Power and water outages across Texas have spawned a fresh crisis for long-term-care facilities still reeling from COVID and underscored longstanding weaknesses in these facilities’ emergency planning.
As a winter storm caused blackouts throughout the state, many nursing homes and assisted-living facilities had no running water and no backup generators on hand to help protect residents from frigid temperatures. In Burnet County, one nursing home had just a few portable heaters to warm dozens of residents because its backup power couldn’t operate its heating system, while an assisted-living facility with 32 residents had no backup generator and no heaters, according to a report published Thursday by the Texas Division of Emergency Management.
After a year spent in a perpetual struggle to survive the pandemic, residents have faced cascading emergencies. At Parmer Woods at North Austin, an assisted-living facility in Austin, the power went out Monday morning, and there was no backup generator on site, says Justin Wray, senior vice president of operations at Pegasus Senior Living, which operates the facility. To keep the roughly 50 residents warm, “we bundled them up a little bit more” and served hot coffee and tea, he says. Due to poor road conditions, the company couldn’t get a generator delivered until Tuesday evening, he says. Then, on Wednesday, the water was shut off, so the facility had to resort to “creative measures,” like melting snow to fill toilet tanks, Wray says. The water was still off and power was intermittent on Thursday. “Like many folks in Texas,” he says, “we’re at the mercy of the grid coming back online.”
More than 400 Texas facilities had reported weather-related emergencies to the state as of Wednesday evening, according to the Texas Health and Human Services Commission, and 100 had relocated or evacuated residents.
The situation should not have grown so dire, resident advocates say. “Once again, facilities have been caught off-guard, not just by the pandemic but by this natural disaster,” says Brian Lee, executive director of Families for Better Care. “The emergency management and preparation for long-term-care facilities is still fractured and is failing to protect residents from inclement weather.”
The U.S. Department of Health and Human Services inspector general warned just a year ago about holes in Texas nursing homes’ emergency plans. In inspections of 20 nursing homes in the state, the inspector general found that 18 had life-safety and emergency-preparedness violations that put residents “at increased risk of injury or death” during an emergency, including issues relating to emergency water supplies and backup power.
Power failures and other fallout from natural disasters often prove deadly for nursing-home residents. There were more than 430 excess deaths of Florida nursing-home residents linked to Hurricane Irma in 2017, according to a 2020 study by researchers at Brown University and the University of South Florida, including some who died in the sweltering temperatures after the storm knocked out their facility’s air conditioning. In 2018, Florida passed a law requiring all facilities to have generators.
It’s time for Texas and other states to consider similar requirements, says Patty Ducayet, Texas long-term-care ombudsman. All long-term-care facilities should be required to have generators capable of powering their HVAC systems, she says.
At Kingsland Hills Care Center in Kingsland, Texas, the facility’s backup power didn’t operate its heating system and 48 patients were relying on three portable heaters this week, according to the Texas Division of Emergency Management report. Residents were moved to the warmest areas of the building and given extra clothing, blankets and warm drinks, says Chris Slimmer, president of facility operator Summit LTC Management. The facility made evacuation plans but ultimately determined that staying put “was a safer option than the risk of transporting our residents on icy and dangerous roads,” he said. “After a herculean effort we were able to source a generator” capable of powering the HVAC system, which was installed Tuesday evening, Slimmer said. “We are planning to purchase one or two portable generators to reduce future reliance on renting from a third party.”
In the midst of an emergency, connecting nursing homes and other facilities that don’t already have generators with backup power supplies “is not as simple as going to Lowe’s or Home Depot and plugging in an extension cord and getting power,” Nim Kidd, chief of the Texas Division of Emergency Management, said at a Thursday press conference. “So we will continue to work with those facilities that did not prepare ahead of this storm to have the transfer switches installed, to have the right connections and the right cables in place.”
For now, many other facilities are leaning on residents’ family members for help or crowdsourcing emergency supplies. “We’ve had family members bringing five-gallon buckets of water from their pool over,” says Wray of Pegasus, which on Thursday had four Texas facilities without water. To protect residents of Focused Care at Fort Stockton, a nursing home in Fort Stockton, Texas, local businesses and community members donated a new generator, space heaters and blankets after the facility’s generator blew a fuse early Monday morning, says Rebecca Reid, a spokeswoman for facility operator Focused Post Acute Care Partners.
About 30 Texas long-term-care facilities have sought help this week from CrowdSource Rescue, a Houston-based nonprofit that connects people in need with volunteers as well as professional first responders, says Matthew Marchetti, the organization’s co-founder. By Thursday, he reports, the organization had been able to help six facilities secure generators, food and water.