Eight dead at Florida nurs­ing home

Po­lice probe deaths of res­i­dents af­ter post-Irma gen­er­a­tor fail­ures led to loss of air con­di­tion­ing

The Washington Post - - FRONT PAGE - BY MARK BER­MAN, KATIE ZEZIMA AND AARON C. DAVIS

At least eight el­derly peo­ple died in a swel­ter­ing South Florida nurs­ing home af­ter it ap­par­ently lost its air con­di­tion­ing amid on­go­ing, wide­spread power out­ages re­lated to Hur­ri­cane Irma.

The deaths, which prompted a crim­i­nal in­ves­ti­ga­tion on Wed­nes­day, were what many feared might hap­pen af­ter Irma knocked out power for mil­lions of peo­ple in Florida, which is known for its ex­treme heat. With­out the respite of air con­di­tion­ing, the heat poses a par­tic­u­lar threat to Florida’s large pop­u­la­tion of el­derly res­i­dents, who are more sus­cep­ti­ble to heat-re­lated ill­nesses.

In Hol­ly­wood, Fla., where tem­per­a­tures are forecast to reach the 90s through the end of the week, author­i­ties were called early Wed­nes­day to the Re­ha­bil­i­ta­tion Cen­ter at Hol­ly­wood Hills, a nurs­ing home not far from Fort Laud­erdale with a trou­bled his­tory.

What they found was grue­some: Three peo­ple inside al­ready were dead, while other pa­tients were in “vary­ing de­grees of med­i­cal dis­tress,” city of­fi­cials said. At least five were pro­nounced dead later, while dozens of the home’s res­i­dents were spir­ited from the sti­fling build­ing to lo­cal hos­pi­tals, in­clud­ing Memo­rial Re­gional Hos­pi­tal just down the street.

Those who died — five women and three men — were be­tween the ages of 71 and 99.

“We be­lieve at this time it may be re­lated to the loss of power in the storm,” To­mas Sanchez, the Hol­ly­wood po­lice chief, said at a news brief­ing Wed­nes­day. “It’s a sad event.”

Po­lice later said they are work­ing to de­ter­mine what caused the tragedy.

“The ini­tial in­ves­ti­ga­tion has de­ter­mined that the fa­cil­ity’s air con­di­tion­ing sys­tem was not fully func­tional,” Hol­ly­wood city of­fi­cials said in a state­ment Wed­nes­day evening. “Por­ta­ble units were be­ing used in the fa­cil­ity, but the fa­cil­ity was ex­ces­sively hot.”

The first call came in to fire­fight­ers at 3 a.m. Wed­nes­day, about a pa­tient be­lieved to be in car­diac ar­rest, of­fi­cials said. Fire­fight­ers re­turned to the fa­cil­ity an hour later for a pa­tient with breath­ing prob­lems, and they then called a state agency with con­cerns about the fa­cil­ity. When a third call for help came in, more Hol­ly­wood Fire Res­cue crews were dis­patched, and they were joined by Memo­rial Re­gional

Hos­pi­tal staff.

“There was no air con­di­tion­ing,” said Randy Katz, chair­man of the depart­ment of emer­gency medicine at Memo­rial. “The tem­per­a­tures, par­tic­u­larly on the sec­ond floor, were ex­tremely hot.”

El­lie Pina, whose 96-year-old mother, Mirelle, is a res­i­dent at the cen­ter, said the fa­cil­ity had been run­ning on gen­er­a­tors since the power went out on Sun­day while Hur­ri­cane Irma swept through Florida. Pina said she and oth­ers re­peat­edly called Florida Power and Light about the lack of elec­tric­ity and were ig­nored.

“I told Florida Power and Light the gen­er­a­tors were go­ing to give up soon. And it hap­pened,” said Pina, recit­ing her ticket num­ber, which recorded her seek­ing help. “I told my hus­band peo­ple were go­ing to die in there. And it hap­pened.”

Florida Power and Light, which said Wed­nes­day it ser­viced part of the fa­cil­ity, said it ex­tended its sym­pa­thies to those who lost loved ones and was lim­ited in what it could say be­cause of the in­ves­ti­ga­tion.

