Nursing homes struggled with choice to evacuate in hurricane
DALLAS » Murky water started seeping into a Port Arthur, Texas, nursing home four days after administrators decided to shelter in place. Volunteers — one even brandishing a gun — demanded relocation of the elderly residents, at least two of whom died in the days after police ultimately ordered the evacuation.
The deaths of elderly residents at Lake Arthur Place and other Texas and Florida facilities after hurricanes made landfall in August and September have heightened scrutiny of the evacuation procedures at nursing homes and assisted living facilities.
“A lot of things went wrong, and went very tragically wrong,” said Chip Ferguson, a lawyer representing families who have filed civil lawsuits against two Port Arthur nursing homes.
It’s difficult for investigators to determine whether decisions on when to evacuate played a role in the deaths. That’s partly because many older residents at the facilities have underlying medical conditions, and local emergency officials use different criteria to decide whether to categorize a death as storm-related.
Thirteen residents of a Hollywood, Florida, nursing home that sheltered residents in place during Hurricane Irma died in the weeks after the storm left the overheated facility without power for air conditioning for days.
A man being evacuated from a Friendswood, Texas, nursing home facility during Hurricane Harvey was found dead on a charter bus. And another man died in a Corpus Christi, Texas, nursing home that decided to shelter in place during Harvey, although the county medical examiner’s office said it was not called to investigate that death as being storm-related.
The Texas Health Care Association, which represents long-term health care providers, including the state’s nursing homes, said about 4,000 patients in more than 160 nursing home and assisted living facilities were evacuated either before Harvey made landfall or during the intense rain and flooding in the days after. Nearly 33,000 patients in hundreds of other facilities sheltered in place.
“A greater emphasis has been placed on sheltering in place in recent years, given the challenges and issues that can go with evacuations of this population,” said Kevin Warren, the chief executive officer and president of the association.
Kathryn Hyer, the director of the University of South Florida’s Center on Aging, said a study she coauthored found that nursing home patients who were evacuated during a hurricane had a 3 to 5 percent higher chance of dying within 90 days than those who stayed put and an 8 percent higher chance of being hospitalized.
She also said hurricanes can change their forecast tracks, which poses another danger in evacuating. As Irma neared Florida, some nursing homes on the Atlantic coast moved their patients 100 miles (160 kilometers) or more to the Gulf Coast, only to have the storm’s track also move west, forcing a retreat.
“You shelter in place until you can’t shelter in place,” Hyer said.
Until the evening of Aug. 29, when the swirling, rainswollen remnants of Harvey shifted, sheltering in place seemed like the right decision for the two Port Arthur nursing homes owned by Dallas-based Senior Care Centers. Then 26 inches (66 centimeters) of water fell and started seeping into the homes.
The company’s official statement said once water started entering the facilities, on-site administrators called for help. By that time, county emergency personnel were overwhelmed with similar calls for help.
Members of the Cajun Navy, a group of volunteers with private boats mostly from Louisiana, began offering help to water-logged residents. But Lake Arthur Place staff declined the offer, concerned about releasing frail residents to volunteers without medical training.
Statements to Port Arthur police and reports by officers who responded paint a picture of desperate events.