A recent report issued by the U.S. Department of Health and Human Services confirms that seven years after the devastation of Hurricane Katrina along the Gulf Coast, many nursing homes are still unprepared to protect residents during a natural disaster. Among the deficiencies cited, investigators emphasized that emergency plans "lacked relevant information" and were challenged by "unreliable transportation contracts, lack of collaboration with emergency management, and residents who developed health problems."

While on the surface many of the nation's 16,000 nursing homes appear to be prepared for a disaster, with 92 percent meeting federal regulations for emergency planning and 72 percent meeting the standards for emergency training, the investigation found through its on-site inspections that facilities were in fact lacking in basic preparations. Emergency plan documents were not readily accessible. Many plans did not cite specifics on handling resident's medical needs, or how to identify residents during an evacuation. Back-up plans weren't clear for addressing staff shortages, and transportation plans were insufficient, including how to transport patients in wheelchairs as well as clear instructions for transporting medications and emergency food and water supplies.

In general, the plans fell short. Clearly, greater collaboration with emergency management agencies and other resources can help nursing homes address these shortcomings. Criteria must be clear and training should be comprehensive. With many of our most vulnerable citizens residing in nursing homes and assisted living facilities across the country, effective emergency planning should be a top priority.

Ken Rudnicki, who is president of the Virginia Emergency Management Association and emergency manager for the City of Fairfax, is among the professionals who have helped lead the charge in providing nursing homes with the criteria, guidance, and tools they need to become better prepared. We recently worked with the city to develop a "Model Emergency Management Plan"—a template for developing a Comprehensive Emergency Operations Plan, which Ken and Representative David Bulova are now working to incorporate into Virginia's Emergency Services and Disaster Law. This comprehensive template enables facilities to gather the key information and outline basic steps for handling emergency situations.

Once emergency plans are developed, it's vital to provide the necessary training and associated exercises. From there, gaps in the plan can be addressed and plans further updated. Nursing homes can also be designed to help support emergency operations, as Dewberry architect Anita Moran addresses in her blog this week. Every resident of a nursing home deserves this diligent and thoughtful preparation.