Most Nursing Homes Lack Pandemic Flu Plans

While nursing homes may be expected to assist with patient overflow in the event of an influenza pandemic, a new study in the <em>Journal of the American Medical Association</em> suggests these facilities are not prepared for the task.

Of the more than 400 nursing homes in the study, just 23 percent had a specific pandemic influenza plan. Another quarter of the nursing homes had a pandemic response incorporated into an overall disaster response plan. And more than half – 52 percent – did not have any pandemic plan.

“If nursing homes are called upon to serve as alternative care centers for patients who can’t be treated in overcrowded hospitals, the impact on the nursing homes could be vast. Nursing homes serve a vulnerable population prone to dire consequences from an emergency,” said lead author Philip W. Smith, M.D., professor and chief, Section of Infectious Diseases, University of Nebraska Medical Center. “While most facilities felt that nursing homes were being counted on to take hospital overflow patients in a pandemic, in reality few homes would be able to do so.”

Senior author Lona Mody, M.D., assistant professor of internal medicine at the University of Michigan Health System and research scientist at the Geriatric Research, Education and Clinical Center at the Veterans Affairs Ann Arbor Healthcare System, pointed out that nursing homes run a high occupancy rate and would have difficulty accepting a lot of patients in a short period of time.

“Nursing homes may not be equipped to handle an influx of influenza as well as non-influenza patients,” Mody said. “They may also be unwilling to accept overflow patients, if it means displacing their current residents.”

Mody added that specific areas of improvement should include planning for staff shortages, communicating with nearby health departments and hospitals in planning stages and exercising formulated plans.


Half of the nursing homes in the study had stockpiled some commonly used supplies such as gloves and hand hygiene products. Less than half had provided pandemic education to staff members. Just 6 percent had conducted pandemic influenza outbreak exercises.

In more optimistic findings, more than three-quarters – 77 percent – of all Michigan and Nebraska nursing homes had a person or staff position designated as being responsible for pandemic preparedness. Access to laboratory facilities for the detection of influenza was available at 84 percent of these nursing homes. Another 71 percent provide mental health and/or faith-based services.

A pandemic is an outbreak of a disease on a global scale. Typically, a pandemic is lengthy and would create a strain on traditional health care institutions, infectious disease experts say. To relieve some of that burden, additional sites known as Acute Care Centers and Neighborhood Emergency Help Centers would be set up at places such as schools, armories, shopping malls and nursing homes.

Visit and for more information about pandemic preparedness.

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