As temperatures surge, nursing home operators face the complex task of ensuring the safety of their residents while also maintaining seamless business operations during scorching heat waves.
With the nursing home population being particularly vulnerable to extreme heat, the industry is pressed to develop and implement effective strategies to protect residents and keep their facilities running smoothly.
Kristen Knapp, senior director of strategy and communications at the Florida Health Care Association (FHCA), emphasized the foundational importance of well-defined policies and procedures geared towards managing hyperthermia – both in the context of extreme heat and cold.
But Knapp also said that although CMS places a premium on these strategies to ensure resident safety and uninterrupted operations, some situations that put residents at risk require creative solutions.
“You’re going to have residents who might smoke, who might like to go outside,” she said. So you have to accommodate and account for that. So, in situations when it’s excessively hot, maybe you lose an outside smoking area. Maybe you move that to somewhere where it’s more shaded in the summertime, maybe you encouraging them to wear that sunscreen, or you might have additional water passes throughout the day.”
She said that for residents who don’t like to drink excessive fluids, supplying them with foods that can hydrate like watermelon jello and applesauce can help.
Staff training and regulations
Priority Management CEO Rick Forscutt said that during extreme heat, training staff to be keenly aware of the risk of residents leaving on their own is of vital importance, since extreme weather conditions can make elopement even riskier. Priority Management operates facilities in Texas and Louisiana, where summers get hot.
“It’s just making sure, for instance, that receptionists or staff members who are closest to that front door to just be a bit more cognizant of what’s happening,” he said.
Among the core requisites required by CMS are maintaining cooling systems at optimal levels and educating staff on identifying early signs of heat-related illnesses among residents. This dual focus on infrastructure and personnel underscores the holistic nature of nursing home management, Knapp said.
“I think you’re going to look at your environment, your physical plant. In Florida, we have generator requirements. So we have that backup cooling system, which requires that we make sure that our facilities don’t go above certain degrees.”
Beyond air conditioning to mitigate the risk of heat-related illnesses, nursing homes can implement various strategies, she said. She highlighted the importance of an ecosystem of care that extends beyond policies and procedures to encompass everyday practices that actively contribute to resident safety.
“If you have rooms that have large windows, are you making sure you’re having shades or tinting, things that can kind of account for that, much like you would in your own home,” she said.
Budgeting for elevated utility costs
Knapp acknowledged the necessity of budgeting for elevated utility costs during hotter months. She said that keeping residents comfortable and safe during extreme heat requires air conditioning systems to work at full capacity, leading to increased energy consumption.
For off-site care, Knapp said that ensuring that vehicles are equipped with efficient air conditioning and an ample supply of water bottles are two practical approaches to ease risk of heat stroke.
Moreover, residents should be dressed appropriately to protect them from the sun’s rays. While on-site care might seem ideal during extreme heat, Knapp suggested that maintaining outdoor spaces with ample shading can provide residents with a blend of freedom and safety.
Planning ahead to have cooling systems running smoothly is key to avoiding any heat-related illnesses. Kevin Warren, president and CEO of the Texas Health Care Association (THCA) emphasized that cooling systems must be meticulously designed, installed, and maintained to ensure temperatures remain below the 78-degree Fahrenheit threshold.
“The extreme heat can put a strain on an AC unit, causing the unit to break,” he said. “Depending on what is broken, parts may need to be ordered. In the interim, the facility may need to bring in portable backup units and in some instances, gather residents in central locations. As a last resort, depending on the extent of the repairs, some residents may need to be temporarily moved to another facility.”
Warren emphasized the significance of adequately cooling heat-intensive areas like kitchens to maintain a temperature below 85 degrees Fahrenheit. Consistent maintenance routines and effective communication among staff play a pivotal role in averting breakdowns and tracking residents’ hydration and well-being, he said.
“It’s also important to have effective communication and coordination among staff and monitoring of patients/residents, knowing who has gone outside, even for a short period and keeping outside hydration stations full,” he said.
Warren added that having as many on-site services as possible is a good investment for resident’s safety.
“Extreme heat is only one of the reasons to have services available in-house,” he said. “Other situations would include pandemics, extreme cold, wildfires, floods, and emergency situations like hurricanes.”
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