Rod Aydelotte / AP

Emergency workers evacuate the elderly from a damaged nursing home following an explosion at a fertilizer plant Wednesday in West, Texas.

Rescuers evacuating more than 130 elderly people from a nursing home during a fire at a nearby fertilizer plant were suddenly confronted with chaos and danger when an explosion ripped apart the building.

Many of the senior citizens at the West Rest Haven home are related to residents in the tiny Texas town of West, which has been devastated by the blast.

It's unclear how many were removed before the inferno at the West Fertilizer Company plant erupted in a earth-shuddering blast that killed between 5 and 15 people and injured at least 160 more.

Nursing home worker Lola Millhollin and another employee were wheeling two residents out through the building’s foyer at about 8 p.m. on Wednesday when disaster struck, she told the Associated Press.

Rod Aydelotte / Waco Tribune Herald via AP

Persons are seen pushing wheel chairs in front of a damaged nursing home following an explosion at a nearby fertilizer plant Wednesday, April 17, 2013, in West, Texas. An explosion at a fertilizer plant near Waco caused numerous injuries and sent flames shooting high into the night sky on Wednesday.(AP Photo/ Waco Tribune Herald, Rod Aydelotte)

“I was trying to figure out exactly where we were supposed to be,” Millhollin said. “All of a sudden it just blew, I mean, everything went flying everywhere, and once that happened I looked around and debris was just down. Everything fell down, the ceiling fell down and the windows blew out.”

Workers went back into the damaged building and searched rooms for trapped residents, she said. Many of the elderly were panicked and in shock.

“I helped loosen debris so that we could wheel the ones that were out in the main part first,” Millhollin said. “We did the best we could with what we had, and we got them out safely. We were taking them out through broken windows, putting a mattress across the windows so we could get them out without getting them all cut up and stuff.”

Denise Day, a nurse at West Rest Haven, told the Waco Tribune-Herald that she heard the blast from her house, which is 23 miles from the plant. After hearing the details over her police scanner, she raced back to town to help evacuate residents, she told the paper.

William Burch entered the damaged building with his wife, a retired Air Force nurse, and found water filling the hallways and wires dangling from the ceilings. The two found some residents trapped in wheelchairs in their rooms. The scene was “completely chaotic,” Burch told the AP.

“They had Sheetrock that was on top of them,” Burch said. “You had to remove that.”

The extent of the damage was not clear. All of the residents had been moved to other rest homes, said David Moon, 85, a former president and current board member.

“We just have to wait and probably tear down and rebuild,” said Moon, who has lived in West since 1950. He was on the nursing home’s board when it was founded in 1966, he said.

“We’re doing OK here,” Moon said. “We just have a lot of work to do.”

Related:

• 5 to 15 killed, 160 wounded in 'devastating' Texas chemical plant blast
• 'The whole street is gone': Bloodied eyewitnesses describe Texas explosion horror
• Witness: Texas plant blast lifted my truck off the ground

Gosia Wozniacka / AP

Shown is the main gate of Glenwood Gardens in Bakersfield, Calif., Monday March 4, 2013, where an elderly woman died after a nurse refused to perform CPR on her last week.

A woman who died after a nurse at her elder home refused to provide CPR had chosen to live in a facility without medical staff and wanted to pass away without life-prolonging intervention, her family said Tuesday.

Lorraine Bayless' family said in a statement to The Associated Press that it does not plan to sue the independent living facility where the 87-year-old woman died last week.

A 911 tape recounts a dramatic conversation between a dispatcher and a nurse who refused to cooperate with pleas for someone to start CPR as firefighters sped to the scene. In the 7-minute, 16-second exchange, the dispatcher insisted the nurse perform CPR or find someone willing to do it.

The home's parent company said in a statement that the employee wrongly interpreted company policy when she declined to offer aide.

"This incident resulted from a complete misunderstanding of our practice with regards to emergency medical care for our residents. Glenwood Gardens is conducting a full internal investigation," Brookdale Senior Living said, adding that the employee was on voluntary leave during the process.

City fire officials say Bayless did not have a "do not resuscitate" order on file at the home. Her family said, however, "it was our beloved mother and grandmother's wish to die naturally and without any kind of life-prolonging intervention."

Glenwood Gardens is an independent living facility, and company officials say no medical staff is employed there. The woman who identified herself as a nurse to the dispatcher was employed at the facility as a resident services director, the company said.

The nurse's decision has prompted multiple state and local investigations at Glenwood Gardens in Bakersfield.

