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Following deaths from Irma, Florida looks to new rules for keeping nursing homes cool after outages

A woman is transported from The Rehabilitation Center at Hollywood Hills as patients are evacuated on Sept. 13, 2017 after a loss of air conditioning due to Hurricane Irma. Fourteen residents of the Broward County facility died of exposure to heat in the days following the hurricane, prompting new rules for nursing homes. [AMY BETH BENETT | South Florida Sun-Sentinel, via AP]
Published Feb. 19, 2018

After national headlines and a public outcry over the deaths of 14 people at a Broward County nursing home after Hurricane Irma, nursing homes across the state are working to comply with new rules requiring them to have back-up power.

But the process has been murky, with the rules being modified twice since late last year. And nursing home operators say preparing their facilities to meet these new standards have been complicated and expensive.

"There have been challenges. This is not something you can do overnight," said Vernon Zeger, director of operations for Florida Living Options, a nonprofit organization with nursing homes across the state, including in Brandon, Sarasota and Lakeland.

PREVIOUS COVERAGE: 14th patient from Hollywood nursing home that overheated after Irma has died

In September, Gov. Rick Scott issued an emergency rule that required all nursing homes and assisted living facilities to install generators within 60 days and to have enough fuel on hand to power them for 96 hours. If the facilities didn't comply within that time frame, they were subject to fines of $1,000 a day until they did. Plus, the Agency for Health Care Administration released lists of nursing homes that were not in compliance every few weeks.

"I do think the governor's heart was in the right place and we want to comply with the rules. It just takes time to do so," Zeger said.

Scott put the rule in place after a dozen residents at the Hollywood Hills Rehabilitation Center in Broward County died of heat exposure after Hurricane Irma knocked out power. A criminal investigation was launched and eventually sparked the governor's office to respond.

The rule was struck down by an administrative court judge, and later an appeals court, when industry groups sued. In January, the governor's office released a set of modified rules that were a little more lenient to nursing home operators. They are awaiting approval from the Legislature.

The new rules would require nursing homes and assisted living facilities to have generator access, but not necessarily a costly generator physically installed. For example, a nursing home could have a contract with a company to install a portable generator at a later date.

The rules also would require operators to submit plans on how they would keep their facilities at or below 81 degrees in case of power loss after a declared state of emergency. Each nursing home should be able to cool a large enough space to give each resident 30 square feet of space, the rules state, and have 72 hours worth of fuel on site — with the ability to tap into another 24 hours' worth if an emergency is declared.

All assisted living facilities with 16 or fewer beds would be required to have 48 hours worth of fuel on site.

"Since these new rules have come out, our members have been working toward meeting the requirements and submitting waivers," said Kristen Knapp, spokeswoman for the Florida Health Care Association, with 550-plus members, including many nursing homes in the state.

PREVIOUS COVERAGE: Temperature hit 99 degrees in nursing home where a dozen died after Irma

"It was a challenge with the original timeline," she said. "Everyone agrees that we need to work to keep our residents cool and comfortable in an emergency situation. But now that we have greater flexibility, there's more time to invest in this process."

Florida Living Options applied for a variance with the state, which gave them more time to comply with the rule, Zeger said. The organization has multiple facilities in Florida, and most were already in compliance, he said.

"It used to be that we had to have 72 hours worth of fuel on site. Most of our generators could already hold that much," he said. The organization did buy several above-ground tanks to make sure it could hold the additional required amount.

Despite the expense, Zeger said the tanks were far less costly than having to buy all-new generators.

"That's a huge cost," he said. "We do have to purchase another generator for a facility in Lakeland, and we're doing that. But it won't be here for another five to six months."

Contact Justine Griffin at or (727) 893-8467. Follow @SunBizGriffin.


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