The pressures on the senior living sector only abated marginally in 2023, as operators tried to maintain their balance in a precarious business and economic environment. And any significant reversal in fortunes is unlikely to occur until 2025, as political volatility in 2024 will continue to influence the regulatory and interest rate environment.

Managing against countervailing forces has been an ongoing struggle that’s not going to ease much in the new year.

There’s good news, for example, in that senior living occupancy rates are coming back from the pandemic’s devastation. And in nursing homes, occupancy reached 82.3% in August, topping 82% for the first time since April 2020. Regardless of setting, however, providing adequate resident care is a challenge given severe staff shortages amidst the worst job losses of any healthcare sector.

And although cooling inflation is a positive, it’s still running above the Federal Reserve’s 2% target and has not yet resulted in relief on costs. Interest rates are stubbornly high, and operators should be worried about the impact on the cost of long-term debt coming due, not to mention revolving credit lines.

Plus, unlike other sectors, parts of the industry can’t just offset inflationary costs by raising its fees — assisted living operators that rely heavily on Medicaid, for instance, and nursing homes, most of which depend on Medicare and Medicaid reimbursements, which are based on data two years behind and not adjusted for inflation.

Managing the risks is do-able, if difficult. One area where senior living and care organizations can help themselves in 2024 is by staying open to and leveraging risk mitigation and transfer strategies and solutions.

Meeting the staffing challenge

In early 2023, more than 70% of assisted living communities and 80% of nursing homes reported staffing shortages, and for some operators, the situation only has gotten worse as the year progressed. Providers have been forced to ask current staff members to work overtime or additional shifts, depend on temporary agency staff, or limit new move-ins.

Minimum staffing requirements proposed for nursing homes by the Centers for Medicare & Medicaid Services may further sap the industry given associated costs of some $6.8 billion, according to one study. And the effects of that proposal, if it is implemented, will be felt by assisted living operators and others.

The pace at which the population is aging and pressuring the system suggests that better pay alone is not the answer. Still, many are watching California to see whether its new $25 minimum wage for healthcare workers moves the needle.

Equally important may be balancing out a tough working environment by providing a quality employee experience built around individualized benefits. By offering benefits that respond to where people are in their personal and professional lives, employers can make their work environments stand out.

More than just health benefits, this means those benefits that simplify and improve employees’ lives or help them save money, including auto, home or renters’ insurance. Or that improve their lives, like mental health services or emergency backup services. Or even other benefits that might demonstrate the value that is placed on employees, such as recognition and motivation programs. Such benefits may be no or low-cost but can yield big returns for the investment.

Two coverages to transfer hard and soft risks

The healthcare industry continues to be a top target for cyber intrusions, and the senior living and care sector is just as vulnerable as the big hospital systems. The good news overall is that the number of healthcare data breaches dropped 15% through 2023’s first half. The bad news, though: a new record of 40 million individuals were affected.

The issue is not going away in 2024, and senior living and care providers should take heed. Cyber breaches often stem from human error, which is more likely to occur with the pressures of staff shortages. Plus, most communities and facilities are underinsured for the risk, with policies that leave big exposures. When cash-strapped, they’re not likely to want to think about better coverage against the risk, even with more moderate rate increases of about 10% ahead. That should make improved digital security controls an imperative.

A softer risk, but one that’s no less costly, is workplace violence, and particularly active shooter incidents. These incidents have occurred this year in senior living and care facilities from California to Texas to Florida, involving family members, workers and outsiders. It makes the case for workplace violence coverage, which is a relatively inexpensive business interruption protection.

The Mother Nature effect

A continuing concern for every business sector, including senior living, has been the pressured market environment for property insurance. Building valuations still are escalating on top of pure rate changes.

Blame Mother Nature, and not just for the cost of hurricanes, winds and storms, particularly in coastal areas. Add in scorching heat, which stands to cost the United States $100 billion in lost productivity, even as it causes mortality and disrupts business continuity.

Looking ahead, communities and facilities in more vulnerable regions can expect double-digit rate increases, whereas those less exposed will see rates stay flat.

