Preparing for the worst looks good to local nursing homes, residents

How can we ensure that the 60,000 residents of this state's nursing homes and similar facilities have enough food, water and medication to survive a major disaster?

That paid caregivers don't abandon them?

That evacuation plans will work, given the practical realities of moving wheelchairs, IVs and oxygen tanks — not to mention fragile residents?

And that there's someplace for them to go?

In the wake of Hurricane Katrina, such life-and-death challenges — and possible remedies — are being grappled with anew this week by regulators, administrators and residents of Washington's long-term-care community.

At a meeting in Edmonds yesterday of the Resident Councils of Washington, an advocacy group of individual residents and their councils from around the state, Ron Costa, who lives at an assisted-living facility on Capitol Hill, advised fellow residents to be prepared to care for themselves.

"Get that water, a little food, light, a radio, cellphone," Costa said. "Eventually, they'll get to you."

The attention to nursing-home disaster planning follows some of the most disturbing developments to date in the devastation left by Katrina along the Gulf Coast, where 34 residents of a nursing home outside New Orleans drowned in floodwaters that rose nearly to the ceilings of their rooms.

While the home's owners had a plan that called for residents to be evacuated 48 to 72 hours before a hurricane was to strike, the plan was not followed. The owners have since been arrested and charged with 34 counts of negligent homicide.

In Washington, the law requires long-term-care facilities to have disaster plans that spell out evacuation procedures and requires enough food and water to sustain residents for three days. Caregivers also have a legal duty to provide care and are not supposed to abandon residents.

Now attention is being given to what more can be done.

In the next few days, the state Department of Social and Health Services (DSHS) will send a letter to long-term-care facilities directing operators to re-evaluate their plans and make sure they can handle whatever disaster might befall their region, be it a volcanic explosion, earthquake or tsunami.

The letter will tell operators to make sure they can sustain their residents if evacuation doesn't work.

"It's too soon to say if we have weak spots. Safety issues have been a big concern for us all the time," said Pat Bossert, assistant director for residential-care services at DSHS.

Many nursing homes in the region have begun looking at their operations.

"What's happened with Katrina has made us re-evaluate our disaster planning," said Charlene Boyd, administrator at Providence Mount St. Vincent in West Seattle, which has more than 400 residents in its nursing home, assisted-living and adult-day-health programs.

"If we can avoid some unnecessary harm, that's what we want to do."

Providence plans to revisit agreements it made five years ago with local churches and schools to make sure they're still willing to help in a disaster.

It's also investigating how to evacuate residents to a destination beyond the neighborhood — say, to another Providence nursing home in a different city. And it will conduct workshops to help employees better prepare at home for a disaster so they will feel secure about staying at work to care for residents.

Providence also will conduct a practice evacuation, stopping short of moving residents off-site because that could prove too traumatic, Boyd said.

Caroline Kline Galland Nursing Home near Seward Park, with 205 residents, also is reviewing its disaster plan. The home has two backup generators and provisions to last three days. It also has agreements with other nursing homes, neighbors and synagogues to take in its residents.

But in a real disaster, will the plan work?

"I am a Holocaust survivor," said Joshua Gortler, the home's chief executive officer. "I have seen catastrophes where life and death are at stake. People under these circumstances do act differently than under normal conditions."

Meanwhile, some residents of long-term-care facilities have decided to do more to protect themselves.

"New circumstances have arisen. It's challenging us to lead into the future," Louise Clark, president of the Resident Councils of Washington, said at the group's meeting yesterday at Aldercrest Health and Rehabilitation Center in Edmonds, where she lives.

Another meeting participant half-joked that in addition to cellphones and radios, water and crackers, "don't forget the peanut butter."

The residents decided to find out more about the disaster plans of their respective facilities and, if necessary, help make them better. They intend to contact local fire and police officials to see if they can be placed on a priority-rescue list.

And they'll write to the governor and lawmakers asking for an assessment of long-term-care emergency readiness.

The group's activity is a result of a national push by advocates for residents in long-term care.

On Wednesday, the National Citizens' Coalition for Nursing Home Reform wrote a letter to Congress, signed by numerous state advocacy groups, calling for an independent commission to investigate the failure of public-emergency systems to rescue disabled and older adults during Hurricane Katrina.

Marsha King: 206-464-2232 or mking@seattletimes.com