plan, 0 of 24 had included the full check list, 0 of 24 had an adequate source of potable water for 7 days, 0 of 24 had an adequate source of food, 23 of 24 had no evacuation routes with alternates – the table from the report says it all, and there is a lot more to see for those who might want to double-check before putting a loved one in a specific nursing home. Link to the report here. Makes me wonder a bit about this self-reported 92% compliance number that is the key message of industry reporting: 92% compliance is an “A”, not having Food, Water or Evacuation Routes is an “F”. Not to mention that the 24 selected, had actually gone through real life situations within the previous several years, making them more likely to have updated their plans most recently.

Given the data above, it looks like we are doomed to repeat past mistakes, which will inevitably result in death and suffering. Quoting from our last article on the subject:

“An example of being unprepared was cited from the (Washington Post) article: St. Rita’s, where 35 patients died during Katrina (of a total 136 in LTC facilities), several of whom drowned while strapped into their wheelchairs and beds while the water inched over their heads.”

Press coverage of the GAO and OIG reports ranges from a benign wake up call from the Washington Post, to what looks like an industry PR release from the print edition of Modern Healthcare; extolling the virtues of the 92% compliance and quoting industry executives’ claims on the “progress” made since Katrina; progress that is dubious at best and outright negligence at worst.