1. The Buckingham Disaster Plan - Lessons Learned Hurricane IKE September 2008

2. We are a 329 unit Continuing Care Retirement Community (CCRC) offering all levels of care that includes, Independent living, Assisted living, Memory care, Long Term care and Post Acute rehab. The Buckingham is a nonprofit provider sponsored by SQLC based in Dallas which also operates similar communities in Dallas, Austin, Corpus Christi and Fort Worth. For more information on all our communities please visit www.sqlc.orgwww.sqlc.org

3. Overview Hurricane IKE, a Category 4 hurricane struck the Gulf of Mexico By the time it made landfall in Galveston it was a Category 2, it came ashore at 2:10am, September 13, 2012 Our Community is a Shelter In Place, CCRC and we manage our business 24/365. Our challenge is to provide care to all residents, before, during and after the hurricane. The Buckingham has a hurricane plan that focuses on the whole community. We communicate our plan to the residents, resident family members and staff, as well as outside vendors and sister properties. We also communicate with many agencies (DADS, Leading Age, City of Houston, CenterPoint) to get the latest updates and information. A straight line of communication is key to successful planning during disaster situations.

4. Number of People in our building the day of the Storm Residents Independent 255 Assisted Living 41 Memory Support 16 Nursing/Long Term Care48 Staff/Family Essential Staffing During Ike 15 Non Essential Staff30 Staff Family Members10 Total415

5. Storm Announcement Houston Weather authorities report a Hurricane in the Gulf of Mexico, with possibility of landfall near the Houston Area. September 7, 2008 We have an estimated 4 – 5 days before it makes landfall. – With this announcement our plans come out and a directors meeting is held. The plan is now in Place and all steps begin. – Letters are written and distributed to staff, residents and family members of residents. – From this day until the storm arrives we meet daily to give updates on issues and or progress.

6. The Walk Before the Storm On September 12, 2008, we did our last property walk before the storm was to arrive. This allowed us to see if there were any other areas of concern and to make sure the property was ready for IKE. All Balconies were cleared of flying objects.

7. IKE the Morning After Assess the Damage

8. Power Outage 4 hours into the Storm Our Plan - call and contact power company to report outage. However, during a hurricane there is not a guarantee that your community is on list or that your power will be restored in a timely manner. In our Healthcare, Assisted Living and Skilled Nursing, we have generator power, however in Independent Living there are NO RED PLUGS to aide during a storm. As a result, Command stations were set up, so resident could watch news and get community updates. 13 DAYS without POWER

9. Items we brought in to help us cope with the power loss Facility Solutions Group- Supplied (4) 17Kw generators to supply emergency lighting to Assisted Living Building, they also Supplied power to laundry room. $ 33,374.97 SMF Generator Fueling Services- The cost of diesel fuel to run all generators for 14 days $ 16,139.00 Maintenance Source- Supplied (2) 200KW generators to supply power to the IL bldg and (1) 100 Ton Chiller to supply Air conditioning to the Skilled Nursing Floors. $ 20,789.40 Hi - Tech Electric, Inc $ 8,696.00 Portable A/C Units $ 7,266.75 These are just a few expenses, Not all of these items were taken into consideration in the 1 st Plan, however, they have been added since and additional upgrades have been made to our community to help if ever needed again.

10. Other Areas to Consider You need to take each of your critical areas and really look at ALL the possible issues. Labor/Staffing Services to Provide Equipment/Supplies Outside Providers/Contacts

11. Staffing Issue – we need labor to provide care Plan – follow the staffing levels that are written in the disaster plan. Obstacles – What staff stays, before, during and after? – What do they do with their family? – Who feeds them? – Where do they sleep? – What do we do with their children, animals, ect.. – What types of compensation do we provide? – Is it safe for them to come to work? Question: How do the employees know there is a Plan for Hurricanes? Do they know we NEED them to be a part of this plan?

12. Inclement Weather Form

13. Supplies/Equipment/Service Issue – with out power how do we provide services and use our equipment? Plan – How detailed is your Plan, in covering your NO’s? Obstacles - No Power – No Laundry/Clean Linen – No Hot Meals – No Dishwasher – No Lights – No Cell Phones – No Refrigerator to hold food. – No AC – No fuel for the Generator There are many others… In our Plan we consider all of the NO’s, so we can turn them into a YES. We don’t have to wait for a hurricane, “No Power” can happen at any time.

14. Outside Providers Issue – Can your outside providers meet your needs? Plan – Do you know what your outside service providers Hurricane plan is? Obstacles – Can they make deliveries in a disaster situation? – How soon after a disaster will they resume services? – Will your contact person be available before, during and after the storm? – Do you have a contract, how many other communities have the same contract? We did not have the proper Plan for waste disposal and this provider was not able to help us until Day 10! Review your contracts make notes and after a storm, revise your contracts for the future.

15. Is your Community ready for another IKE?

16. Questions We Asked? Do we have a Hurricane Plan that fits our Community? What is in it? Who Wrote it? Do we know the cost associated with our Plan? Can you realistically follow your plan, and is there a Plan B, C and D? Do all levels of the staff know the Hurricane Plan? Have we learned from our “Lessons Learned”? You can never ask to many questions

17. Who wrote your Disaster Plan? Who wrote your Hurricane plan? Since the last hurricane has it been revised? How often do you look at your plan?

18. Successful Planning Hurricane Planning doesn’t only take place a week before June 1 st, we start talking about it in February and March. All levels of management need to be involved in helping write and review your disaster plan. Each team member has a section of the plan and reviews it, to make sure phone numbers and contacts are still the same. If there are changes you should update your plans immediately. Learn from your mistakes. Attend lectures and meetings that the City and or other agencies provide. Develop relations with other similar communities share ideas, issues and concerns.

19. Success During the Storm Requires good strong leadership which is in control, calm and reassuring A great team of volunteers, it is not mandatory for our staff to work, they work because they care. Be in communication with the agencies, they helped us locate certain suppliers and gather information. Be visible work in shifts Review the recovery process of your hurricane plan We try to have FUN during the recovery process Last ALWAYS be in COMMUNICATION on all Levels.

20. WE SURVIVED IKE All the staff who helped carry out our Hurricane Plan during IKE - 2008

21. Thank you Pam Ortiz – Director of Resident Services Liz George – Assisted Living Director John Thomas – Director of Plant Operations www.buckinghamhouston.com www.buckinghamhouston.com