911 calls set off ‘red flag’ be­fore care home deaths

Honolulu Star-Advertiser - - NATION - By Terry Spencer, Jen­nifer Kay and Tim Reynolds

HOL­LY­WOOD, FLA. >> The first 911 call from the Re­ha­bil­i­ta­tion Cen­ter at Hol­ly­wood Hills didn’t sound omi­nous: A nurs­ing home pa­tient had an ab­nor­mal heart­beat.

An hour later came a sec­ond call: a pa­tient had trou­ble breath­ing. Then came the third call. A pa­tient had gone into car­diac ar­rest — and died.

Over the next few hours of Wed­nes­day morn­ing, the dire sit­u­a­tion at the Re­ha­bil­i­ta­tion Cen­ter for frag­ile, el­derly peo­ple would come into clearer view. Three days af­ter Hur­ri­cane Irma hit Florida, the cen­ter still didn’t have air con­di­tion­ing, and it ul­ti­mately be­came the grimmest tragedy in a state al­ready full of them. Eight peo­ple died and 145 pa­tients had to be moved out of the sti­fling-hot fa­cil­ity, many of them on stretch­ers or in wheel­chairs. Au­thor­i­ties launched a crim­i­nal in­ves­ti­ga­tion to fig­ure out what went wrong and who, if any­one, was to blame.

Within hours of the tragedy, Gov. Rick Scott and U.S. Sen. Bill Nel­son made no ef­fort to hide their anger and frus­tra­tion that some­thing like this could hap­pen. On Saturday, Scott or­dered the di­rec­tors of the Agency for Health Care Ad­min­is­tra­tion and the Depart­ment of Elder Af­fairs to is­sue emer­gency rules to keep res­i­dents safe in health care fa­cil­i­ties dur­ing emer­gen­cies. The man­date re­quires all as­sisted liv­ing fa­cil­i­ties and nurs­ing homes to ob­tain am­ple re­sources, in­clud­ing gen­er­a­tors and the ap­pro­pri­ate amount of fuel, to main­tain com­fort­able tem­per­a­tures for at least 96 hours fol­low­ing a power out­age.

‘Chaotic’ scene

In Hol­ly­wood on Wed­nes­day morn­ing, Judy Frum, the chief nurs­ing of­fi­cer at the air-con­di­tioned hos­pi­tal just across the street from the re­ha­bil­i­ta­tion cen­ter, was work­ing in the Irma com­mand cen­ter when the emer­gency room no­ti­fied her that three pa­tients had been brought in from the nurs­ing home.

“It set off a red flag that some­thing might be go­ing on,” said Frum, who grabbed a col­league and hur­ried across the street. When they ar­rived, paramedics were treat­ing a crit­i­cally ill pa­tient near the en­trance. She saw har­ried staff mem­bers try­ing to get pa­tients into a room where fans were blow­ing.

The cen­ter had some elec­tric­ity, but not enough to power the air con­di­tion­ing. Frum called her fa­cil­ity, Me­mo­rial Re­gional Hos­pi­tal, to is­sue a mass ca­su­alty alert. As many as 100 hos­pi­tal employees rushed over to help.

“The scene on site when I got there was chaotic,” said Randy Katz, Me­mo­rial’s emer­gency ser­vices di­rec­tor.

The Re­ha­bil­i­ta­tion Cen­ter said the hur­ri­cane knocked out a trans­former that pow­ered the air con­di­tion­ing. The cen­ter said in a de­tailed time­line of events re­leased Fri­day that it re­peat­edly was told by Florida Power and Light that it would fix the trans­former, but the util­ity did not show up un­til Wed­nes­day morn­ing, hours af­ter the first pa­tients be­gan hav­ing emer­gen­cies.

The util­ity re­fused to an­swer any spe­cific ques­tions about the nurs­ing home case.

State and lo­cal of­fi­cials said that the nurs­ing home had con­tacted them, but did not re­quest any help for med­i­cal needs or emer­gen­cies.

Paulburn Bogle, a mem­ber of the house­keep­ing staff, said employees fought the lack of air con­di­tion­ing with fans, cold tow­els, ice and cold drinks for pa­tients. Rose­mary Cooper, a li­censed prac­ti­cal nurse at the re­ha­bil­i­ta­tion cen­ter, de­fended the staff’s work but de­clined to dis­cuss specifics.

“The peo­ple who were work­ing there worked hard to make a good out­come for our pa­tients,” she said in a brief in­ter­view be­fore hang­ing up on a re­porter. “We cared for them like fam­ily.” Owner Jack Michel’s at­tor­ney didn’t im­me­di­ately re­spond to a re­quest for com­ment.

State records showed prob­lems with fire and safety stan­dards, as well as more se­ri­ous is­sues with gen­er­a­tor main­te­nance and test­ing, ac­cord­ing to Fe­bru­ary 2016 reports by in­spec­tors with the Florida Agency for Health Care Ad­min­is­tra­tion.


Jan­ice Con­nelly of Hol­ly­wood, Fla., set up a me­mo­rial Thurs­day in mem­ory of the eight nurs­ing home pa­tients who died at the Re­ha­bil­i­ta­tion Cen­ter at Hol­ly­wood Hills.

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