Nursing Home Deaths Prompt New Rules by Florida Governor (NY Times)

Corporate homicide? A South Florida nursing home is a crime scene. Search warrants have been executed. But it all began in Tallahassee, where since first proposed by then-Rep. Daniel Saul Gelber in 2004, lobbyists have blocked legislation to protect nursing home and assisted living patients by requiring backups for air conditioning systems. Introduced after Hurricane Wilma, it was blocked by the kind of devious dealmakers who hang out at the Governors Club, a no-reporters-allowed bad-'ole-boy watering hole, a prestigious club where decisions get made. You were not in the room where it happened, but you can just imagine what took place there. Seeking to avoid regulation and make higher profits, for-profit nursing homes traded campaign contributions and other favors (some legal, some perhaps criminal) and prevented progressive legislation from being enacted. Result: people die.

This is no different than decisions that get made in Congress, 50 state capitals, 3000+ county courthouses and city halls every single day. Corruption is rampant. People are angry. And we have a right to be angry.

Thanks to Governor RICHARD LYNN SCOTT for doing the right thing and moving to protect nursing home and assisted living patients from greedy capitalists.

Should nursing homes be profit-making? Or should governments providing funding require that funds only go to non-profit organizations?


Nursing Home Deaths Prompt New Rules by Florida Governor
By SHERI FINK and MATT STEVENS
SEPT. 16, 2017
The New York Times



Emergency workers at the Rehabilitation Center at Hollywood Hills, where eight residents died after the center lost air-conditioning. Credit Amy Beth Bennett/South Florida Sun-Sentinel, via Associated Press

Gov. Rick Scott of Florida announced new rules on Saturday requiring nursing homes and assisted-living facilities in the state to have generators capable of maintaining comfortable temperatures for at least 96 hours in the event of a power loss.

The governor’s announcement came three days after eight residents of a nursing home in Hollywood, Fla., the Rehabilitation Center at Hollywood Hills, died when the home lost power to its cooling system in the wake of Hurricane Irma.

The public outcry over the episode has intensified after the home said that its staff, or people calling on their behalf, had contacted the governor himself, as well as the power utility and several county and state agencies, to get the problem resolved, to little avail.

Under the new rules, all of the state’s assisted-living facilities and nursing homes will have 60 days to obtain what the governor’s statement called “ample resources” that will “sustain operations and maintain comfortable temperatures” for at least four days after a power failure. Those resources, the statement said, include a generator and fuel.

The emergency action also requires that the state fire marshal inspect the generators within 15 days of installation.

In his statement, Mr. Scott warned that failure to comply would result in fines and the possible revocation of a facility’s license.

Lauren Schenone, the governor’s press secretary, said the rules were effective immediately and would last 90 days, after which they could be renewed. She said that Mr. Scott would “fight aggressively” to put the rules into law, and that the rules do not include state support to pay for what could end up being daunting expenses.

“It is our expectation that these facilities will do everything they can to protect lives,” she said.

In response to criticism over the home’s attempts to get the government to help, a spokesman for Mr. Scott has said the calls made to the governor were referred to the state Agency for Health Care Administration and the Florida Department of Health and quickly returned.

Florida requires nursing homes to ensure emergency power in a disaster as well as food, water, staffing and 72 hours of supplies. A new federal rule, which will not be enforced until November, adds that the alternative source of energy must be capable of maintaining safe temperatures. But it does not specify that the source of energy must be a generator, or that the energy source must power air-conditioning.

The nursing home under scrutiny in Florida had a generator, but it did not power the air-conditioning. Hurricane Irma had affected a tree that apparently hit the transformer that powered the cooling system, leading to fatally hot conditions in the home.

Overhauling health care rules — even after problems arise from natural disaster — can prove challenging. Hospitals and nursing homes have sometimes pushed back against requirements, arguing that they are costly, unnecessary and a particularly crushing burden on smaller homes.

In a telephone interview on Saturday, Martin Goetz, the chief executive of River Garden Senior Services, a nursing home in Jacksonville that did not lose power or air-conditioning, said the governor’s newly imposed requirements would be “impossible” for many homes to comply with in such a short time.

“What I think nursing homes will do is buy a lot of fans,” he said. “You can’t just go triple and quadruple generating capacity.” Doing so, he said, takes planning, reviews and approvals — all of which takes time.

The governor, Mr. Goetz added, is “shooting from the hip” and choosing to require more resources, when in fact, “the problem at the Hollywood facility was a failure of management.”

Robert E. Solomon, a division manager at the National Fire Protection Association, said the emergency rules also seemed “like the kind of thing that normally would have to go through a public rule-making process.”

“The idea and intent is worthy,” he said, “but that is a lot of generator capacity, design, installation and inspection to complete in 60 days.”

Others welcomed the rules. Gail Coleman, who runs Gail’s Assisted Living Facility in Tampa, said that they were “a good idea” and that she planned to buy a generator. Her home, with eight residents, lost power for four days after the storm. “Times like these you find out exactly what you need and should get,” Ms. Coleman said.

Dr. David Marcozzi, an associate professor at the University of Maryland School of Medicine who helped develop the federal rule, praised the governor’s action.

“I think this is a bold move by the governor,” Dr. Marcozzi said. The new Florida initiative “sets firm requirements and provides needed specificity to protect residents and patients,” he said.

Kristen Knapp, a spokeswoman for the Florida Health Care Association, an advocate for nursing homes, said her group was reviewing the rules. Gail Matillo, president and chief executive of Florida Argentum, which represents assisted living communities, said the industry was still evaluating the rule’s impact and had several questions for regulators.

On Friday, a state senator filed legislation that would require nursing homes and assisted-living facilities to have working generators. A similar bill collapsed in the State Legislature in 2006, in the aftermath of Hurricane Wilma, when it met with strong industry opposition.

A version of this article appears in print on September 17, 2017, on Page A18 of the New York edition with the headline: Florida Imposes New Rules After Nursing Home Deaths. Order Reprints| Today's Paper|Subscribe