Moving into 2024…

Now is the ideal time for senior living and care management to enlist its brokerage partners to undertake a thorough assessment of how much risk they are comfortable with and the cost of transferring that risk. That should lead to a better understanding of whether it would make financial sense to put alternative risk structures in place.

When there’s a financial squeeze from the perspective of cash flow, profitability and insurance cost, it’s time to reassess how if dollars spent on insurance are rendering the most profitable outcome. Now is the time to be asking those questions, because status quo no longer works.

Gerald Stoll is the US senior care segment leader with global insurance brokerage Hub International. He specializes in developing comprehensive insurance and risk management solutions for the long-term care industry, including independent living, assisted living, nursing homes, clinics and urgent care centers.

Jordan Parnell is the healthcare practice group leader for Hub International’s Gulf South Region. The practice group consults, designs risk management programs and brokers insurance transactions. He also is involved in the national healthcare team that brokers complex multi-state and international healthcare transactions.

The opinions expressed in each McKnight’s Senior Living marketplace column are those of the author and are not necessarily those of McKnight’s Senior Living.

Have a column idea? See our submission guidelines here.

Senior living properties, including those providing assisted living services and memory care support, are being integrated into the greater community all around the nation. No longer are senior living communities confined to the outskirts of town; they now are being developed in local neighborhoods, downtown urban areas and even on college campuses, such as an innovative project on the campus of Arizona State University known as Mirabella at ASU.

Regardless of where those communities are located, senior living providers are compelled to develop plans for emergencies and disasters that can affect their operations. The development of an “all hazards” emergency management plan will help you identify the wide variety of threats and perils that you must be prepared to manage.

One threat that every senior living community, as well as every type of occupancy, must prepare for is the presence of an armed intruder or active shooter on campus. Whether the cause is civil unrest — including violent protests, criminal activity, domestic violence or armed robbery — or a mass shooting, there are ways that senior living communities can prepare, respond and recover from the unthinkable.

Unlike other occupations where, for the most part, individual employees simply can focus on their own personal safety in the workplace, the senior living environment clearly is different. Members of the workforce in senior living communities become connected with residents and, in times of peril, will not leave them to fend for themselves.

Security experts have developed protocols that focus on the nuances of the senior living “careforce.” Those simple protocols provide practical solutions and the options that can be considered, including a life-saving strategy known as the Four Outs, to effectively respond to fast-moving and unpredictable incidents.

Senior living communities are uncommon in the way they must approach preparedness for an armed intruder or active shooter. In most industries with an adult workforce, workers are trained in survival techniques based on “me focusing on me”; in other words, each adult takes care of himself or herself. In senior living, much like elementary schools, workers not only have themselves to worry about; they also have to worry about others who can’t take care of themselves and rely on them.

The Four Outs is a program that addresses this factor as it applies to senior living communities. Often compared to the Run-Hide-Fight protocol promoted by the US Department of Homeland Security, the Four Outs was developed by the team at Sorensen, Wilder & Associates as a program based on practical choices for those situations when one has to think about more than just himself or herself. The Four Outs must be applied with both the resident and the caregiver or other staff members in mind.

Broken down, the key elements of the Four Outs are as follows:

1. Get out. Move residents and staff members out of and away from the building to a designated reunification point. Remember, the Occupational Safety and Health Administration, as well as licensure regulations, require a senior living community’s emergency evacuation plan to identify a designated reunification point(s) and provide for an immediate accountability of all employees and residents during an emergency evacuation.
2. Hide out. When getting out isn’t possible, then Plan B is to hide out. Seclude yourself in a room, preferably with a locked door, where you can hide without being seen or heard. This includes taking steps such as covering interior windows and turning out lights.
3. Keep out. Not all rooms have locks on the doors, and in some cases, locks even may be prohibited by regulatory standards. In those cases, such as in a resident’s room in a memory care unit where the door does not lock, you will have to create your own barriers. Doing so may include barricading the room’s door with a resident’s bed (remember to lock the wheels) as well as other furniture in the room. The more material barricading the door, the better. In other areas, you can use anything and everything available to create a wall of obstruction, such as in front of hallway smoke doors. Those temporary barricades are not intended to prevent the door from being opened (many swing in opposite directions). Rather, they are intended to create such an obstruction that the offender, who is looking for targets of opportunity, will choose to move on rather than set down his weapon and waste time trying to move all of the obstructions. 
4. Take out. As a last resort, and only as a last resort, you may have to fight back. This fight against the offender is truly a fight for your life. There are no rules; there is no “fair fight,” and your focus is on your survival by stopping the offender by incapacitating him or her. Use any weapon of opportunity available — such as scissors, a stethoscope, a fire extinguisher, a chair or a trouser belt — and be prepared to do whatever you must do to stop the offender and save yourself, up to and including the use of lethal force.

