Emergency Planning & Residential Care: Is Your Loved One’s Facility Prepared for Wildfire?

In October 2017, when the Tubbs Fire ravaged Sonoma County, nearly 100 residents of an assisted living facility were left to fend for themselves after staff fled the scene. The facility was destroyed. Had the residents not been evacuated by emergency responders and family members, they would have perished, the Department of Social Services investigation concluded.

The operators of Villa Capri in Santa Rosa later settled a lawsuit for $500,000. The complaint pointed to the owner-operator’s failure to “adequately plan for and train staff on emergency evacuations and preparedness… [and to] timely and adequately notify residents of the need for an emergency evacuation.”

These failures were not part of an isolated incident, but the disastrous consequences of inadequate or non-existent emergency planning procedures that are endemic to the residential care industry.

Aging Population & Fire Threat Leaves California Facilities Exposed

California is disproportionately at risk for two key reasons. The first is the sheer scale of the threat posed by wildfires. As of October 8th 2024, California has lost more than a million acres to wildfires – a staggering 29 times more than in 2023. In early August, CalFire reported that overall wildfire activity had surged by 2,816% from last year.

The second risk factor is demographics. California’s population is aging faster than the rest of the country, and demand for nursing homes and long-term residential care facilities is growing.

There are approximately 1,230 licensed long-term care nursing facilities in California, and – according to the Department of Social Services – around 7800 residential care facilities, including assisted living facilities.

While both types of facilities are responsible for the safety and well-being of their residents, they are regulated by different entities. Skilled nursing facilities employing medical professionals are licensed by the Department of Public Health and subject to greater federal oversight. Residential long term care communities that do not offer health care services are overseen by the Department of Social Services.

Between them, these types of facilities are responsible for around half a million vulnerable citizens. And that number is growing. By 2030, one-quarter of the population – around 11 million people – will be 65 or older. Many will require care and accommodations from assisted living facilities, nursing homes, or both.

Elder abuse advocates warn that this upward curve in demand is not being matched by an increase in emergency preparedness measures. Both types of facilities are bound by law to run fire drills and train their staff for emergencies, but enforcement is weak.

Villa Capri is a case in point. According to the DSS evaluation report, “most of the staff lacked the required emergency disaster training and/or disaster leader training.”

Wildfire poses a significant threat to an alarming number of facilities in state-designated fire zones.

A Harvard study published in the American Journal of Public Health in March 2023 looked at the proximity of more than 3,000 inpatient facilities and high fire threat zones. Researchers found that 95% of inpatient beds at hospitals, nursing homes, and mental health facilities are situated less than 3.7 miles of a high threat zone. Half of all beds were located within a mile of a high threat zone.

There is little evidence that high-risk facilities are better prepared for the worst. A 2023 evaluation of nearly 1200 Centers for Medicare & Medicaid Services-certified nursing homes found that facilities within 5km of wildfire risk areas were more deficient in emergency preparedness than those located further afield.

Most Nursing Homes are Ill-Equipped for Emergencies

In 2018, federal audits of 19 California nursing homes found that all of them failed to meet emergency preparedness standards. A 20th facility – Cypress Meadows – was among three nursing facilities in Paradise destroyed by wildfire shortly after the audit, and was therefore excluded from the final report.

The Office of Inspector General (OIG) stated in the report that:

“The identified deficiencies occurred because the nursing homes lacked adequate management oversight and had high staff turnover. In addition, California did not adequately follow up on deficiencies previously cited… or have a standard life safety training program for all nursing home staff.”

The report recommended that the California Department of Public Health conduct more inspections, provide training to facilities, and increase regulatory oversight.  

Know Your Rights – and the Right Questions to Ask

Knowing your rights and being ‘the squeaky wheel’ when your loved one moves to a nursing home or assisted living facility will help you improve your chances when an emergency strikes.

If you’re considering moving your loved one into a facility, find out whether it’s in a fire zone and what the threat level is. Research complaints, violations, and inspection histories to learn more about their track record. Ask questions about their evacuation plans and the results of any emergency preparedness inspections:

• What is the emergency evacuation plan?
• Is the plan posted prominently in the facility and on the website?
• Are new staff members trained for the plan?
• Does the facility have buses or other evacuation vehicles on-site?
• How frequent are emergency drills?
• Does the facility have trained designated ‘disaster leaders’?
• How can loved ones contact them in the event of an evacuation?
• How will the facility generate power in an emergency?
• In the event of a power outage, what is the plan for maintaining safe temperatures for residents, equipment, and medication, and protecting oxygen and life support systems?

Holding Corporate Overseers to Account for Inadequate Emergency PlanningTaken separately, emergency preparedness and a rapidly aging population are key concerns for California in the decades ahead. Together, they’re a perfect storm.

Climate experts tend to agree that the severity and frequency of wildfires are expected to increase over the 21st century. Adapting to changing environmental risks is always more complex for vulnerable individuals — especially in groups with wide-ranging medical and functional needs, such as those in nursing homes. Ensuring that facilities are prepared to respond to such risks is crucial to the future safety of their residents.

A robust emergency response plan (or lack thereof) can tell you a lot about the core competencies of a facility, and how it is likely to respond in non-emergency situations. Those facilities that are well-run and prioritize resident safety and well-being above profit are likely to have better emergency response and evacuation plans.

Unfortunately, too many owner-operators are shielded from the consequences of their actions, limiting their liability with complicated corporate structures that allow them to absorb fines and settlements as a cost of doing business. For them, wildfires and other emergencies are just data points on a spreadsheet, That’s why it’s so important to take them on and hit them in the only place it hurts their wallet.

Seeking Legal Advice from an Elder Abuse Attorney

If you are considering legal action related to elder abuse in California, consult an attorney who specializes in elder abuse in nursing homes and assisted living facilities. They can help you understand your rights and options.