Why did nursing home patients have to die?
The Rehabilitation Center at Hollywood Hills boasts that the Florida facility provides “topquality medical care” and assures potential nursing home residents that “in case of an emergency, we are located directly across the street from Hollywood’s Memorial Regional Hospital.”
That proximity was no help to eight residents, ages 71-99, who died last week after being stuck in stifling heat at the nursing home after Hurricane Irma knocked out power to the air conditioning. Hospital staff weren’t called to the home “across the street” until the fire department responded to two medical emergencies and discovered three residents already deceased. Concerned, hospital staffers walked over and found residents in desperate need of emergency care. A ninth resident died this week.
The deaths have set off the predictable round of finger-pointing among the nursing home, the electric utility, state agencies and the governor. This blame game avoids the real problem. The facility had one operable backup generator, which did not run air conditioning. And no one — not the federal government, not the state and not the county — required the facility to have one.
In Florida’s often sweltering climate, air conditioning is not a luxury for elderly people; it’s a necessity. Just as emergency gener- ators are necessities in cold climates when power outages occur. It should not have taken nine deaths to make that obvious.
Yet the Centers for Medicare and Medicaid Services, which sets standards for homes that receive federal payments, only requires generators for running medical equipment such as ventilators. The closest the agency comes, in a new rule set to for November, is requiring facilities to provide “alternate sources of energy to maintain temperatures to protect resident health and safety.” Why not be perfectly clear? Further, states, which take the lead in regulating nursing homes, ought to do the same. It’s unclear how many do.
After the outrage over the recent deaths, Florida Republican Gov. Rick Scott has gotten on the right track. On Saturday, he announced that nursing homes and assisted living facilities will be required to have generators that can maintain comfortable temperatures for four days. The state fire marshal will inspect the generators, a key to ensuring this gets done.
Getting past the powerful nursing home lobby, however, is a challenge. While the Florida Health Care Association says it favors the “intent” of Scott’s order, the group initially raised “a host of concerns,” including cost.
In 2006, after Hurricane Wilma, a legislative proposal to require facilities to buy generators was whittled back to a pilot program with shared state funding. Even that measure died.
Some Florida nursing homes have been leaders. In 2011, Bon Secours nursing home in St. Petersburg, a non-profit where 70% of patients are on Medicaid, bought a generator for its 274bed facility for about $500,000.
In the Miami area, the monthly cost for a private room in a nursing home is nearly $10,000. Nursing homes ought to be able to easily pay for this necessity. If nursing homes won’t make the investments voluntarily, public officials across the country should make them. No resident should die because it gets too hot or too cold to survive.