Robert Gould, chief com­mu­ni­ca­tions of­fi­cer for Florida Power and Light, the state’s largest util­ity, said dur­ing a brief­ing Wed­nes­day that Broward County did not list the Hol­ly­wood fa­cil­ity as crit­i­cal in­fra­struc­ture in a hur­ri­cane plan­ning meet­ing ear­lier this year. Such lo­ca­tions are pri­or­i­tized for power restora­tion af­ter a storm be­cause of the ser­vices they pro­vide to vul­ner­a­ble peo­ple. Broward County Mayor Bar­bara Sharief did not re­spond to an email seek­ing com­ment Wed­nes­day.

Pina said the nurs­ing home’s staff set up por­ta­ble air con­di­tion­ers and put pa­tients, clothed in as lit­tle as pos­si­ble, in the hall­ways close to the cool­ing units. She was there Mon­day and Tues­day around noon and said it was ex­tremely hot.

“They were try­ing to help the peo­ple,” she said of the staff, which she said kept call­ing the util­ity for help. Pina said she and oth­ers also called 911 and re­ceived no re­sponse. On Wed­nes­day morn­ing, Pina said, she was told by a staffer that “the gen­er­a­tors gave up.”

Pina said her mother is hos­pi­tal­ized but do­ing well. She is among the more than 150 pa­tients taken from the fa­cil­ity to one of the hos­pi­tals in Memo­rial’s sys­tem. Katz said they were treated mainly for de­hy­dra­tion, res­pi­ra­tory is­sues in­clud­ing res­pi­ra­tory fail­ure, heat ex­haus­tion and high fevers.

“There’s no rea­son pa­tients that age with chronic med­i­cal is­sues should be in a fa­cil­ity with­out air con­di­tion­ing,” Katz said.

Fed­eral re­quire­ments state that nurs­ing homes must have writ­ten, de­tailed plans and pro­ce­dures for emer­gen­cies and dis­as­ters such as se­vere weather. Kris­ten Knapp, spokes­woman for the Florida Health Care As­so­ci­a­tion, said hun­dreds of fa­cil­i­ties for the el­derly have re­lied on backup sys­tems since Irma passed over the state Sun­day.

“Through­out this whole process, we haven’t heard of any af­fected nurs­ing homes op­er­at­ing with­out a gen­er­a­tor,” Knapp wrote in an email.

While Hur­ri­cane Irma did not ful­fill the most dire fore­casts, the storm still man­aged to wreak en­dur­ing havoc across all of Florida. Af­ter Irma lashed the state and parts of the South­east with rain and wind, power out­ages re­main the chief con­cerns. Power com­pa­nies had re­stored power to mil­lions, but about 3.5 mil­lion power com­pany cus­tomer ac­counts in Florida — or 1 in 3 statewide — still lacked elec­tric­ity on Wed­nes­day. Util­i­ties have warned it could be days or weeks be­fore the lights come back on in some places.

This presents a par­tic­u­lar risk in Florida, where about 1 in 5 res­i­dents are 65 or older. Peo­ple in that age range are more prone to heat-re­lated health prob­lems be­cause they do not ad­just as well as younger peo­ple to sud­den shifts in tem­per­a­ture, are more likely to have chronic med­i­cal con­di­tions and of­ten take med­i­ca­tions that af­fect the body’s abil­ity to reg­u­late its tem­per­a­ture, ac­cord­ing to the Cen­ters for Dis­ease Con­trol and Pre­ven­tion.

“The el­derly and the young are more sus­cep­ti­ble to get­ting de­hy­dra­tion from the heat,” said David Gif­ford, se­nior vice pres­i­dent of the Amer­i­can Health Care As­so­ci­a­tion. “Keep­ing them well hy­drat- ed is im­por­tant and keep­ing them as cool as pos­si­ble.”

The Florida as­so­ci­a­tion, which rep­re­sents more than 4 in 5 nurs­ing homes in the state — it does not rep­re­sent the Hol­ly­wood fa­cil­ity — said about 150 out of nearly 700 fa­cil­i­ties in the state did not have full power ser­vices re­stored as of Wed­nes­day.

“As with mil­lions of other Florid­i­ans, our cen­ters are cop­ing with the loss of power and in­fra­struc­ture in the com­mu­ni­ties that were most af­fected by the dev­as­ta­tion,” the as­so­ci­a­tion said in a state­ment.

Florida Gov. Rick Scott (R), a for­mer hos­pi­tal chief ex­ec­u­tive, called the sit­u­a­tion at the Hol­ly­wood nurs­ing home “un­fath­omable.”

