Combating "sick building syndrome." (nursing homes)(Cover Story)

Risk management is -- or should be -- central to the day-to-day operations of every nursing home. But some of the risks we attempt to reduce or eliminate in the nursing home setting aren't quite as apparent as those posed by medication errors or falls. While risk management clearly involves careful monitoring of all aspects of personal care, it also extends to the obvious -- and not so obvious -- dangers sometimes found in the residents' physical surroundings.

According to the National Fire Protection Association, fire ravages nearly 4,000 nursing homes each year. Nursing home fires are particularly devastating since residents are unable to act quickly in the event of a fire or other disaster and, as a result, are more likely to be injured.

Not quite as dramatic, but equally disturbing, are the increasing numbers of reports of "sick building syndrome", a term coined to describe a situation in which the health of patients and personnel is materially affected by the slow dissemination of man-made mineral fibers. According to the recent Cornell University Indoor Air Study, these fibers, in the form of settled dust, foster and create further illness.

This very real risk has provided the impetus to take a close look at the building materials in ElderCare Management Services' facilities since those materials can dramatically affect both health and safety.

The Hidden Danger

It has become increasingly evident to us at ElderCare that ceiling panels made from man-made mineral fibers, such as asbestos, are a health hazard, contributing to respiratory illness, as required federal government labels indicate. They also release toxic fumes when exposed to fire. It is also our opinion that these panels are highly combustible, increasing the chance of catastrophic fires and, in essence, posing a time-bomb-type threat from a health and fire standpoint.

Because traditional ceiling panels burn quickly, fires rapidly get out of control. In addition, the emissions from these panels are lethal and many organizations consider man-made mineral fiber ceiling panels as dangerous as asbestos. It certainly appears that they represent significant future liability.

Organizations such as the Department of Health and Human Services, the United States Department of Labor, the World Health Organization, Centers for Disease Control, Cornell University and various European governmental agencies have labeled man-made mineral fibers as "hazardous to health". Germany was one of the first countries to prohibit the use of asbestos in public construction and in 1994, the Republic of Germany banned the use of man-made mineral fiber acoustical ceiling panels in all government buildings. It is anticipated that Switzerland will follow suit.

This information prompted ElderCare to seek non-hazardous substitute building materials, such as humidity-resistant inorganic ceiling tiles, in the facilities it manages. Eurostone Safety Ceilings are virtually impervious to the growth of mold, mildew and microorganisms. The material is non-toxic, non-lethal and does not spread flame, contribute fuel or develop smoke.

In 1991, Valley Grande Manor, a 147-bed nursing home in Weslaco, TX, became the first long-term care facility in the United States to begin installing these ceiling panels. Today, the full renovation is completed. Because this product seems to meet our needs with respect to protecting facilities from fire and eliminating the potential for sick building syndrome, we're installing them at additional facilities as well.

Conclusions

The elderly are at risk under the best of conditions. They are in various stages of infirmity and are more susceptible to illness than are their younger, healthier counterparts. It falls to the administration and the direct care staff to reduce or eliminate risks, thereby keeping residents safe from harm and enhancing their quality of life.

Administrators of long-term care facilities are continually seeking new ways to make these environments healthier and safer and the decisions we make in those directions affect the longevity and well-being of our residents. To this end, the goal of every nursing home owner, administrator and management staff member should be to look at virtually every aspect of our homes -- from the quality of the staff to the physical facility -- and make them as responsive as possible to the needs of our residents.

As more research is conducted in this field, we're finding more efficient ways to assist our residents and to keep them safe from the dangers posed by phenomena such as sick building syndrome. In the case of ElderCare and its facilities, after completing our research, we really didn't have a choice in the matter.