1. Florida Politics

Agency chief to Florida nursing homes: Get backup generators, gas by Nov. 15

He wants the industry to use the lessons learned from Hurricane Irma to better prepare for the future.
Ten patients of the Rehabilitation Center in Hollywood Hills, Fla., have died after being kept inside a nursing home that turned into a sweatbox when Hurricane Irma knocked out its air conditioning for three days, even though just across the street was a fully functioning and cooled hospital. [John McCall | South Florida Sun-Sentinel via AP]
Published Sep. 22, 2017

TALLAHASSEE — The head of the agency that regulates nursing homes and assisted-living facilities said Friday the state would “aggressively” implement a rule to require them to obtain back-up generators in an emergency by Nov. 15 and urged members of the industry to use Hurricane Irma as an opportunity to keep Florida’s growing population of frail elders safe in a storm.

“There’s a lot more people in these facilities than there were 10 years ago, and there will be more 10 years from now,”′ said Justin Senior, Agency for Health Care Administration Secretary, at the industry’s Emergency Preparedness Summit in Tallahassee. He also suggested the agency “will be working aggressively across the state to make sure everybody is fully prepared.”

RELATED: Was it a crime? 10 patients at nursing home died after Irma

Three days after eight elderly people died at The Rehabilitation Center of Hollywood Hills after power to their air conditioning system failed, Gov. Rick Scott ordered AHCA and the Department of Health to issue the emergency rule. It requires the facilities to obtain a generator and the appropriate amount of fuel “to sustain operations and maintain comfortable temperatures for at least 96 hours following a power outage,” the essence of legislation the industry vigorously opposed 12 years ago if there was no taxpayer financing to pay for it.

Current state law requires that nursing homes have power generation in an emergency for limited needs, like oxygen tanks and nursing station lights, and the rule greatly expands that mandate.

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

Senior provided some answers to the industry questions as they worry that the deadline is too short for many of them to meet. He clarified that homes do not have to purchase enough back-up generation and fuel to cool and power their entire facility, but instead they must have enough power to cool “some place where residents can reside during the course of the emergency” for four days after the storm.

“If you do, then we can be comfortable that hyperthermia will not be a problem,” he said.

He said regulators learned that after four days, 80 to 90 percent of the state will have its power restored.

Before the storm, he said, the state opened communications channels to long-term care operators to report the status of their resources, such as generators, ice and fuel. But the lessons learned after the storm prompted the rule.

“What happened with Hurricane Irma, we had a storm that really knocked out every major metro area in a single swoop,”′ he said. “It was all need and very few resources for at least the first 48 hours of the storm.”

He said he fielded calls to the personal cell phone number he gave out to nursing homes throughout the storm, and long-term care officials “gave us a lot of insight into what happened” and how to develop the rule.

Another lesson learned, he warned, is that “evacuation plans generally fell through” and the need to “shelter in place” also led to the call for back-up generators.

“There was no place to hide. No place to go,” Senior said. For many long-term care facilities, “the places they were going to evacuate were every bit as dangerous.”

Senior also urged the industry to be vigilant about making sure their new generators are properly installed to avoid poisonous gases that can be fatal. He predicted that in the aftermath of Hurricane Irma “more people will have died from carbon monoxide poisoning than hyperthermia.”

His agency has begun tracking facilities that are in compliance and will publish information on all facilities and their compliance record, he said.

Senior said “the work that was done in this storm saved a lot of lives,”′ but also acknowledged the tragedy in Broward that by Thursday had taken 10 lives.

“I know there was a significant tragedy and loss of life and it’s a painful and haunting thing,” he said. “The headlines are very difficult sometimes and certainly what happened down there should never happen again, so we will work with you to make sure you have all the same goals.”