“I am go­ing to ag­gres­sively de­mand an­swers on how this tragic event took place,” Scott said in a state­ment. “Ev­ery fa­cil­ity that is charged with car­ing for pa­tients must take ev­ery ac­tion and pre­cau­tion to keep their pa­tients safe — es­pe­cially pa­tients that are in poor health.”

Scott said he di­rected two state agen­cies — the Depart­ment of Chil­dren and Fam­i­lies and the Agency for Health Care Ad­min­is­tra­tion — to work with lo­cal author­i­ties on the in­ves­ti­ga­tion, and he warned that “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.”

Ac­cord­ing to Scott’s of­fice, the fa­cil­ity had re­ported as re­cently as Tues­day af­ter­noon that they had power and ac­cess to fans and spot cool­ers.

The fa­cil­ity’s ad­min­is­tra­tor, Jorge Car­ballo, said in a state­ment sent to me­dia out­lets that the cen­ter had evac­u­ated “due to a pro­longed power fail­ure to the trans­former which pow­ered the fa­cil­ity’s air con­di­tion­ing sys­tem as a re­sult of the hur­ri­cane.” Car­ballo did not re­spond to The Wash­ing­ton Post’s re­quests for com­ment.

The fa­cil­ity has a his­tory of ci­ta­tions, and it is rated “be­low av­er­age” on the Medi­care web­site. Fed­eral records, court doc­u­ments and state in­spec­tion re­ports show the fa­cil­ity’s own­ers and man­agers had lurched from one prob­lem to an­other dur­ing the past decade, in­clud­ing a fed­eral bank­ruptcy, al­le­ga­tions of fraud, com­plaints from res­i­dents and re­peated doc­u­men­ta­tion of poor care and un­safe con­di­tions.

State in­spec­tors last year found pa­tients who had been left in their night­gowns, fac­ing tele­vi­sions that had been turned off. Oth­ers were un­shaven and had untrimmed nails, in­clud­ing a man with black­ened, jagged nails who had scratched him­self raw.

“The fa­cil­ity failed to en­sure res­i­dents were treated with dig­nity with re­spect for their in­di­vid­u­al­ity and pref­er­ences,” the re­port found, say­ing in­spec­tors ob­served a “fail­ure to ad­dress res­i­dents in a re­spect­ful man­ner.”

State re­ports show vi­o­la­tions were recorded on 23 vis­its to the fa­cil­ity since 2010, with the vi­o­la­tions in sev­eral re­ports de­scrib­ing sys­temic mis­treat­ment.

Safety also was a re­peated con­cern. Smoke alarms, emer­gency ex­its and the nurs­ing home’s emer­gency gen­er­a­tor were cited for de­fi­cien­cies.

In Fe­bru­ary 2016, an in­spec­tor wrote that the fa­cil­ity failed to main­tain its emer­gency gen­er­a­tor to man­u­fac­turer and code re­quire­ments — and that it wasn’t the first time. More re­cently, in May, an­other state of­fi­cial who vis­ited the fa­cil­ity wrote that he found no prob­lems. “All pre­vi­ously cited Fire & Life Safety de­fi­cien­cies were cor­rected” and no new de­fi­cien­cies were found, he wrote.

Those who died at the nurs­ing home in South Florida were part of a death toll that, while rel­a­tively low com­pared with other mas­sive storms, has slowly climbed in re­cent days.

In Mon­roe County, which in­cludes the Florida Keys, author­i­ties have be­gun let­ting res­i­dents trickle in, though that re­gion — where Irma made land­fall early Sun­day morn­ing — was still as­sess­ing the storm’s toll.

“Con­trary to re­ports, no com­pre­hen­sive as­sess­ments have been done to ac­cu­rately de­ter­mine per­cent­age of dam­age or dol­lar fig­ures,” Mon­roe County said in a state­ment Wed­nes­day.

AMY BETH BEN­NETT/SOUTH FLORIDA SUN-SEN­TINEL/AS­SO­CI­ATED PRESS

More than 150 res­i­dents of the Re­ha­bil­i­ta­tion Cen­ter at Hol­ly­wood Hills in Hol­ly­wood, Fla., were taken to a hos­pi­tal Wed­nes­day.

MICHAEL S. WIL­LIAMSON/THE WASH­ING­TON POST

Sev­eral days af­ter Hur­ri­cane Irma passed through South Florida, a car re­mains sub­merged in a canal in Le­high Acres, near Fort My­ers. Lo­cals said the driver sur­vived by kick­ing out the back win­dow and climb­ing out.

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