The California attorney general was "aware" of the incident, said a spokeswoman, Lynda Gledhill. Bakersfield police were trying to determine whether a crime was committed when the nurse refused to assist the 911 dispatcher looking for someone to start CPR.

The nation's largest trade group for senior living facilities has called for its members to review policies that employees might interpret as edicts to not cooperate with emergency responders.

"It was a complete tragedy," said Maribeth Bersani, senior vice president of the Assisted Living Federation of America. "Our members are now looking at their policies to make sure they are clear. Whether they have one to initiate (CPR) or not, they should be responsive to what the 911 person tells them to do."

Bayless collapsed in the Glenwood Gardens dining hall on Feb. 26. Someone called 911 on a cellphone asking for an ambulance to be sent and eventually a woman who identified herself as a nurse got on the line.

Brookdale Senior Living said in a statement that the woman on the 911 call was "serving in the capacity of a resident services director, not a nurse."

The Tennessee-based parent company also said that by law, the independent living facility is "not licensed to provide medical care to any of its residents." But it added later that it was reviewing company policies "involving emergency medical care across all of our communities."

Bayless' family said she was aware that Glenwood Gardens did not offer trained medical staff, yet opted to live there anyway.

"We understand that the 911 tape of this event has caused concern, but our family knows that mom had full knowledge of the limitations of Glenwood Gardens and is at peace," the family's statement said.

The death shines a light on the varying medical care that different types of elderly housing provide — differences that consumers may not be aware of, advocates say.

Even if independent living homes lack trained medical staff, some say they should be ready to perform basic services such as CPR if needed.

The California Board of Registered Nursing is concerned that the woman who spoke to the 911 dispatcher did not respond to requests to provide aid or to find someone who might want to help.

"If she's not engaged in the practice of nursing, there's no obligation (to help)," agency spokesman Russ Heimerich said. "What complicates this further is the idea that she wouldn't hand the phone over either. So that's why we want to look into it."

"I would certainly hope someone would choose human life over a facility policy, said Robyn Grant, director of public policy and advocacy at the National Consumer Voice for Quality Long-Term Care. "That's pretty rotten."

The family said it would not sue or try to profit from the death, and called it "a lesson we can all learn from."

"We regret that this private and most personal time has been escalated by the media," the statement said.

Two former workers at a Pennsylvania nursing home are in jail after police say they were caught on camera abusing an elderly patient.

Investigators say the abuse happened at the Arbors at Buck Run, a nursing home in Bucks County, Pa. The daughter of a patient at Arbors became suspicious about how her mother was being treated and decided to take action, according to investigators.

“The patient’s daughter installed hidden cameras in her mother’s room and captured the abuse that’s alleged in this case, including one of the accused literally dancing in the face of a wheel-chair bound victim,” said Detective Eric Landamia of the Lower Southampton Police Department.

Police and the Pennsylvania Department of Public Welfare began to investigate. According to the DPW, the two workers were seen “dumping” a resident on a bed and “manhandling” the patient.

Read more at NBCPhiladelphia.com

The DPW also says one of the workers danced in front of the resident while holding a cell phone and then singing and yelling directly into the resident’s face. The ongoing abuse happened repeatedly from October 16 to November 13, according to the DPW.

Police identified the two workers as Regina Battles, 20, and Irene Rodriguez, 22. Both women turned themselves in Tuesday morning and were sent to the Bucks County Jail after failing to post $100,000 bail. They are charged with neglect of a care dependent person, reckless endangerment, simple assault and harassment.

The lawyer for both women says his clients did nothing wrong. He also calls the surveillance video that captured the alleged abuse “a matter of interpretation.”

“I understand the victim’s family seeing it in a way that they’re perceiving it,” said Defense Attorney Alan Zibelman.  “I completely understand that. But I also believe that if an objective person looked at it, it could be perceived in a different way.”

The two women aren’t the only ones in hot water due to the alleged abuse. The DPW revoked the Arbors’ license, citing “gross incompetence, negligence and misconduct.”

NBC10 Philadelphia talked to a spokeswoman from Arbors.

“Do you have anything to say on behalf of the facility?” asked NBC10’s Deanna Durante.

“No,” said the woman. “I just think it’s a wonderful place to work.”

The woman eventually directed NBC10 to the nursing home’s management company. The company told NBC10 the nursing home previously received a citation also related to patient care back in February which they were in full compliance with by May. The company also claimed they would appeal the DPW’s order to close and will stay open for the next 30 days.