The call came in to the Ombudsman of the Day about a week after the 2017 Sonoma County Fires.
“They left my mother in her apartment during the fire!”
Where was your mom living?
“In an assisted living facility. She called me from her apartment during the fire. My mom could see the flames and smell the smoke. She didn’t have any electricity. She is 90 and was scared and she didn’t understand what was going on.”
She wasn’t evacuated?
“No, they left her in her apartment! No one came to help her get out. When she called me, I couldn’t understand and asked her Where are You? She said in her apartment. I couldn’t believe it, so I jumped in my car and drove up there. At first the emergency services refused to let me in and said that the facility had evacuated everyone. I had to convince them that my mom was STILL IN HER APARTMENT!”
This was an unusual call during the Sonoma County fires of 2017. Most facilities evacuated residents safely, but few had a formal evacuation plan in place.
The role of the Ombudsman in the weeks following the fires was to track down where facilities evacuated their residents to. We visited all the evacuation centers in Sonoma County and scoured the faces and rooms for our residents. We developed a log of who was where and updated licensing, the CA State Ombudsman Program and family members. We also collected reports from callers like the one above, visited with residents and listened to lots of stories of that terrible night and the days ahead. When residents asked us to advocate for them, we sent off reports to licensing to ensure that licensing understood the changes that needed to be made in how facilities handled emergencies.
Since the fires, Community Care Licensing (licenses Assisted Living facilities for Seniors) and the CA Department of Public Health (licenses Skilled Nursing Facilities) have revamped their regulations around Disaster Preparedness.
Community Care Licensing (CCL) has developed a formal Disaster Plan template that must be completed by all assisted living facilities. The plan includes the all-important requirement for staff training. It includes:
- The facility must list staff assignments during a disaster, so staff stay with the residents and understand their role in keeping residents safe.
- Communication requirements so CCL, the Ombudsman and family members know where the residents have been relocated.
- Setting an Evacuation meetup site and Person Count – so logical and simple but not part of many facilities’ evacuation plan. (Many residents ended up in the ER with NO identifying information.)
- A grab and go binder/folder with all resident’s medications needs, primary care physician and contact information for the responsible party.
- Quarterly drills by the administrator for each shift. So often, day staff are trained but not the night staff. Emergencies are not limited to daylight hours!
You can view and download the CCL Disaster Plan
The California Association of Health Facilities (CAHF) has released a Handbook for Nursing Homes (Skilled Nursing facilities). Effectively responding to a disaster requires additional training that must be done before the incident occurs. This plan includes:
- Assigning an Incident Commander whose responsibility is to direct the response to the threat and determine if evacuation is required.
- Identifying a Resident Services Branch Director who ensures that residents’ health services and needs are met even if they are evacuated.
- Developing the Logistics Section, the people assigned to identify and inventory current supplies, equipment, personnel, medications and vehicles that may be needed in a disaster.
- Creating an Incident Communications Plan
This handbook stresses the crucial work of pre-incident planning and annual completion of a Hazard Vulnerability Analysis. Read the complete Handbook
For both licensing agencies, the emphasis is on pre-planning and training. We only know what to do in an emergency if we practice, practice, practice until training drives our actions, not fear.