Nursing homes struggle with decision during hurricanes

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.

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 during Hurricane Harvey was found dead on a charter bus. And another man died in a Corpus Christi, Texas, nursing home, 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 homes 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.

Kathryn Hyer, the director of the University of South Florida’s Center on Aging, said a study she co-authored 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.