After Hollywood nursing home horror, legislators want new laws

After a week in which the aftermath of Hurricane Irma was more deadly for Florida elders than the storm, a handful of South Florida legislators drafted bills that would require nursing and retirement homes to maintain generators to cool their facilities during power outages.

The legislation is meant to prevent the kind of tragedy that occurred Wednesday when eight frail elders perished in a Hollywood nursing home-turned-hothouse after a temporary cooling system failed.

The proposals emerged a day after the Miami Herald reported that a similar effort before the 2006 Legislature was derailed when the long-term care industry balked at the price tag of paying for generators — and lawmakers objected to subsidizing them.

And they came Friday as state officials reported that 40 nursing homes and 177 assisted living facilities had evacuated thousands of residents this week — after the storm left.

The primary reason: lack of power and sweltering temperatures made conditions unsafe.

Florida emergency operators would not say how many people were evacuated from the elder care homes this week, or how many of the evacuations occurred after the deaths in Broward, but industry representatives blamed the exodus on the loss of electricity.

“Their residents are susceptible to heat stroke and other issues exacerbated by the heat,’’ said Shaddrick Haston, CEO of the Florida Assisted Living Association, which represents the state’s 3,100 ALFs. “They’re looking for places that may be able to provide some cool.”

Haston said Gov. Rick Scott was aware of the difficult decision facing many operators, who chose to have their residents shelter in place only to face days without power.

Scott fielded desperate calls from members of Haston’s association — seeking generators and assistance evacuating before the storm, and pleading for higher priority treatment from local utilities after it passed, he said.

Related: 8 dead, others evacuated at Hollywood nursing home without power after Irma

In daily conference calls with ALF operators, nursing homes and hospital executives, Scott gave out his personal cell phone number, urging people to call with problems or concerns. Agency for Health Care Administration Secretary Justin Senior, Florida Surgeon General Celeste Philip and others in the administration also shared cell phone numbers, Haston said.

Calls to the governor and others were routed to AHCA or the Department of Health “and quickly returned,” said Scott spokesman John Tupps. He denied allegations Friday that the governor had failed to properly alert health administrators after receiving three calls from the Rehabilitation Center at Hollywood Hills.

“At no time did the facility report that conditions had become dangerous or that the health and safety of their patients was at risk,” Tupps said in a statement.

Haston, of the assisted living association, said the state’s emergency managers worked throughout the week with members of his association, and officials at nursing homes to coordinate the movement of portable generators and other cooling equipment from facilities that had electricity restored to those without it.

The goal was to avoid uprooting frail residents to other facilities, often causing steep health declines and what the industry calls “transfer trauma,” he said. “You do more harm than good sometimes.”

But, Haston acknowledged, those resources didn’t come in time to keep some elders from being evacuated or, in some cases, hospitalized.

“We’ve seen the good, the bad — and we’ve seen the ugly,” he said.

It is one of the “glaring lessons” Irma has taught Florida, said Sen. Gary Farmer, who is one of several legislators drafting bills to require both nursing homes and ALFs to be equipped to power not only lighting and medical equipment, but air conditioning units, as well, during the recovery phase of a storm.

“We learned that post-storm impact is more significant from a resources standpoint than the storm itself,” he said.

The tragedy in Broward prompted Farmer, Sen. Lauren Book, D-Plantation; and Rep. Shevrin Jones, D-West Park, to call for a Florida Department of Law Enforcement investigation.

Said Book: “We just had a mass casualty event. Eight individuals lost their lives. One of those was a woman who got to be 99 years old. I know we can do better. We have to do better.”

They also want to change the law for thousands of people still living in limbo as they wait for power to return at their evacuated homes.

One bill, filed Friday afternoon by Book, would require nursing homes and assisted living facilities to have “an emergency power source” to run air conditioners, in addition to what the law already requires: one that powers life-saving equipment like fire alarms and nursing call buttons.

The bill would require the state Agency for Health Care Administration to oversee the effort and ensure compliance.

The effort likely is facing a strong headwind.

Related: After Wilma, bills were pushed to ensure nursing homes had emergency AC. They were killed.

The 2006 legislation would have done what Book seeks to do: require the industry to install and maintain generators or other power sources, and pay for them themselves. Several lawmakers involved in discussions told the Herald nursing home owners strongly objected to being ordered to pay for an alternative power source.

Lawmakers, for their part, didn’t want to pay either. What emerged was a modest compromise bill, sponsored in the House of Representatives by then-Rep. Dan Gelber, that would have created a pilot program in which some nursing homes would have been partially reimbursed, so long as they agreed to accept evacuees from other homes.

Among nursing homes, 669 had power late Friday, 34 were using generators, 10 were “closed” and 40 reported post-storm evacuations, according to the Florida Department of Health.

Among ALFs, 1,978 were with power, 182 reported being “closed,” 193 were using generators and 177 reported evacuating residents after the storm.

The numbers were revealed for the first time Thursday by state officials after the Herald/Times had requested them repeatedly.

“The challenge for nursing homes isn’t getting through the storm; it’s after the storm,” said Marty Goetz, the CEO of River Garden Senior Services, a Gold Star nursing home in Jacksonville, which never lost power.

With an unprecedented number of people ordered to evacuate during the storm, “some facilities found themselves minimally staffed and couldn’t continue,” he said.

Others likely had to close or evacuate because their generator capacity was not large enough to run air conditioning or they faced fuel shortages to power the generators.

Because of the trauma and stress transferring patients has on their health, evacuating is the last resort for most nursing homes, he said.

The industry, however, is not convinced the generators will solve all their problems. The Hollywood home had a generator.

“Nursing homes are not on the same level of response from the electric companies as hospitals are — and that’s a mistake,” Goetz said. “We have old, sick, frail, vulnerable people here. … It really does require a different level of response by the electric companies and that needs to come from the state.”

Sen. Anitere Flores, R-Miami, agreed that requiring generators doesn’t necessarily fix the problem.

“It’s unacceptable, inexcusable, no reason whatsoever for anybody to have died in the way those eight individuals did,” she said, but she warned about seeking the easy fix. “The goal should be … a safe, livable environment for the individuals that are in this care. Obviously that did not happen.”

This story was originally published September 15, 2017 at 9:05 PM with the headline "After Hollywood nursing home horror, legislators want new laws."