MDS Alert

Water is crucial for life, especially in a nursing facility accommodating multiple residents’ dietary and hygiene needs.

Make sure your facility is prepared for all aspects of a power outage. Remember: Power outages can happen outside of hurricane season — from strong summer storms to blizzards, power outages are not an uncommon phenomenon. Although many of us take the availability of water for granted for our hydration and hygiene needs, a power outage would directly affect water availability for many facilities.

Having water available and accessible is important, and providers should have a plan in place, says Linda Elizaitis, Rn, RAC-CT, BS, CIC, president of CMS Compliance Group in Melville, New York.

Evaluate Your Policies Accordingly

Appendix PP State Operations Manual instructs that all facilities should have a written policy in place to ensure water availability.

The policy should specify a water source if the normal water supply is compromised, and include provisions for storing both potable and nonpotable water, as well as a means of distributing the water when it’s needed. The policy should also demonstrate that the facility has a method of estimating the water of volume necessary to function. 

Surveyors are instructed to ask the facility administrator about the water availability during the entrance conference portion of the survey. If the surveyor finds that the facility’s water availability is lacking, the surveyor may cite the facility under Ftag 922 Establish procedures to ensure that water is available to essential areas when there is a loss of normal water supply.

Analyze Use and Accessibility

Although the official documentation may only require the aforementioned provisions and methods, Elizaitis recommends that providers plan for potable water needs for individual resident use, as well as what is available in storage for emergency use. Keep in mind that water delivery may not be available during an emergency, she points out.

Make sure that the amount of water your facility keeps on hand for an emergency reflects the amount of water needed, according to your facility’s water availability volumetric calculations. Facilities have been cited under F922 when surveyors determined that the facilities’ actual water storage did not reflect their hypothetical water needs, per the current census, Elizaitis says.

If your facility doesn’t already incorporate water availability in your facility assessment and emergency preparedness plan, consider doing so. The emergency water supply should be large enough to accommodate the residents’ physical care and their dietary needs — as well as meal preparation and drinking water for residents, staff, and anyone else who may end up in the facility during an emergency, Elizaitis says.

Consider what you have on hand at this moment — would it suffice for your facility with its current population for three days? Elizaitis recommends that you check.

Know That the Stakes are High

Four nursing home workers — an administrator, two registered nurses, and a licensed practical nurse — were charged with aggravated manslaughter in August 2019. None of the four had any previous discipline or complaints on their records. The four were working at a Hollywood, Florida, nursing home in September 2017 that lost power after being hit by Hurricane Irma. Twelve residents died during the power outage while in their care.

Although healthcare workers do not frequently face criminal charges for the patient or resident health outcomes while working, the local police chief said that the four former employees did not do enough to protect the residents.

“These four individuals neglected their duties and failed to provide adequate care,” said Hollywood Police Chief Chris O’Brien at a press conference, according to reporting by the Miami Herald.

While the Hollywood tragedy is an extreme example, all facilities should have plans in place that address every aspect of a power outage, from resident comfort to temperature control and regulation to hygiene needs.