![]() It demonstrates a need for additional evidence to inform policies created to protect vulnerable NH residents in disasters. However, the response to Hurricanes Harvey and Irma in August and September of 2017 suggest a continuation of the trend toward long-term care evacuations that we first observed in the response to the Gulf storms a decade ago. Our prior examinations of nursing home (NH) resident outcomes after the Gulf hurricanes from 2005-08 showed that significant morbidity and mortality occurred in the months following the storms, and that those who were evacuated suffered greater morbidity and mortality compared to those who sheltered in place. A fundamental question in disasters is whether to evacuate residents or shelter in place. Older adults are especially vulnerable to harm during disasters because of their medical comorbidities, such as dementia, and functional impairments. Strategic Approach to Facilitating Evacuation by Health Assessment of Vulnerable Elderly in Nursing Home and Assisted Living Facilities (SAFE HAVEN II Study PROJECT SUMMARY/ABSTRACT Over 12,000 nur sing home residents and over 12,000 assisted living residents were evacuated from Texas and Florida facilities during Hurricanes Harvey and Irma. Other policy and practice implications, including the need for better and more uniform investigation processes and staff training, will be discussed. These results suggest that the compliant investigation process warrants further investigation. We also found a number of asymmetries in the allegation categories suggesting different processes by Centers for Medicare and Medicaid Services (CMS) region. More surprisingly, a fifth of complaints that were categorized as “immediate jeopardy” at intake did not result in any deficiency citations. Surprisingly, 28% of substantiated abuse and neglect allegations resulted in no deficiency citations. While two-thirds (N=239) of the substantiated complaints generated from 1 to 19 deficiency citations, nearly one third had no citations. Of the deficiency citations resulting from complaints in our sample, 27.9% were categorized as quality of care and 19.5% were in the category of resident behavior and facility practices, which includes abuse and neglect. ![]() Among the 369 substantiated single-allegation complaints, we found most were categorized as quality of care (31.7%), resident abuse (17.3%), or resident neglect (14.1%). Our data were drawn from federally collected NH complaint and inspection records. Because a complaint may contain multiple allegations, and the data do not identify which allegation(s) lead to a complaint’s substantiation, we identified all substantiated single allegation complaints for NHs in 2017. The purpose of this study is to understand the relationship between substantiated complaints and deficiency citations. Complaints that are substantiated often lead to an investigation and potentially a deficiency citation. Complaints provide important information to consumers about nursing homes (NHs).
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