An analysis of 914 nursing homes in Hurricane Ian's path examined whether for-profit ownership, already associated with lower staffing levels and less favorable skill mix, corresponded to wider staffing gaps during a major disaster. The work situates institutional ownership structure as a determinant of care continuity at precisely the moments when frail older adults are most physiologically vulnerable. For a population whose reserve capacity is already narrow, staffing during acute disruption is a direct input to survival and recovery.
Key Points
- 914 nursing homes in Hurricane Ian's 2022 path were assessed
- For-profit ownership linked to lower staffing levels and skill mix
- Disaster conditions examined as amplifier of pre-existing staffing disparities
Longevity Analysis
Resilience in late life depends less on individual effort than on whether the surrounding environment continues to deliver hydration, medication, mobility assistance, and temperature regulation when infrastructure fails. Older adults in institutional care have limited capacity to buffer a sustained stress load, and understaffing during a storm converts an external event into internal decompensation — dehydration, pressure injury, infection, delirium. Ownership structure functions here as an upstream variable worth identifying and acting on long before a disaster, since no individual intervention compensates for the absence of a trained person at the bedside.
Original published by SAGE Research on Aging, by Natalia Festa, Kelsey Alexovitz, Kendra Davis-Plourde, David Dosa, Andrew B. Cohen, Thomas M. Gill1Department of Internal Medicine, 12228Yale School of Medicine, New Haven, CT, USA2VA Connecticut Healthcare System, West Haven, CT, USA3Department of Biostatistics, Yale School of Public Health, New Haven, CT, USA412262Department of Internal Medicine, Division of Geriatrics, University of Massachusetts Chan Medical School, Worcester, MA, USA.