When someone is in a position of relative safety, as quickly as possible, the authorities should be called through the 911 system. A concept taught by the team at SWA and other security professionals is that there is no such thing as too many calls to 911 during those types of violent and fast-moving emergencies.

Additionally, many jurisdictions now have 911 texting capabilities, so emergency text messages, instead of voice communications, can be sent to the 911 center when hiding out. It is important to know whether this service is available in the jurisdiction where your senior living community is located. Once you have confirmed whether this option exists in your area, all members of your team should be trained on proper 911 procedures, including text messaging, if available.

The program developed by SWA also focuses on making the most difficult decision that may need to be considered in times of peril: whether to focus on yourself or your residents.

Identified as the Safety Transition Adjustment Formula, or STAF, protocol, caregivers are trained in what to look for in the initial moments of an event, to guide themselves to making the right decision based on personal and resident safety.

When a shot is heard, the normal (and expected) reaction is anxiety. That is understandable. But when that moment occurs, your first question needs to be, “Where am I in relationship to where the shot came from?”

If you are close to the shooter, then your personal safety comes first. If the shooter is a distance away from you — perhaps on a different floor or in a different building — then you can then focus on resident safety first, using the Four Outs to evacuate residents or secure them in place.

And remember, when the best option is placing yourself first, you aren’t being a coward or being selfish. If something happens to you, who will take care of residents and others?

The recovery aspect of a shooting incident often is the part of the preparedness continuum that is overlooked, considering that no organization or individual thinks that such an event really will happen to them. But if you are willing to accept the fact that an incident involving an armed intruder or active shooter really can occur at your senior living community, then you also must realize that when the initial incident ends, you must initiate the recovery process to eventually return to a state of normalcy.

For those who have experienced the unthinkable, they know that this is not as easy as it sounds. The recovery process must be addressed long before the first shot ever is fired. It requires the development of relationships with outside providers who likely will be needed to provide support after the incident. This support includes the restoration resources that may be needed to address physical damage to the community, as well as the emotional support that will be needed from mental health professionals to address the psychological trauma associated with this type of adverse incident.

Training, both in the didactic mode and the practical skills mode, are essential elements of an effective armed intruder / active shooter awareness program in a senior living community.

Although both authors of this article are strong supporters and allies of law enforcement, relying on your local police department or sheriff’s office for training may not give you the results you need. Law enforcement training focuses on law enforcement’s response to the threat. Your community’s training must focus on how to minimize casualties and maximize survivability from the moment the first shot is fired until the time police arrive on the scene. To do this, your community’s training should be provided by a qualified person who is intimately familiar with the senior living environment and the unique challenges you face.

The thought of an armed intruder or active shooter in a senior living community is difficult to imagine. Providers, however, must prepare their staff members for the unexpected by empowering them with the knowledge needed to exercise one of the Four Outs or take other appropriate action to protect themselves and those in their care should this type of emergency occur.

Stan Szpytek is the president of Fire and Life Safety Inc., a national consulting firm based in Mesa, AZ. He is a consultant for the American Assisted Living Association and is the life safety/disaster planning consultant for the Arizona Health Care Association, the California Association of Health Facilities and the Utah Health Care Association. Szpytek is a former deputy fire chief and fire marshal, with more than 40 years of experience in life safety compliance and emergency preparedness. For more information, visit www.FLSafety.org or e-mail Szpytek at Stan@FLSafety.org.

