February 1999

Information Bulletin 99-1
NH-24

Guidelines For Facilities Impacted By Disasters

Following a disaster it is sometimes necessary to relocate nursing home residents. The following guidelines may be used by facilities to answer questions regarding expectations of the Minnesota Department of Human Services and the Minnesota Department of Health.

1. Facilities who are impacted by a disaster are urged to contact the Health Regulation Division as soon as possible. You may contact the Health Regulation Division in St. Paul at 651-201-4200, or contact a supervisor in a health department district office. At that time you will be provided with names, phone numbers and pager numbers of staff who will be your primary contacts at the Minnesota Department of Health. We encourage you to call us. The Department most likely will be trying to contact you to offer our assistance.

2. The first priority is to serve facility residents. Use common sense first, worry about regulations second.

3. When residents need to be relocated, it is the responsibility of the facility to secure appropriate placements. Please call the Health Regulation Division if you need help in locating vacant beds. It may be possible for the division to allow facilities to exceed licensed capacity in order to meet resident and community needs.

4. The facility who is moving the residents (the Sending Facility) should send the medical record, care plan, medicine and supplies along with the resident to the Receiving Facility. If the records and supplies are not available, due to the nature of the disaster, the Sending Facility must write a short profile of the resident and their needs as well as a list and dosage of medications.

5. The Sending Facility is not discharging the resident, the Receiving Facility is accepting the resident as a "temporary guest" of the Receiving Facility. This will be true for the first 30-60 days of the disaster. During this period of time, an assessment will be made as to the future viability of the Sending Facility. If it is determined that the Sending Facility will NOT be able to resume services, further instructions will be given by MDH and DHS.

6. The Receiving Facility is not required to perform usual admission procedures. An MDS assessment, case mix assessment and care plan do not have to be prepared. The Sending Facility does not have to write a discharge summary.

7. The Sending Facility will continue to bill for the services and will reimburse the Receiving Facility.

8. During a disaster, water supplies may be limited. Facilities may need to reduce bedside water, and regular bathing. Hydration and hygiene needs must be met, but usual procedures can be modified. Staffing resources are also constrained if the disaster is one that affects the community. Please do your best to keep staffing at appropriate levels. If staffing cannot be maintained, strong consideration must be made to transferring the residents to other facilities.

9. Health care facilities may be called upon by the community to provide support. This might include meals, water, shelter, etc. Feel free to do whatever you can to help, remembering that your primary responsibility is first to your residents, and then to others as staff and resources permit. We have, for instance, allowed facilities to temporarily (a week or so) house seniors from the community in facility day rooms. Please use your best common sense.