Post-Irma Deaths Bring Probe for Florida Nursing Home

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By Chris Marr

A Florida nursing home damaged by Hurricane Irma is now under investigation and could face liability lawsuits after at least eight of its residents died.

The air conditioning system wasn’t functioning at the Rehabilitation Center at Hollywood Hills after Irma passed through the state on Sept. 10. Local fire and rescue personnel were called to the facility early on the morning of Sept. 13 where they found patients in “varying degrees of medical distress,” including three dead, according to the Hollywood (Fla.) Police Department. More residents died at local hospitals after all 115 patients were transferred out of the nursing home.

The incident raises questions of potential liability for health-care facilities in the event of natural disasters and whether regulations governing disaster planning are adequate or adequately enforced. Industry experts recently told Bloomberg BNA that facilities—hospitals in particular—are getting better at disaster response thanks in part to new federal regulations the Department of Health and Human Services announced in September 2016 and is working to implement.

Florida Gov. Rick Scott (R) said he would be “demanding answers” about the deaths. The state’s Agency for Health Care Administration, which administers Florida’s Medicaid program, and its Department of Children and Families are investigating, he said in a statement.

“If they find that anyone wasn’t acting in the best interests of their patients, we will hold them accountable to the fullest extent of the law,” Scott said.

‘Prolonged Power Failure’ Causes Evacuation

The nursing home is owned by the Larkin Community Hospital system in Miami, which bought the nursing home in a bankruptcy auction in 2015. Larkin also operates two acute-care hospitals in the Miami area, along with behavioral health, cancer treatment, and other facilities.

The evacuation was necessary because of “a prolonged power failure to the transformer which powered the facility’s air conditioning system,” the nursing home’s administrator, Jorge Carballo, said in a statement.

He added the company is cooperating with the investigations into “this unfortunate and tragic outcome. Our hearts go out to the families and friends of those who were affected.”

Enforcement Actions, Litigation

The Rehabilitation Center is likely to face enforcement actions from the state, including fines, and could be required to get the facility back into a safe, functional condition before taking its patients back, Steve Watrel, a Jacksonville, Fla., attorney who represents plaintiffs suing nursing home in liability cases, said.

Lawsuits are likely too, he told Bloomberg BNA Sept. 13, arguing they tend to be the most persuasive way to get nursing home owners to improve the health and safety conditions of their facilities.

“You just don’t let people swelter and die,” Watrel said. “These are people who are very, very ill. They can’t sit in the heat for very long. They can’t sit in the cold for very long.”

State and federal regulations require nursing homes as well as hospitals to have emergency plans in place, to train staff members on those plans, and to test them annually and revise as needed, he said. Among the requirements, facilities must have an alternative power source in case the electricity goes out, and they’re required to provide certain subsistence needs including acceptable room temperatures, he said.

He questioned whether the company had an adequate disaster plan in place or had tested it. “I highly doubt it,” he said.

“If they are part of a hospital group that has beds, that’s even more egregious because they could have moved them right over there,” Watrel said.

Industry ‘Doing Everything’ Possible

The Florida Health Care Association, an industry group that represents Florida’s nursing homes, said in a statement that its member facilities put patients’ safety first and “are doing everything in their power to meet their immediate and ongoing needs.”

About 150 facilities of the almost 700 in the state still didn’t have full power services restored as of the morning of Sept. 13, the association said. The hurricane knocked out power to more than 6 million homes and businesses in Florida. As of noon Sept. 13, the governor’s office reported 3.7 million power customers still lacking electricity.

All of those 150 facilities were running off back-up generator power and still had residents in-house, according to Kristen Knapp, spokeswoman for the association.

“Some centers are starting to make the decision whether to evacuate given the unknown as to when their power may be restored,” Knapp told Bloomberg BNA. “They are required to have some method to provide air conditioning to the residents who must have A/C, such as someone with breathing issues, COPD, for example.”

Adam Rabinowitz, a health-care attorney with Broad & Cassel in Fort Lauderdale who represents nursing homes, said it’s impossible to determine a nursing home’s liability in a situation like this without knowing all the facts.

“We all need to be careful not to jump to conclusions because this is a unique circumstance,” he told Bloomberg BNA Sept. 13. “We need to allow the state of Florida to do their due diligence.”

Below Average Ratings

A previous state inspection of the Rehabilitation Center found 11 health and safety deficiencies at the facility in March 2017. More recent inspections noted additional deficiencies had been corrected, according to records from the Agency for Health Care Administration, which inspects the state’s nursing homes on behalf of the federal Centers for Medicare & Medicaid Services.

On Medicare’s nursing-home comparison webpage, the facility is rated “below average” for its overall rating (two stars out of five) and “much below average” for its health inspection (one star out of five).

The facility has 152 beds and participates in Medicaid and Medicare.

To contact the reporter on this story: Chris Marr in Atlanta at cMarr@bna.com

To contact the editor responsible for this story: Brian Broderick at bbroderick@bna.com

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