Steve Wilder is president and CEO of Sorensen, Wilder & Associates, a nationally recognized healthcare safety/security consulting group based in Bradley, IL. Since 2014, SWA has been the recognized leader in active shooter preparedness in the senior living and care industry. A retired fire chief in the suburbs of Chicago, Wilder was the 2019 recipient of the Leadership in Emergency Preparedness Award from the Illinois Security Professionals Association, for his leadership role following the murder of two residents in an assisted living community in Pennsylvania. For more information, visit www.swa4safety.com or contact Wilder at swilder@swa4safety.com.

The opinions expressed in each McKnight’s Senior Living guest column are those of the author and are not necessarily those of McKnight’s Senior Living.

Have a column idea? See our submission guidelines here.

The senior living sector, prone to unpredictable crises, requires adept crisis communication experts who can transform panic into poise while safeguarding the trust that older adults and their families place in those communities.

Much like life itself, senior living is a tapestry woven with unpredictability. From natural disasters and power outages to issues such as wandering residents and disgruntled employees, crises can emerge from unexpected corners, leaving operators grappling for stability. A well-crafted crisis communication plan becomes essential when a situation escalates.

Even the most unforeseen circumstances can be managed when guided by a crisis communications expert. They bring the ability to assess the situation objectively while safeguarding the brand reputation that older adults and their families rely on.

Delegation of duties to a well-prepared team is the bedrock of effective crisis communication. Each member knows his or her role, from disseminating information to internal stakeholders to liaising with media outlets. This thorough process ensures a unified front and consistent messaging, an imperative in times of uncertainty. A comprehensive strategy outlines the steps to respond to the crisis. This strategy encompasses the immediate actions and the roadmap to recovery. What needs to be temporarily shut down, such as digital ads or social media posts, and when can operations be resumed? Having a clear plan minimizes confusion and instills confidence.

In addition, written pieces may be needed, such as press statements, announcement letters, talking points or social media posts.

The crisis communication expert becomes the compass that steers the ship through tumultuous waters. This person evaluates the situation, determines the appropriate messaging and guides the operator’s actions while aligning them with the brand’s core values.

A crisis can be a catalyst for transformation, an opportunity to showcase the resilience of the senior living community and its dedication to the well-being of its residents. By communicating openly, transparently and empathetically, operators actually can improve their brand’s reputation, building stronger relationships with both current and potential residents.

Having witnessed the effects of effective crisis communication firsthand, a seasoned crisis public relations expert is an essential asset for any senior living operator. This person is the shield against misinformation and panic and the strategic mind that crafts a path toward stability. With the guidance this person provides, operators can move beyond survival mode and embrace a proactive approach to crises. A senior living community that can weather the storm with grace earns not only the trust of its residents and their families but also the respect of the industry at large.

Senior living is a realm that thrives on trust and connection. As a sector that faces its fair share of unexpected challenges, the importance of having a crisis communication plan cannot be overstated. With the right expert, operators can navigate crises while enhancing their reputation and solidifying the trust they’ve worked hard to build. From panic to poise, crisis communication isn’t just a strategy — it’s a testament to senior living communities’ resilience and commitment to the well-being of those they serve.

Blair Burney is communications director for Craft & Communicate, a digital marketing and public relations senior living agency.

The opinions expressed in each McKnight’s Senior Living guest column are those of the author and are not necessarily those of McKnight’s Senior Living.

Have a column idea? See our submission guidelines here.

Every scenario in senior living potentially could become a crisis situation. The key to surviving is a solid crisis communication plan, according to a communications expert.

“There’s risk in everything we do as senior living providers and communities,” Christopher Ruth, senior director of public relations for the nonprofit, faith-based social service organization Buckner International, headquartered in Dallas. “Anything can escalate if not properly tended to.”

Ignoring warnings or complaints from residents or employees can gradually snowball, Ruth said. Crisis communication is preparation and response, but also thinking about how to avoid getting into a crisis.

The three types of crises, he said, are immediate, emerging and sustained.

Ruth likened an immediate crisis to a tornado — it can come out of nowhere — whereas emerging crises involve issues that are brewing and provide warning signs that a situation could escalate.

