Minnesota Nursing Home Flood Forced 36 Residents Out, and Families Choosing a Facility Can Ask About Evacuation Plans

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A joint analysis by KFF Health News and WCCO identified 100 U.S. nursing homes where at least 2 feet of water is predicted in a 100-year flood, one with a 1% chance of happening in any given year. The nation has nearly 15,000 nursing homes housing more than 1.2 million people.

For families choosing a nursing home for a parent or grandparent, the finding turns flood planning into a practical question to ask before signing admission papers. Most facilities will never flood, but frail residents depend entirely on staff when one does.

Storms dropped 4 to 8 inches of rain across much of southeastern Minnesota the day before the evacuation, according to National Weather Service meteorologist Brennan Dettmann. The farmland around New Richland funnels runoff into creeks and ditches that lead to a low-lying area near the nursing home, KFF Health News reported.

“Every community across the United States carries some level of flood risk,” said Oliver Wing, chief scientific officer at Fathom, the flood-modeling firm whose data powered the analysis.

The reporters mapped more than 14,000 nursing homes against Fathom’s flood model, which accounts for climate change and many rivers and creeks missing from other maps. More than 750 facilities were flagged at first, and visual checks narrowed the list to 100 high-risk homes. Fathom’s model is not the same as FEMA flood maps, so results can differ.

Moving frail older adults carries its own dangers. “It’s Russian roulette. You’re damned if you do. You are damned if you don’t. Older adults and disasters don’t mix,” said Dr. David Dosa, head of geriatrics at UMass Chan Medical School.

Nursing home residents tend to be frailer than people in other senior housing. “Assisted living residents are quite frail in their own right. But nursing home residents are usually at higher risk,” said Cassandra Hua, an assistant professor at UMass Lowell.

Researchers expect more storms like the one that hit New Richland. “Storm tracks are changing their trajectory,” said Drew Gronewold, a climate scientist at the University of Michigan, who added that such unanticipated events will be part of the future. Some nursing homes on the at-risk list have flooded in the past five years, including facilities in Florida, Kentucky, Texas, and Washington state, KFF Health News reported.

That is why federal rules require planning before a disaster arrives. Under the CMS emergency preparedness requirements, nursing homes that accept Medicare or Medicaid must assess the hazards likely in their area, maintain an emergency plan, and review it at least once a year.

The federal rule for long-term care facilities, 42 CFR 483.73, requires plans for safe evacuation and for sheltering in place. Homes must track residents and staff during an emergency, keep medical records secure and available, maintain alternate energy sources for safe temperatures and emergency lighting, and run emergency exercises at least twice a year.

Families can ask a nursing home’s administrator a few direct questions. Is the building in a flood-prone area, and what hazards does the facility’s risk assessment list? Where would residents go if they had to leave, and how would they get there?

They can ask how the facility would notify families during an emergency and how it would keep track of each resident if people were sent to different locations. New Richland’s residents ended up spread across about nine homes, which shows why tracking matters.

Families can also ask about backup generators, how much food, water, and medication the facility keeps on hand, and when it last held an emergency drill. A clear, confident answer is a good sign, while vague replies deserve follow-up.

Checking records independently helps too. FEMA’s free Flood Map Service Center lets anyone search an address for mapped flood zones. Medicare’s Care Compare tool shows inspection results, and families can ask the facility directly whether it has been cited for emergency preparedness problems.

Families with a relative already living in a nursing home can request a copy of the emergency communication plan and confirm that the facility has current contact numbers. Keeping medication lists and power of attorney papers up to date also helps if a resident must be moved quickly, since paperwork can lag behind people in a fast evacuation.

What happened in Minnesota? Floodwater entered New Richland Care Center on Sept. 19, and 36 residents were evacuated, first to a school gym and then to about nine area nursing homes.

How many nursing homes face serious flood risk? A KFF Health News and WCCO analysis found 100 nursing homes where at least 2 feet of water is predicted in a 100-year flood.

Are nursing homes required to have emergency plans? Yes. Nursing homes in Medicare or Medicaid must keep an emergency plan, review it at least once a year, and plan for both evacuation and sheltering in place.

How often must they practice? Federal rules require emergency exercises at least twice a year.

How can families check a facility’s flood risk? Search the address on FEMA’s Flood Map Service Center and ask the administrator what hazards the facility’s risk assessment lists.

Where can families find inspection records? Medicare’s Care Compare website lists inspection results for nursing homes.