Proposed requirements for nursing homes to have backup generators after Hurricane Irma sailed through a House committee Tuesday — but similar requirements for assisted living facilities have stalled over how much they would cost.
The two rules, which call for long-term care facilities to have backup power sources that could continue to maintain cooling systems in the event of an outage, were pushed by Gov. Rick Scott after a dozen residents died of overheating at a Broward County nursing home after Hurricane Irma. Though the House Health and Human Services Committee voted unanimously to introduce legislation that would ratify the rule for nursing homes, it held back the second rule — both issued by the state Agency for Health Care Administration — that would set similar requirements for assisted living facilities.
Committee chair Travis Cummings, R-Orange Park, said he remained concerned about mandating such a cost on assisted living facilities, many of which are smaller businesses. "Nursing homes will be reimbursed with the Medicaid system, but there's extreme fiscal impact to doing that" for assisted living facilities, he said.
Both the proposed nursing home and assisted living facilities rules call for facilities to obtain portable backup power sources like generators, capable of providing 30 square feet of cool space for each resident, and up to 72 hours of fuel on site. Smaller assisted living facilities with less than 17 beds would only be required to keep at least 48 hours of fuel on site. Nursing homes would be required to have equipment that could maintain safe indoor air temperatures for 96 hours after an outage, and set the ambient temperature at 81 degrees.
Because the rules would call for more than $1 million over five years, they need to be ratified by the legislature to go into effect. A staff analysis estimated nursing homes will have to spend more than $121 million over the first five years to comply with the rule, though about $66 million could come from Medicaid. The proposed assisted living facilities rules, which would affect about 3,000 facilities, would cost about $243 million.
Scott had proposed more stringent rules shortly after the deaths at the Rehabilitation Center at Hollywood Hills, including requirements that generators be installed permanently and that there be 50 square feet of cool space per resident. But after months of legal challenges, the administration and the long-term care industry agreed to modified rules that relaxed some of those requirements.
Scott spokesman McKinley Lewis said hundreds of nursing homes and assisted living facilities had already agreed to abide by the rule, and that for the latter, the governor's office is "continuing to work with the Florida Legislature to make sure this gets done."
If the assisted living facilities rule does not pass, it's unclear what might happen next to the generator requirements Scott has called for, said Tom Parker of the Florida Health Care Association, a long-term care industry group. "We're in a position where the [original] emergency rule may be back on the table" though it has been challenged, he said.
Justin Senior, the secretary for the Agency for Health Care Administration, said the agency is still working with lawmakers on ways to mitigate costs for assisted living facilities before the legislative session ends in a week and a half. He added that for smaller facilities with just a few residents, sufficient generators could be purchased at a typical hardware store and paired with a window unit to satisfy the rule.
If passed, the rules would require facilities to comply by June 1, the start of this year's hurricane season.