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Nursing Homes Say Adding Generators 'Huge Challenge'

a nurse checks the heart of an elderly patient
The Florida Channel
Leon County Judge John Cooper on June 30, 2022, in a screen grab from The Florida Channel.

Florida nursing-home officials made clear Friday they think it is unrealistic — if not impossible — to carry out a demand by Gov. Rick Scott that facilities quickly install generators that can power air-conditioning systems.
Two major nursing-home groups held a “summit” in a conference center at Florida State University to address new emergency rules that call for nursing homes and assisted-living facilities to have generators within 60 days. Scott last weekend ordered the emergency rules after the high-profile deaths of residents of a Broward County nursing home where air conditioning was knocked out by Hurricane Irma.

Industry officials were careful Friday to say they share the governor's goal. But during panel discussions that touched on issues such as the need to design and upgrade the electrical systems of older buildings, gain permits and order generators, speakers repeatedly contended the 60-day timeframe is unworkable.

Speakers indicated that it typically would take six months or longer to go through the process of adding a generator to a nursing home.

“Up until this point, we've only heard anecdotally how cumbersome this is,” said Emmett Reed, executive director of the Florida Health Care Association, one of the groups that hosted the summit. “This is alarming to hear the timeframes. There's a huge challenge.”

Steve Bahmer, president and CEO of the other group, LeadingAge Florida, described the 60-day timeframe as “impractical, if not impossible,” though he added that carrying out the directive “isn't for a lack of willingness.”

But while industry officials raised concerns about quickly installing generators, state Agency for Health Care Administration Secretary Justin Senior addressed the summit and said the Scott administration plans to move forward with the emergency rules. He said the state will publish a list of facilities that comply.

“We do think that this is going to be a significant step forward in the safety that our elders experience during a crisis like Hurricane Irma,” Senior said. “We're going to be working aggressively across the state in the coming couple months to ensure that every facility is fully prepared to comply with these new requirements.”

Under the rules, Senior said nursing homes and assisted-living facilities would not have to install generators that could cool entire buildings. He said they could comply by being able to cool portions of the buildings where residents could congregate for 96 hours.

But Senior, speaking with reporters after addressing the summit, indicated the Scott administration is not swayed by the logistical concerns raised by the nursing-home industry.

“We think very strongly that the cost of not complying with this rule is greater than the cost of compliance,” he said.

Scott last weekend directed the Agency for Health Care Administration and the Department of Elder Affairs to issue the emergency rules in the aftermath of the deaths Sept. 13 of eight residents of The Rehabilitation Center at Hollywood Hills in Broward County. Three more seniors who had been residents of the facility died this week, including 94-year-old Alice Thomas, who died Thursday, the Hollywood Police Department said Friday.

The nursing home lost its air conditioning system Sept. 10 when Hurricane Irma knocked out a transformer. The air conditioning had not been restored three days later when the deaths occurred and the rest of the facility's residents were evacuated.

Under the emergency rules ordered by Scott, nursing homes and assisted-living facilities have 45 days to submit plans that would include acquiring generators to ensure temperatures could be maintained at 80 degrees or cooler for 96 hours after losing electricity. Nursing homes and assisted-living facilities would have to carry out the plans within 60 days.

It was not clear Friday whether nursing homes might challenge the rules.

“We're exploring all options,” said Kristen Knapp, a spokeswoman for the Florida Health Care Association. “But we want to work with the governor. We know he has good intentions.”

Under state law, emergency rules are designed to be in effect for only 90 days. But lawmakers are already preparing to consider the generator issue during the 2018 legislative session, which starts in January.

House Health Care Appropriations Chairman Jason Brodeur, R-Sanford, Senate Children, Families and Elder Affairs Chairman Rene Garcia, R-Hialeah, and Rep. Cyndi Stevenson, R-Saint Johns, appeared on one of the panels Friday.

“The reality is we had one bad actor, and we just can't allow that to happen again,” Garcia said. “Whatever the facts will come out … we just can't wait for this investigation to go forward and do nothing. It's going to happen. We're going to move forward with some legislation in the state of Florida having to do with generators and alternative power. It just needs to happen.”

One issue likely to confront the Legislature is the cost of adding generators, as many nursing homes rely on the Medicaid program for large chunks of their funding. Lorne Simmons, who served on one of the panels Friday and is with the accounting and consulting firm Moore Stephens Lovelace PA, estimated that it would cost an average of $350,000 for a 120-bed nursing home to add a generator.

Kip Corriveau, direct of mission at the Bon Secours St. Petersburg Health System, which includes a nursing home and an assisted-living facility, said the organization installed a generator in 2011 at a cost of $500,000.

During Hurricane Irma, Bon Secours had to use school buses to evacuate about 310 nursing-home and assisted-living residents because it was in a mandatory evacuation zone. The facility never lost power.

As an indication of the complexity of handling emergencies at nursing homes, Corriveau said evacuations can be difficult for many residents. He said planning for storms is critical.

“It is a huge trauma to move people like that in a hurry,” Corriveau said. “Even in a blue-sky kind of day before the storm hits.”