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Sarah B. Laditka, PhD, James N. Laditka, DA, PhD, Sudha Xirasagar, PhD, MBBS, Carol B. Cornman, BS, PA, RN, Courtney B. Davis, MHA and Jane V.E. Richter, DrPH, RN, CHES

Sarah B. Laditka and Sudha Xirasagar are with the Department of Health Services Policy and Management, University of South Carolina, Columbia. James N. Laditka is with the Department of Epidemiology and Biostatistics, University of South Carolina, Columbia. Carol B. Cornman and Courtney B. Davis are with the Office for the Study of Aging, University of South Carolina, Columbia. Jane V.E. Richter is with the Center for Public Health Preparedness, University of South Carolina, Columbia.

Correspondence: Requests for reprints should be sent to Sarah B. Laditka, PhD, Department of Health Services Policy and Management, Arnold School of Public Health, University of South Carolina, 800 Sumter St, Columbia, SC 29208 (e-mail: sladitka{at}gwm.sc.edu).

Objectives. We examined nursing home preparedness needs by studying the experiences of nursing homes that sheltered evacuees from Hurricane Katrina.

Methods. Five weeks after Hurricane Katrina, and again 15 weeks later, we conducted interviews with administrators of 14 nursing homes that sheltered 458 evacuees in 4 states. Nine weeks after Katrina, we conducted site visits to 4 nursing homes and interviewed 4 administrators and 38 staff members. We used grounded theory analysis to identify major themes and thematic analysis to organize content.

Results. Although most sheltering facilities were well prepared for emergency triage and treatment, we identified some major preparedness shortcomings. Nursing homes were not included in community planning or recognized as community health care resources. Supplies and medications were inadequate, and there was insufficient communication and information about evacuees provided by evacuating nursing homes to sheltering nursing homes. Residents and staff had notable mental health–related needs after 5 months, and maintaining adequate staffing was a challenge.

Conclusions. Nursing homes should develop and practice procedures to shelter and provide long-term access to mental health services following a disaster. Nursing homes should be integrated into community disaster planning and be classified in an emergency priority category similar to hospitals.

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