Nursing Homes Use Katrina Lessons for Latest Storm

By Janet McConnaughey and Tom Murphy, Associated Press

August 29, 2008

About six of every 10 nursing homes in the New Orleans area didn't evacuate before Hurricane Katrina hit three years ago, and about 70 patients died in them. That won't happen with Hurricane Gustav, officials said.

Several nursing homes were moving residents Friday, and others planned to do so over the weekend.

CommCare Corp., which owns 45 nursing homes in Louisiana and Mississippi , put about 500 residents of five facilities in Houma , Thibodaux , Lutcher and Destrehan onto buses Friday for its nursing homes farther north, CEO John Stassi said. An additional 650 were going home with their families, he said.

Jefferson Healthcare Center outside New Orleans had already evacuated its Alzheimer's unit by Friday afternoon, and the nursing home was ready to move patients on dialysis.

Nursing homes near the Louisiana Gulf Coast drew on lessons learned from the devastating 2005 hurricane as they braced for another storm. Some had started evacuating on Friday, and others were preparing for evacuation.

Gustav was still about three days from landfall, but administrator Robert Rhea had no plans to gamble.

"We stayed here through Katrina," Rhea said. "We wanted to be in a position if it looks like it's going to be a close one, we don't want to be in the building this time."

The 19 sickest residents at St. Margaret's Daughters Home were to leave in ambulances Friday night for nursing homes in Jackson , administrator Manda Mountain said. She said families leaving the city planned to take about a dozen residents with them, and the rest will leave Saturday on three buses for a Baptist church north of Jackson .

Some nursing homes were planning evacuations reluctantly.

"I could stay right here with my fantastic, 300-kilowatt generator and be safe inside these walls, but politics and society won't let me do that this time," said Covenant Nursing Home Executive Director Margaret Hoffmann, whose residence sits on high ground in New Orleans. "There's too much pressure to leave."

Before Katrina, many nursing homes worried that a long bus trip would be harder on their fragile residents than a hurricane. Their main evacuation plan was to "shelter in place," stocking up on food and water.

Their fears had reason: as many as 55 who were evacuated for Katrina died during the storm or immediately afterward.

Only 21 of the 57 nursing homes considered at risk during Katrina evacuated. Patients died at 13 of the others during or shortly after Katrina, the attorney general's office said in 2006.

That included 35 who drowned at St. Rita's Nursing Home in St. Bernard Parish, and 19 at another nursing home who died in the heat wave afterward. The only people charged in such deaths, the owners of St. Rita's, were acquitted of negligent homicide and cruelty to the infirm, but still face dozens of lawsuits.

State laws passed since Katrina require homes to have contracts with transportation companies and alternative sites to house their residents, said Joseph Donchess, executive director of the Louisiana Nursing Home Association. New regulations also require homes to have seven days of supplies and a plan for keeping residents comfortable if they don't evacuate.

Donchess said many homes had evacuations planned before Katrina, but that storm also taught them to send electronic copies of patient records by computer disc or e-mail to the alternative sites.

Staff also learned the importance of identification bands. In the chaos following Katrina, some patients became separated from staff, and they arrived at alternative homes without identification.

"For days, we were trying to actually identify people," Donchess said.

He thinks many homes also will consider hiring private security or off-duty police for protection if Gustav hits.

"Nursing homes that did not evacuate (during Katrina) became islands, and there were drug addicts who were trying to break in to steal drugs," he said. "You can't just assume the police department is going to be there to help you."

A truck full of armed men threatened the residents of Covenant Nursing Home as they evacuated a few days after Katrina, Hoffmann said.

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