1. Elder Care in Harvestland Great Harvest Public Health Department Council in Geriatric Care

2. Overview Poor standards exist in nursing homes Poor standards exist in nursing homes Key issues and concerns Key issues and concerns Solutions for better emergency preparedness Solutions for better emergency preparedness

3. Message # 1 Elder care in nursing homes and assisted living facilities inadequate in addressing needs of elders… especially in times of emergency and/or crisis.

4. Devastation in New Orleans 34 residents of St. Rita’s nursing home died as a result of criminal negligence. 34 residents of St. Rita’s nursing home died as a result of criminal negligence. Owners and staff did not evacuate residents Owners and staff did not evacuate residents 34 counts of negligent homicide have been filed; no convictions as of yet 34 counts of negligent homicide have been filed; no convictions as of yet (Source: CNN News (9/13/05)

5. Elderly Most Vulnerable A majority of people killed by Hurricane Katrina were older residents unable or unwilling to evacuate in the rising floodwaters Source: http://www.cnn.com/2005/US/10/23/katrina.deaths.ap/index.html

6. Inadequate care in Harvestland Only 3 out of 9 nursing Only 3 out of 9 nursing facilities have consistent staff/patient ratio facilities have consistent staff/patient ratio No nursing facilities have an operational emergency preparedness plan No nursing facilities have an operational emergency preparedness plan Recent fire shows need to develop Recent fire shows need to develop a plan of action a plan of action

7. DHHS Recommendations Minimum of two hours of care Minimum of two hours of care each day from nurses aides each day from nurses aides Patients receive at least 12 minutes Patients receive at least 12 minutes a day of care from registered a day of care from registered nurses. nurses. –Source: http://archives.cnn.com/2000/HEALTH/aging/07/24/nursing.homes.ap/index.html

8. Message #2 Staff turnover is extremely high and is a contributing factor Increase staff training Increase staff training More rigorous health care worker certification process More rigorous health care worker certification process Increase salaries and improve working conditions (e.g. schedules) Increase salaries and improve working conditions (e.g. schedules) Higher licensure requirements for institutions and personnel Higher licensure requirements for institutions and personnel

9. High Turnover Results from a recent U.S. Department of Health and Human Services study revealed understaffing contributes to increased patient incidences of: severe bed sores severe bed sores malnutrition malnutrition abnormal weight loss abnormal weight loss Source: http://archives.cnn.com/2000/HEALTH/07/26/nursing.home.danger/index.ht ml

10. High Turnover High turnover can lead to nursing facility residents vulnerable to injury or death. High turnover can lead to nursing facility residents vulnerable to injury or death. Low staff-to-patient ratio doesn’t contribute to the safety/well-being of nursing residents. Low staff-to-patient ratio doesn’t contribute to the safety/well-being of nursing residents.

11. Message #3 Comprehensive policies and procedures, such as emergency evacuation, must be established and practiced.

12. Solutions Mandatory accreditation for nursing care homes and assisted living facilities in excess of those established by Centers for Medicare and Medicaid Services (CMS) –Establish operational procedure manuals and drills –Modify and improve staff variables Increase facility and staff licensure requirements Increase facility and staff licensure requirements Increase salaries Increase salaries Improve schedules Improve schedules

13. Medicare Improvements require continued Medicare and Medicaid funding Improvements require continued Medicare and Medicaid funding Great Harvest Council in Geriatric Care advocates for reversal of cuts in Medicare reimbursement Great Harvest Council in Geriatric Care advocates for reversal of cuts in Medicare reimbursement

14. Emergency Preparedness Create emergency plans for each long term care facility to be reviewed by the DOH Create emergency plans for each long term care facility to be reviewed by the DOH Practice drills on a regular basis Practice drills on a regular basis

15. Target Audience Target audience for this story include: –Harvestland baby-boomers –Harvestland elderly –Citizen watch groups –Governors and legislators involved with funding

16. Best news outlets Local Newspapers Local Newspapers –Harvestland Daily Tribune –Smaller regional weekly papers Internet Outlets Internet Outlets –Harvestland Daily Tribune web publication

17. Other Resources National Citizens’ Coalition for Nursing Home Reform (http://www.nccnhr.org/) National Citizens’ Coalition for Nursing Home Reform (http://www.nccnhr.org/) The US Administration on Aging (http://www.aoa.gov/) The US Administration on Aging (http://www.aoa.gov/)http://www.aoa.gov/ Centers for Medicare and Medicaid Services (http://www.cms.hhs.gov/medicaid/survey- cert) Centers for Medicare and Medicaid Services (http://www.cms.hhs.gov/medicaid/survey- cert)