Sustained crises, he said, are situations in which providers “shoot themselves in the foot” through continued negativity due to a situation being poorly handled from the beginning. In those cases, Ruth said, the news cycle may latch onto a crisis and perpetuate public attention to it even though the organizations may have moved past it.

Preparation is key

The key to avoiding a crisis, Ruth said, is preparation by having a crisis communications plan. That means less reacting to “fires” and more effort in risk management and crisis management.

“Take the time to really try and predict your problems, anticipate your threats and minimize those risks,” he said. “You can do that through an environment scanning of your organization.”

Among the potential scenarios that could escalate into a crisis are resident falls, abuse situations and even severe weather events. Although they are unpredictable, Ruth said, once an organization identifies scenarios, it can create potential responses and put processes in place to act quickly.

“The goal of all crises is to restore or maintain trust with your stakeholders,” he said, adding that senior living providers need to understand that employees are their No. 1 stakeholder. “From there, your objectives are to respond in a timely manner, demonstrate we care [and] continue that restoration of trust.”

Organizations that have survived a crisis are the ones who take responsibility for addressing it, respond immediately, and apologize and empathize without admitting fault, Ruth said. 

“Look at demonstrations of care, and walk the walk,” he said. “That honesty, that transparency, it resonates; it’s genuine. You cannot fake that.”

To create a crisis plan, Ruth suggested that organizations summarize their emergency plans. Plans should include a chain of command and an outline for when to activate the crisis communication plan.

“Any crisis is a business problem before it’s a communications problem,” he said, adding that a need exists to jump into action as an organization.

Ruth credited several sources for many of the crisis communications concepts and theories he discussed, including Helio Fred Garcia’s “The Agony of Decision,” Steven Fink’s “Crisis Management,” James Lukaszewski’s “Why Should the Boss Listen to You?” and Tony Jacques’ “Crisis Counsel.”

“These plans require investment in a mental health workforce that has capacity and flexibility to respond during disasters,” the authors wrote.

The “special communication,” published Wednesday, seeks to help guide implementation of the National Academy of Medicine’s National Plan for Health Workforce Well-Being, released in 2022, by sharing information about programs begun at the Columbia University Irving Medical Center and the University of California, San Francisco, using lessons learned from the pandemic. Neither university previously had integrated mental health or workforce well-being into disaster planning, leaving them unprepared for the impact and duration of the COVID-19 public health emergency, according to the JAMA Psychiatry article.

Structural changes are needed to promote worker well-being, the authors said, adding that paying attention to staff member needs “creates workplace environments that either mitigate or exacerbate the inherently stressful jobs involved in caring for ill patients.”

The COVID-19 pandemic brought increasing public awareness to caregivers’ mental health, they noted, but even before that, “anxiety, burnout, depression, stress and suicide were increasingly recognized as a growing crisis in the healthcare workforce.”

Compassionate leadership is needed in creating a positive culture, the authors said.

“We believe that leaders should be evaluated by their ability to prioritize well-being and mental health, in addition to productivity,” they wrote.

Most importantly, according to the authors, employers must take steps to destigmatize mental health support and treatment. 

“We recommend that institutions launch mental health destigmatization campaigns to encourage all staff to seek treatment when needed, connected with scalable low- resource interventions,” they wrote.

Financial resources at the local, regional and national levels are needed to implement the National Academy of Medicine’s recommendations to support healthcare workers, the authors said.

Planning for a future crisis must start now, they said.

One senior living provider is taking steps to safeguard employees’ mental health. Benchmark Senior Living, which operates continuing care retirement communities and skilled nursing facilities throughout the Northeast, has announced a partnership with Spring Health, a virtual mental health service, to provide personalized care, dedicated support, confidential therapy, medication management and family care to all of its employees and their dependents.

“Benchmark supports mental health parity or any measure that improves access to quality mental health services to individuals and families,” said Tom Grape, CEO of the Waltham, MA-based company. “The healthcare sector has witnessed the dramatic and painful impact the pandemic has had on our dedicated and compassionate caregivers. While COVID did not create this problem, it certainly illuminated a longstanding and growing concern. As a society, we must seize this moment and effect change for the long-term.”

