This piece was first published in The Assembly.
Written by Kari Brosseau
parliament
For at least a decade, no list of top retirement destinations would be complete without Asheville, praised for its warm climate, proximity to natural wonders, and vibrant arts scene.
The retirement age population has rapidly increased in mountainous cities. The Asheville Watchdog reports that Buncombe County’s population grew by 3,400 people from 2020 to 2022, with people 65 and older accounting for 96%. The proportion of older adults in Western North Carolina is currently about 5 percentage points higher than the statewide average, according to data compiled by the state’s Department of Vital Statistics.
So when Hurricane Helen brought “biblical devastation” and widespread power outages to the area, some residents were particularly vulnerable. Researchers have repeatedly found that older adults are at increased risk of death during and after tropical cyclones. Deaths from Helen could reach into the thousands over the next few years, with about half of those deaths expected to occur among the elderly, according to an analysis of more than 500 such storms released this week.
Days after Helen struck, thousands of people in western North Carolina were still living in senior living facilities that remained disconnected from utility power and city water services, officials said. Residents of at least four facilities have been forced to evacuate since the storm. North Carolina has less stringent emergency response regulations for such facilities than other states frequently hit by extreme weather, and in recent years both the federal government and advocacy groups for the elderly and disabled have stepped up efforts to enforce North Carolina’s safety standards. It points out that there is a hole in the
Although the majority of older people in the mountain region live at home, approximately 17,000 are in facilities that provide specialized care. North Carolina Department of Health and Human Services Secretary Cody Kinsley said at a news conference Tuesday that there are 91 nursing homes and 121 assisted living facilities in areas hard hit by the storm.
Helene: County resources by Anna MacDonald
State law and federal regulations require nursing homes to have backup power supplies, but in North Carolina, assisted living facilities that typically house people with minor medical problems are not required to do so. .
State Rep. Julia C. Howard Credit: NC General Assembly
In 2019, state Rep. Julia Howard, the senior member of the House Republican majority, called for change after a power outage left residents of a nursing home in the foothills of the Blue Ridge without power for 12 1/2 hours in the frigid cold. that. According to her plan, the facility would need a generator to power not only the lighting and temperature control systems, but also “other essential services” such as pharmacy.
Howard’s proposed bill, HB 410, died in the Senate, even though it was watered down to only require further consideration of the issue. Opponents were bipartisan and centered on cost. Industry lobbyists told lawmakers the requirement would cost adult care facilities about $84 million, NC Health News reported.
Florida has required nursing homes to comply with similar measures since 2018. Maryland now requires similar measures for facilities with 50 or more residents, and other states, including Texas, are evaluating the issue as extreme weather events intensify.
Congress could not determine what percentage of assisted living facilities in Helen-hit areas had installed generators or had contracts to install them before the storm. Jeff Horton, executive director of the North Carolina Senior Living Association, and Frances Messer, president and CEO of the North Carolina Assisted Living Association, said many facilities are taking these steps voluntarily. He said there was. Messer said if a facility has backup power, it can earn merit points for state inspections.
Voluntary compliance rates are high in some areas of western North Carolina. All facilities with six or more residents in Alexander, Burke, Caldwell and Catawba counties have generators installed or readily available, said Tina Miller, director of the Area Agency on Aging for those counties. he said. Similar information was not immediately available from other Mountain County agencies, the state’s long-term care ombudsman, and DHHS spokespeople.
But Horton said some senior living facilities lack backup power. They tend to rely on public funds to pay for residents’ room and board and Medicaid to pay for personal care, he said.
“What we often see is providers whose income is primarily private (often $8,000 or more per month), who are able to charge much higher rates than publicly funded payments, and who are unable to purchase generators. We can afford it,” Horton wrote in an email.
He said some facilities that rely heavily on public funding have concluded they can’t afford the electrical connections needed for contracted generators or the lease agreements struck by major power companies. Horton said depending on the size of the facility, costs start from about $50,000 for just the connections to more than $200,000 for a complete installation. In addition to that, there are maintenance costs.
Before Helen arrived, state officials were in the process of revising emergency response rules for assisted living facilities. The proposed rule, which is open for public comment until Nov. 15, would require assisted living facilities to respond to weather events such as hurricanes, power outages to public facilities, and interruptions in telephone and communications communications. be specified in the emergency plan. internet. A 2020 investigation by the News & Observer found that assisted living facilities in eastern North Carolina often skirted the state’s disaster planning requirements, leaving local emergency managers feeling powerless to hold them accountable. It turned out that
Kay Paxoy Castillo, executive director of Friends of Long-Term Care Residents, said the group supports stronger standards.
Although nursing homes are required to have emergency power supplies, emergency preparedness is uneven. A 2020 audit by the U.S. Department of Health and Human Services inspector general found that North Carolina failed to ensure nursing homes met federal standards. We sampled 20 high-risk nursing homes and identified 124 instances of non-compliance with emergency preparedness requirements, including emergency power supplies. The four nursing homes did not properly conduct weekly maintenance checks, monthly performance inspections, or annual fuel quality inspections on generators, according to the report.
Kinsley and other emergency managers stressed this week that all senior living facilities affected by Helen have been contacted and are receiving assistance, including emergency water supplies.
A department spokesperson said Tuesday that patients have been evacuated from four facilities and DHHS is working with three other facilities to move patients based on medical necessity.
The ministry did not provide details. But some information is trickling out through social media posts and local news accounts.
About 50 people were moved from Rose Glen Manor to another facility in Mount Airy last Thursday due to rising waters in the Reddys River in North Wilkesboro, the Journal-Patriot reported. One of the buildings was less than 100 feet from the water.
On Tuesday, volunteer pilots evacuated about 100 elderly people, many with dementia, from Burnsville near Mount Mitchell, the Charlotte Observer reported. They came from Yancey House, Mitchell House and other nearby properties, the report said.
Navion Senior Solutions, which operates senior living facilities throughout the Southeast, frequently posts updates about local communities on Facebook, noting when power is restored at its facilities. By Wednesday evening, all but two properties had utility power. The exceptions were the Carolina Reserve in Hendersonville and the Carolina Reserve in Laurel Park, also in Hendersonville. Both were powered by generators.
Messer, of the North Carolina Assisted Living Association, said the biggest challenge facing facilities right now is staffing. “With many roads destroyed, the North Carolina National Guard and North Carolina Emergency Management Services are assisting with the delivery of food, medicine and supplies,” she said.
Kari Brosseau is a reporter for the Assembly. She joins us from The News & Observer where she was an investigative reporter. Her work has been recognized by the Online News Association and Investigative Reporters and Editors and published by ProPublica and the New York Times.
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