Nashville’s Power Utility Left 44 Nursing Homes Off Its Emergency List. A Historic Winter Storm Exposed the Gap.

Nashville, Tennessee — When Winter Storm Fern tore through the Nashville area in January, cutting power to roughly 230,000 customers in what became the largest outage in the city’s history, nursing home residents were supposed to be protected. They weren’t — at least not all of them.

A new internal review by Nashville Electric Service reveals that 44 nursing homes and assisted living facilities were never added to the utility’s Critical Referral Program, the system designed to prioritize power restoration for customers who depend on medical equipment and vulnerable populations. The findings, presented to the NES Power Board last week, paint a picture of a preparedness gap that left dozens of care facilities on equal footing with ordinary households during the peak of a life-threatening storm.

“We’ve identified 44 additional nursing homes and assisted living facilities that were not on our priority list,” NES official Teresa Broyles-Aplin told board members.

The storm had already put enormous pressure on the utility. With hundreds of thousands of customers in the dark and temperatures plunging, residents at care facilities have almost no ability to advocate for themselves in real time. Staff, too, are limited in what they can do when heat, refrigerated medications, and powered medical devices all go offline simultaneously.

What Changed — and What’s Still at Risk

The review prompted immediate action. NES has now reclassified all nursing homes, assisted living facilities, and similar care centers into a higher priority category for future outage responses. The utility is also simplifying its registration process for in-home medical device users, making it easier for individuals to flag themselves before the next emergency hits.

“We’ve now classified all critical care facilities into a higher level of priority during storm response,” Broyles-Aplin said.

That’s a meaningful fix — but it raises a harder question the industry has been wrestling with for years: how many other cities have the same blind spot? Power restoration hierarchies vary by utility, and there’s no federal requirement that nursing homes be enrolled in emergency priority programs. Registration, in most cases, falls on the facility itself.

When a major storm hits, the consequences of missing that step are immediate. The situation is not unlike what happened across the country during past extreme weather events, where residents left scrambling after an emergency had nowhere to go and facilities had no backup plan in place.

A National Conversation in the Making

Emergency preparedness at nursing homes sits in a regulatory gray zone. Federal rules require facilities to have emergency plans, but those plans don’t always account for coordinating with local utilities. Whether a nursing home ends up on a priority restoration list often comes down to whether someone at the facility filled out the right form with the right local power company.

Industry watchers say the Nashville situation is a rare case where a utility took the initiative to audit its own gaps after the fact — and acted on what it found. That’s the exception, not the rule.

For nursing home operators across the country, the takeaway is practical: contact your local utility now, before the next storm season, and confirm your facility is enrolled in whatever priority program exists. Don’t assume you’re on the list.