RESUMO
OBJECTIVE: Rural Long-term Care (LTC) providers face unique challenges when planning, preparing for, and responding to disasters. We sought to better understand challenges and identify best practices for LTC in rural areas. METHODS: Case studies including key informant interviews and site visits were conducted with LTC staff and emergency planning, preparedness, and response partners in three rural communities. Themes were identified across sites using inductive coding. RESULTS: Communication across disaster phases continues to be a challenge for LTC providers in rural communities for all disaster types. Communication challenges limit LTC providers' ability to address patient needs during emergencies and limit the resilience of providers and patients to future disasters. Limited coordination among local leadership and LTC providers prevents dissemination of information, resources, and services, and slows response and recovery time. Including LTC providers as stakeholders in planning and exercises may improve communication and coordination. CONCLUSION: More than two decades into efforts to increase preparedness of health care systems to all hazards, rural LTC facilities still face challenges related to communication and coordination. Agencies at the federal, state, and local level should include input from rural LTC stakeholders to address gaps in communication and coordination and increase their disaster resilience.