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  • Writer's pictureCheryl Nelson


Unlike earthquakes, tropical cyclones occur with warning. In the Atlantic Basin, a tropical cyclone forms as a tropical depression and then, if the meteorological ingredients are ripe, it strengthens to tropical storm, followed by a hurricane. Tropical cyclones occur annually during “hurricane season,” which runs from June 1st to November 30th. However, in recent years, tropical cyclones have occurred outside of this window, partially thanks to warmer ocean temperatures adding extra ‘fuel.’ Hurricane season often produces storms that bring catastrophic storm surge, damaging winds and widespread flooding. While we are all vulnerable, seniors, the disabled and the disadvantaged are most at risk because they are less mobile and may have to shelter-in-place.

U.S. coastal areas have dealt with several major hurricanes in recent years that have cost too many lives and billions of dollars in property damage. The effects from these storms are felt miles inland from the coast. In 2005, hundreds of nursing home residents tragically drowned in Hurricane Katrina floodwaters. Despite the harsh lessons of Katrina, a lack of preparation by nursing homes was evident after the 2017 and 2018 hurricane seasons. The owners and managers of these facilities need to better protect their residents from tropical cyclones and power outages.

I had the pleasure of interviewing Albert Slap, the President of Coastal Risk Consulting, LLC to get his point of view on this important issue.

Cheryl: Thanks for your time, Albert. How many Americans are living in assisted living facilities and nursing homes? What impacts have hurricanes had on these types of facilities?

Albert: About 1.5 million people live in nursing homes in the U.S. and more than 10 million Americans — mostly people 65 or older — need long-term services and support. The U.S. Government estimates that there are 22,200 assisted living facilities in the U.S. and 15,700 nursing homes. Of the 877 direct fatalities from Hurricanes Katrina and Rita, 12 percent were nursing facility residents. Almost half of the adults living in nursing facilities in the U.S. reside in the hurricane-prone, Gulf and Atlantic coast states. Most nursing facility patients have significant limitations. Many have dementia, vision and hearing impairments, or other conditions that compromise their ability to respond during emergencies.

Cheryl: That is really scary to hear. Has the government investigated this at all?

Albert: A year after Hurricane Irma and the tragic nursing home deaths at the Hollywood Hills Rehabilitation Center, the minority staff of the U.S. Senate Committee on Finance released a report: “Sheltering in Danger, How Poor Emergency Planning and Response Put Nursing Home Residents at Risk During Hurricanes Harvey and Irma.” In addition to the people who died at Hollywood Hills, more than 100 residents had to be evacuated, evaluated and treated, underscoring that the facility’s missteps put many more people at risk. According to data collected by the Florida Agency for Health Care Administration, just 88 of the state’s 683 active nursing homes evacuated during Hurricane Irma, while 635 of the 3,109 assisted living facilities licensed by the state evacuated. If most long-term care facilities don’t evacuate, and most facilities have not invested in any flood-risk assessments or defenses, then there’s a substantial risk that patients could be injured or even drown in the next tropical cyclone.

Cheryl: Storm surge is the #1 killer in hurricanes, so what measures can long-term care facilities take to be more prepared for flooding?

Albert: Most nursing homes, assisted living facilities and homeless shelter owners and operators know little more about their risks of flooding other than their location relative to a FEMA-designated flood zone, if that. But, there are serious problems with the accuracy and comprehensiveness of FEMA flood maps. They do not include heavy rainfall flooding, which was a huge problem in Hurricane Harvey in the Houston area. In the coastal areas, FEMA’s Base Flood Elevations are typically lower, and in most cases substantially lower, than NOAA storm surge models. This means that relying on FEMA flood maps can put the facilities in unrecognized danger.

Cheryl: We’ve seen this a lot lately…people have relied on FEMA flood maps and thought they were safe. Unfortunately the 2018 hurricane season put more tropical cyclones in the record books. Hurricane Florence brought historic rainfall flooding to the Carolinas and Hurricane Michael caused complete devastation with storm surge flooding on the Florida Panhandle. Did the extent of the flooding catch residents by surprise there too?

Albert: In the case of the storm surge damages at Mexico Beach in Florida’s Panhandle from Hurricane Michael, hundreds of homes in the FEMA X-zone (500-year risk) were destroyed and hundreds of nursing home patients had to be evacuated.

Cheryl: What do you recommend long-term care facilities do to assess their risk?

Albert: In addition to installing backup generators to keep inside temperatures within a safe range, facilities housing the elderly, infirm, and the poor need to comprehensively evaluate their flood risks and investigate appropriate and cost-effective investments to mitigate those risks, including permanent and/or removable flood barrier systems.

Cheryl: Thanks Albert. You’ve given us a lot of think about.

Here in Hampton Roads, we have about 64 area nursing homes and over 75 assisted living facilities. As we all age, it is inevitable that someone we love is or will be in a long-term care facility. We should come together as a community to ensure our loved ones are properly cared for – not only on a daily basis, but also in the face of disaster.

To learn more about the author, Cheryl Nelson, click here .

For information regarding your property’s flood risk, visit .

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