When Catastrophe Strikes

Long Term Care Response TeamA memory care resident believes he is in the trenches in World War II and severely beats another resident to death. A night shift staff member sexually assaults a resident. A nurse steals personal belongings and convinces memory care residents that they misplaced the property. A resident elopes and is hit by a train. These are scenarios that have arisen with facilities and the response is always to implement a plan of action.

The plan of action starts with identifying a response team. The response team should typically consist of the Administrator, Director of Nursing, Social Worker and public relations person. The level of response depends on the nature of the catastrophic event. The response team’s goal is to develop a proactive plan that controls information and addresses responses to inquiries about the event.

Information control is critical to managing catastrophic events. A first step is for the Administrator and Director of Nursing to hold a staff meeting with two goals: providing information of the events to prevent rumor mongering and instructing staff to send inquiries to the Administrator. In the meeting, the staff are usually instructed not to talk openly about catastrophic events, divulge protect health information, defame an employee or resident, or promote misinformation. This caution also applies to social media.

The Social Worker can be available when staff or family members require counseling. Emotionally devastating events may require referrals to employee assistance programs.

The public relations person’s task is usually to prepare news releases that address the events without providing too much information. Any resident health information must be excluded. The public relations person is also assigned the task of scouring the news media. At some point, there may be a need to rebut inaccuracies. However, the first goal is to keep the information out of the press.

The facility may also need to decide whether uninvolved residents and/or their family should be informed. A good gauge is to consider the impact on family members who learn of the events in the morning newspaper. Disclosure is often by a confidential letter, which allows the recipient an opportunity to read and digest the information and which is documentation of what was communicated. The information conveyed cannot contain personal health information. General information can be provided with an invitation to call or set up an appointment with the Administrator. Inflammatory allegations are often conveyed with generic terms, such as “inappropriate physical contact” for “sexual assault.” The goal is to provide information, not to send family members into a panic. The letter typically indicates that the event was a single occurrence and that their loved one was not affected and is safe. Some response plans include meetings with residents and their family members to answer questions and reinforce that their loved ones are safe. These meetings also emphasize that the facility management is open and interested in their concerns.

Resident rights groups can be a byproduct of meetings with groups of family members. The right to organize and participate in resident groups is provided for in state and federal regulations. These groups may meet and articulate concerns and recommendations to facility management, but they are not authorized to direct how the facility is run. Facilities are required to receive concerns and recommendations and act upon them, when appropriate.

Catastrophic events may attract news reporters attempting to extract information from anyone willing to be interviewed. Staff should be instructed to send all inquiries to the Administrator. Receptionists are usually instructed to contact the Administrator when members of the press enter the facility. Because long term care facilities are residential facilities, members of the public are not typically allowed to wander the halls. Accordingly, members of the press can be escorted out of the facility or the police can be requested to remove news reporters from the premises.

Response plans for catastrophic occurrences requiring damage control are often part of management training. Each team member has a job and is prepared to spring into action when an event occurs. Precious time can be wasted assembling a team and deciding a game plan while information that needs to be contained is on the loose. So, plan ahead before catastrophe strikes.

 

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