Abstract
Objectives
To investigate the factors associated with whether assisted living communities (ALCs)
in Florida evacuated or sheltered in place for Hurricane Irma in 2017, focusing on
license type as a proxy for acuity of care.
Design
Cross-sectional study using data collected by the state through its emergency reporting
system and a post-hurricane survey.
Setting and Participants
Analyses included all 3112 ALCs in the emergency reporting system. A subset of 1880
that completed the survey provided supplementary data.
Methods
χ2 tests were used to examine differences between ALC characteristics (license type,
size, payment, profit status, rural location, geographical region, and being under
an evacuation order) and whether they evacuated. Logistic regression was used to test
associations between characteristics and evacuation status.
Results
Of 3112 ALCs, 560 evacuated and 2552 sheltered in place. Bivariate analysis found
significant associations between evacuation status and evacuation order, license type
(mental health care), payment, and region. In the adjusted analysis, medium and larger
ALCs were 43% (P < .001) and 53% (P < .001) less likely to evacuate than ALCs with fewer than 25 beds. Compared with
ALCs in the Southeast, nearly every region was more likely to evacuate, with the highest
likelihood in the Central West (odds ratio 1.76, 95% confidence interval 1.35‒2.30).
ALCs under an evacuation order were 8 times more likely to evacuate (P < .001). We found no relationship between evacuation status and having a license
to provide higher care.
Conclusions and Implications
Prior research highlighting harm associated with evacuation has led to recommendations
that long-term care facilities carefully consider resident impairment in evacuation
decision-making. Evidence that small ALCs are more likely to evacuate and that having
a higher-care license is not associated with evacuation likelihood shows research
is needed to understand how ALCs weigh resident risks in decisions to evacuate or
shelter in place.
Keywords
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Article info
Publication history
Published online: March 07, 2020
Footnotes
This work was supported by the National Institute on Aging of the National Institutes of Health under award number R01AG060581-01.
The sponsors had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; and preparation, review, or approval of the manuscript.
The authors declare no conflicts of interest.
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© 2020 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