“The quality of our mental health impacts many aspects of our lives, from our relationships with family and friends to our physical well-being. As such, supporting our workers and their families is the right thing,” said Grape. He added that his company is committed to building awareness of mental health, using company newsletters, videos, group discussions and other channels to create awareness.

Public health experts recently shared several recommendations for employers as well as federal, state and local agencies to protect workers should another public health emergency occur.

“The lessons from the failure to protect workers during the COVID-19 pandemic can be helpful as the nation anticipates and prepares for the next public health emergency,” David Michaels, PhD, MPH, and Lillian Ryan from the Milken Institute School of Public Health at George Washington University, and Gregory R. Wagner, MD, from the Harvard T.H. Chan School of Public Health, wrote in an opinion piece in JAMA.

Their advice:

1. Prevent potentially infectious people from entering the workplace. To help meet that goal, the authors said, federal law should require paid medical leave “to keep sick workers at home, avoiding disease spread to other workers as well as patients and customers.”
2. Use engineering controls to improve ventilation, filtration and disinfection to reduce the presence of the airborne virus. Social distancing and personal protective equipment also are useful, they said, “after the other steps are applied but there is still residual risk.”
3. Strengthen worker protection efforts. The Occupational Safety and Health Administration, the authors said, “must have resources to conduct more inspections and issue penalties with a greater deterrence value.”
4. Be prepared to respond quickly to a national emergency. The authors recommend that OSHA issue a pandemic-preparedness standard that “requires employers to anticipate and prepare for emerging threats.”
5. Improve workplace air quality now by upgrading existing ventilation systems or using stationary filtration devices to clean indoor air.
6. Strengthen the overall workplace protection infrastructure beyond OSHA. State and local public health authorities must communicate, and the federal government should “stockpile respirators, develop a system to distribute them, and tell employers, workers, and the public when and how to use them.”

Read the opinion piece here.

Read more COVID-19-related articles here.

State and local codes primarily regulate senior living communities that provide assisted living, memory care and independent living options. To achieve optimal safety conditions, several fire protection and life safety systems are integrated into such properties.

Although a great deal of oversight is in place to help ensure the reliability of fire protection systems, there are times when mechanical and electrical systems are vulnerable. For example, fire protection systems such as wet sprinkler systems can be exposed to environmental conditions, including freezing temperatures, that can impair operation. When frozen pipes thaw, they typically break, rendering a critical fire protection and life safety system inoperable.

A devastating fire in a Tennessee assisted living community in late 2022 ignited while a fire watch was in place in the building, due to unexpected frigid temperatures. Those temperatures caused the fire sprinkler system to freeze and placed it out of service until repairs could be initiated. The facility initiated a fire watch while the system was impaired, but a fast-moving fire occurred during the period of time that the fire sprinkler system was inoperable, and a resident died.

A fire watch procedure is designed to monitor a building for smoke and fire conditions when fire protection systems are compromised, but it was not enough to prevent a tragic loss in this particular situation.

Senior living communities should train staff members to understand the significance of fire protection systems and the vulnerabilities that exist when they are out of service. Informed decisions need to be made when a system goes out of service to determine if a Fire Watch is appropriate or if a building should be evacuated when fire protection systems are compromised.  When one of these critical systems goes down due to a mechanical or electrical malfunction, facilities should activate their emergency operations plan and establish an incident management team to effectively manage the situation just like any other emergency incident or disaster.

In addition to fire protection systems such as fire sprinkler and fire alarm systems, there are other safety systems integrated into the built-environment designed to safeguard residents, and those systems rely on technology and electrical power. When those systems are compromised, life safety can be at risk.

Many senior living communities that provide assisted living and memory support services are equipped with sophisticated electronic safety systems, including door alarms, wander management solutions and delayed egress locks. Those systems are designed to keep residents safe and secure under normal conditions, as well as to provide them with an unimpeded path out of the building when evacuation is required during an emergency.

There are times when these systems are compromised, representing a significant life safety vulnerability. For example, when the building’s fire alarm system activates, or a power failure occurs, some of those systems are designed to disengage to allow safe egress during an emergency. Fire drills as well as scheduled and unscheduled power disruptions can disengage some of these systems as well. 

