Nurs­ing home man­date di­luted

Tough new rule on gen­er­a­tors al­ready has wig­gle room, state de­cides

Sun Sentinel Broward Edition - - FRONT PAGE - By David Flesh­ler Staff writer

Af­ter the shock­ing deaths last month in the swel­ter­ing Re­ha­bil­i­ta­tion Cen­ter at Hol­ly­wood Hills, Gov. Rick Scott an­nounced an emer­gency re­quire­ment that all nurs­ing homes in­stall back-up power gen­er­a­tors within 60 days.

Vi­o­la­tors would face fines of up to $1,000 a day and the pos­si­ble loss of their li­cense.

But on Thurs­day, his ad­min­is­tra­tion an­nounced there might be some wig­gle room, say­ing that in “ex­treme cir­cum­stances” waivers may be granted.

The an­nounce­ment stressed that the or­der re­mained un­changed and that com­pli­ance would still be ex­pected in the vast ma­jor­ity of cases. Still, it of­fered the pos­si­bil­ity of a re­prieve to a po­lit­i­cally and eco­nom­i­cally in­flu­en­tial in­dus­try that had com­plained that the gover­nor’s time-frame for mak­ing sub­stan­tial and ex­pen­sive up­grades would be ex­tremely dif­fi­cult to meet.

The Hol­ly­wood nurs­ing home, which had a gen­er­a­tor but not one that pow­ered its air con-

di­tion­ers, lost power in Hur­ri­cane Irma. The heat grew worse, and eight res­i­dents died on Sept. 13. De­spite an emer­gency evac­u­a­tion, six more died in the fol­low­ing days, hav­ing never re­cov­ered from their trau­matic time in the suf­fo­cat­ing build­ing. The Hol­ly­wood Po­lice Depart­ment has be­gun a crim­i­nal in­ves­ti­ga­tion, and sev­eral law­suits have been filed against the nurs­ing home by vic­tims’ fam­i­lies.

The nurs­ing home has been closed since the evac­u­a­tion but is try­ing to get back in busi­ness. But the fed­eral govern­ment dealt a se­vere blow to that plan Thurs­day by cut­ting off its el­i­gi­bil­ity for Medi­care, which pays the bills for many pa­tients. The nurs­ing home has said it plans to fight to re­gain its el­i­gi­bil­ity.

The gover­nor’s emer­gency rule re­quires nurs­ing homes to have backup gen­er­a­tors and suf­fi­cient fuel to main­tain tem­per­a­tures of 80 de­grees or cooler for 96 hours af­ter the loss of elec­tric­ity.

The state­ment Thurs­day from the state Agency for Health Care Ad­min­is­tra­tion, which reg­u­lates nurs­ing homes, said waivers would not be rou­tinely granted but only in un­usual cir­cum­stances “beyond a fa­cil­ity’s con­trol.”

“This does not re­peal or mod­ify the re­quire­ments of the Emer­gency Power Plan Rule,” the state­ment said. “Nurs­ing homes and as­sisted liv­ing fa­cil­i­ties are still re­quired within 60 days of the rule be­ing pub­lished to have work­ing gen­er­a­tors and 96 hours of fuel to keep pa­tients safe and com­fort­able.”

“Each vari­ance re­quest must con­tain: steps the nurs­ing home has taken to im­ple­ment the rule, spe­cific cir­cum­stances beyond the fa­cil­i­ties con­trol that have pre­vented full im­ple­men­ta­tion, what ar­range­ments have been made to fully im­ple­ment the rule, a plan to in­form res­i­dents and their fam­i­lies of the vari­ance re­quest, and an es­ti­mated time of full com­pli­ance with the rule,” the agency said.

Brian Lee, ex­ec­u­tive di­rec­tor of Fam­i­lies for Bet­ter Care, a na­tional ad­vo­cacy group for im­prov­ing con­di­tions at long-term care fa­cil­i­ties, said the pos­si­bil­ity of waivers shows that the gen­er­a­tor rule was never in­tended to be se­ri­ously im­ple­mented. Real change, he said, will have to in changes to state law by the Flor­ida Leg­is­la­ture.

“That rule, to be­gin with, was noth­ing more than a po­lit­i­cal ve­neer, just to stem the tide,” said Lee, for­mer El­der Care Om­buds­man for Flor­ida. “The gover­nor tried to take real lead­er­ship on this, to get a rule out there and ini­ti­ate the con­ver­sa­tion. That’s all this was, a con­ver­sa­tion starter to fig­ure out how to solve this prob­lem and al­low the me­dia mael­strom to pass by.”

McKin­ley P. Lewis, spokesman for the gover­nor, said the an­nounce­ment did not rep­re­sent a change in pol­icy but sim­ply re­stated a pro­ce­dure al­ready in the law.

"It has no ef­fect on the emer­gency gen­er­a­tor rule and its en­force­ment. AHCA has made it clear that they will en­force this rule ag­gres­sively, and they will con­tinue to do just that,” he said.

The nurs­ing home in­dus­try, which has chal­lenged the rule in court, call­ing the dead­line “im­pos­si­ble,” ap­plauded the Scott ad­min­is­tra­tion’s an­nounce­ment.

Kris­ten Knapp, spokes­woman for the Flor­ida Health Care As­so­ci­a­tion, said that while nurs­ing homes sup­port the gover­nor’s goal of equip­ping nurs­ing homes with gen­er­a­tors, they have great dif­fi­culty achiev­ing this within the 60-day timetable.

“Nurs­ing cen­ters face nu­mer­ous com­pli­ance chal­lenges beyond their con­trol, from the need to se­cure suit­able gen­er­a­tors to cus­tomiz­ing the elec­tri­cal wiring of each unique cen­ter to se­cur­ing the ap­proval of lo­cal and state zon­ing au­thor­i­ties and reg­u­la­tors,” she said in an email. “On av­er­age, it takes a nurs­ing cen­ter between six months and two years to com­plete the construction and per­mit­ting pro­cesses to prop­erly in­stall an ef­fec­tive gen­er­a­tor.”

Mem­bers of Con­gress and the state Leg­is­la­ture have pro­posed re­forms, in­clud­ing re­quir­ing nurs­ing homes to have gen­er­a­tors.

Newspapers in English

Newspapers from USA

© PressReader. All rights reserved.