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.

中文翻译：

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艾尔玛飓风期间的辅助生活社区：撤离或就地避难的决定和居民敏锐度

目标 调查与 2017 年佛罗里达州的辅助生活社区 (ALC) 是否因飓风艾玛而疏散或就地避难的相关因素，重点关注许可证类型作为护理敏锐度的代理。设计 横断面研究使用国家通过其紧急报告系统和飓风后调查收集的数据。设置和参与者 分析包括紧急报告系统中的所有 3112 个 ALC。完成调查的 1880 人的子集提供了补充数据。方法 χ2 检验用于检查 ALC 特征（许可证类型、规模、付款、利润状况、农村位置、地理区域和处于疏散令下）与其是否疏散之间的差异。Logistic 回归用于测试特征与疏散状态之间的关联。结果 在 3112 名 ALC 中，560 人被疏散，2552 人就地避难。双变量分析发现疏散状态与疏散命令、许可证类型（精神保健）、付款和地区之间存在显着关联。在调整后的分析中，与床位少于 25 个的 ALC 相比，中型和大型 ALC 疏散的可能性要低 43% (P < .001) 和 53% (P < .001)。与东南部的 ALC 相比，几乎每个地区都更有可能撤离，中西部的可能性最高（优势比 1.76，95% 置信区间 1.35-2.30）。接到疏散命令的 ALC 疏散的可能性是其他人的 8 倍（P < .001）。我们发现疏散状态与获得提供更高级别护理的许可证之间没有关系。结论和意义 先前强调与疏散相关的危害的研究已经导致建议长期护理机构在疏散决策中仔细考虑居民的损害。有证据表明，小型 ALC 更有可能疏散，并且拥有高级护理许可证与疏散可能性无关，这表明需要研究来了解 ALC 如何在决定疏散或就地避难时权衡居民风险。