Once again, it is essential to train senior living staff members to understand the security and elopement risks that exist when those systems are disengaged either during a real-world emergency or drill. Appropriate measures need to be in place to reset or re-arm those critical systems as quickly and efficiently as possible, to reduce the risk of elopement or unauthorized entry into a facility.  

Fire and life safety compliance does not happen by accident in a senior living community. Ensuring a safe and secure environment of care requires the integration of fire protection and life safety systems into the built environment. All staff members should be trained on a regular basis to be aware of the consequences when fire protection or life safety systems are compromised to help them understand what measures are needed to restore those systems in the quickest possible manner and reduce the potential for an adverse incident.

Stan Szpytek is the president of the national consulting firm Fire and Life Safety Inc., based in Mesa, AZ. He is a consultant for the American Assisted Living Association and is the life safety/disaster planning consultant for the Arizona Health Care Association, the California Association of Health Facilities and the Utah Health Care Association. Szpytek is a former deputy fire chief and fire marshal with more than 40 years of experience in life safety compliance and emergency preparedness. For more information, visit www.FLSafety.org or e-mail Szpytek at Stan@FLSafety.org.

Enhancing relationships with senior living providers is one of four recommendations proposed by a federal committee advising the US Department of Health and Human Services on disaster preparedness and older adults.

The National Advisory Committee on Seniors and Disasters released its first set of recommendations ahead of a public meeting on them scheduled for Thursday.

The new NACSD report focuses on building disaster resilience among older adults through an evaluation of the preparedness, response and recovery needs of older adults living in assisted living and memory care communities as well as in skilled nursing facilities and independently in the greater community. The recommendations focus on improving community readiness, infrastructure and behavioral health in assisted living and other settings and cover communication, community partner training, centers of excellence for older adults, and the expansion of the long-term care ombudsman program.

The need to protect the health of a growing population of older adults during disasters grew following adverse physical and mental health outcomes experienced during the COVID-19 pandemic, according to the committee.

Effective communication ‘vital’

Among the communication recommendations are to enhance relationships with independent living, assisted living and memory care communities as well as other aging-related organizations; update national emergency management websites; identify disasters and public health risk communication best practices and messaging for reaching older adults; and develop guidance for state and local governments. 

“Effective communication to the public, including those with access and functional needs, and among preparedness and response organizations, is vital to ensuring that information and opportunities reach older adults and their caregivers before, during and after an emergency,” the report reads.

Partner expansion supported

The committee said it supports sustainable funding for programs addressing training for traditional and other partners, including safety services and volunteer organizations, as well as advocacy groups, businesses and other community groups that contribute to disaster preparedness, response and recovery.

Recommendations include increasing the access that long-term care providers have to community-based preparedness information, and disaster training and exercise lists. HHS also should provide guidance in creating a Presidential Disaster rEadiness Program that includes older adults, the committee said, adding that such a program would improve outcomes for disaster capacity and capabilities.

Collaborative models of care called for

The committee additionally recommends that HHS establish Disaster Care Centers of Excellence for Older Adults as a model for regional collaboration, virtual support and specialized guidance. With funding and guidance from HHS, the centers would support national, regional and local entities with real-time guidance. The DCoEOA would take proactive steps to assess gaps, mitigate risks and build capacity to provide disaster care for older adults.

The committee recommends that, under the centers, HHS develop technical guidance to promote disaster readiness for older adults, families and caregivers, and offer disaster leadership training for the direct care workforce. The recommendations also include standardized curricula for disaster responders and health professionals, with a specific focus on the needs of older adults across all settings, inducing trauma-informed care approaches and disaster behavioral health training.

Ombudsman expansion recommended

The committee also recommends redefining the long-term care ombudsman office to include resident and system advocacy related to disaster preparedness, response and recovery — including dedicated funding for permanent positions to support those functions.

During the pandemic, the committee said, ombudsmen in some states encountered barriers in accessing long-term care communities, which reduced their effectiveness as advocates for older adults.