Kate Ruder | KFF Health News
On a recent day, high winds near Boulder, Colorado, raising the risk of wildfires led the state's largest utility to cut power to 52,000 homes and businesses, including the Fraser assisted living and skilled nursing facility.
Xcel Energy officials said this is the first time the company has proactively shut off power in Colorado as a wildfire prevention measure. The practice, also known as public safety power shutoffs, has taken root in California and spread elsewhere as a way to prevent downed or damaged power lines from sparking fires that have become more frequent and intense in the West.
In Boulder, Fraser staff and residents learned about the rolling blackouts through news reports. Fraser officials called the utility to confirm and were initially told the home's power would not be affected. Then the utility called, and the home's power was eventually cut, said Thomas Mendez, vice president of Fraser. The home had just 75 minutes left before Xcel Energy turned off the power on April 6.
Officials scrambled to prepare the 20-acre campus, home to about 500 residents. Generators kept running oxygen machines, most of the refrigerators and freezers, hallway lights and Wi-Fi for phones and computers, but the heating system and some lights remained off as overnight temperatures dipped into the 30s.
Power was restored to Fraser 28 hours later. Throughout the outage, staff were caring for residents of nursing homes and assisted living facilities, many of whom have dementia, Mendez said.
“These are people who depend on us for everything: food, care, medicine,” he said.
Mendes said 24 hours into the crisis, they still didn't know when power would be restored, which caused stress and expense, including the cost of refilling their two generators the next day.
“Thankfully there were no injuries or major damage, but anytime there's a power outage, whether planned or unexpected, this kind of thing can happen and it puts everyone at risk,” Mendes said.
The widespread use of preventive power outages is forcing nursing homes to reassess their preparedness, but they shouldn't have to do it alone, industry insiders and academics say: Improved communication between utility companies and nursing homes, as well as including them in local disaster plans, are essential to keeping residents safe.
“They need to be prioritized so that when the power goes out, they're first in line to get power restored,” David Dossa, professor of medicine and chair of the geriatrics department at the University of Massachusetts Chan Medical School in Worcester, Massachusetts, said of nursing home residents.
Xcel Energy spokesman Tyler Bryant said in an email that restoring power to hospitals and nursing homes was the company's top priority throughout the storm, but acknowledged that public safety power shutoffs can be improved, and the company is working with community partners and the Public Utilities Commission of Colorado to help health care facilities prepare for longer outages in the future.
Xcel Energy shut off power as a public safety measure after wind gusts of up to 100 mph were predicted for April 6. The storm left about 275,000 customers without power.
Officials were responding to the Marshall Fire two and a half years ago, which killed two people and destroyed or destroyed more than 1,000 homes in Boulder and nearby Louisville and Superior. That fire was the result of two overlapping fires, one of which was “most likely caused” by electricity from an Xcel Energy power line that had been ripped off a pole by hurricane-force winds.
“Precautionary closures are scary because there's no clear end to it. They don't tell you how long they'll be closed for,” said Jenny Albertson, director of quality and regulatory affairs for the Colorado Healthcare Association and Assisted Living Center.
A study released last year found that more than half of nursing homes in the West are located within 3.1 miles of a high-risk wildfire area, but nursing homes in the Mountain West and Pacific Northwest with the highest fire risk were less compliant with federal emergency preparedness standards than facilities at lower risk.
Under federal guidelines, nursing homes must have disaster response plans that include backup power and building evacuation. Those plans don't necessarily include emergency response for public safety outages, which have been on the rise over the past five years but are still relatively new. Nursing homes in the West are scrambling to catch up.
In California, stricter laws to bring emergency power supplies in nursing homes into compliance are coming into force, a cost the California Healthcare Facilities Association estimates could cost more than $1 billion. But the state hasn't allocated any funds to help those facilities comply, said association spokesman Corey Egel. The association is calling on state officials to delay the law's implementation for five years, until Jan. 1, 2029.
Dossa said most nursing homes are operating on the edge when it comes to federal compensation payments, and upgrading old buildings to meet new regulations would be incredibly expensive.
Each of the three buildings for Fraser's 300 residents in independent living apartments has its own generator, plus two for assisted living and skilled nursing, but they aren't connected to emergency air conditioning or heating because those systems require large amounts of energy.
Keeping residents warm on a 10-below night or cool on two days when temperatures reach 90 degrees in Boulder “is something we have to think about as we think about the future of preventative power outages,” Mendez said.
Federal audits of emergency preparedness at nursing homes in California and Colorado have found deficiencies. The report found that eight of 20 Colorado nursing homes had deficiencies in emergency supplies and power, including three that had no plans for alternative energy sources such as generators and four that had no documentation showing that their generators had been properly tested, maintained, and inspected.
For Debra Saliba, director of the Anna and Harry Bolan Center for Gerontology Research at the University of California, Los Angeles (UCLA), making sure nursing homes are part of emergency response plans could help them respond more effectively to any outages. Saliba's research on nursing homes after the magnitude 6.7 earthquake that struck the Los Angeles area in 1994 led Los Angeles County to include nursing homes in local disaster plans and drills.
Saliba added that nursing homes are too often forgotten in emergencies because they are not viewed by government agencies and public utilities as medical facilities like hospitals or dialysis centers.
Albertson said she is working with Colorado hospitals and local emergency response coalitions on disaster plans that could include nursing homes, but understanding Xcel Energy's prioritization plan for restoring power will also help them prepare, she said.
Bryant said Xcel Energy's priority plan for health care facilities dictates how quickly power is restored during public safety outages, not whether it will be shut off.
Julie Soltis, director of public affairs for Fraser, said the home had plenty of blankets, flashlights and batteries during the power outage, but Fraser plans to purchase headlamps for caregivers and, at the town hall meeting, encouraged independent living residents to buy their own backup power sources for cellphones and other electronic devices, Soltis said.
Soltis hopes that the next time there's a public safety power outage, his facility won't be affected, or that he'll at least be given time to respond.
“Given the changing weather and climate, this certainly won't be the last,” she said.
