When a dozen seniors died last summer after temperatures reached 99 degrees in their powerless nursing home, Florida Gov. Rick Scott made it a priority to require such elder care centers be equipped with an on-site emergency power source, preferably built-in generators.
Now with hurricane season gearing up — and the specter again of widespread power outages — the state announced seemingly good news on Friday: All but one nursing home complied. It also touted that a majority of assisted living facilities — which provide a less comprehensive level of care — were meeting standards set by the new rule as required by June 1.
But hundreds of nursing homes and assisted living facilities in Palm Beach County and the state still have no installed emergency power source for the present hurricane season.
That’s because the industry took full advantage of a carve-out of the new rule, which allows for an extension until Jan. 1, 2019, if they have a plan to bring in a temporary way to cool residents or to evacuate them.
And while a “majority” of ALFs were found in compliance by either having installed a power source or being granted an extension, 48 percent of them were not.
AHCA granted extensions for 526 of the 684 nursing homes in the state — or 77 percent. As a result, all but one nursing home was in compliance with the new state rule, but only 157 of them actually had “implemented” a plan to have the emergency power.
The elder care industry says the extensions are needed, especially for large nursing homes and some ALFs, because of the construction required to install these mammoth generators.
Brian Lee, an elderly advocate who once served as Florida’s ombudsman for seniors, called Friday’s news predictable for nursing homes and ALFs.
“The industry doesn’t have the best track record in the world. You probably have a whole bunch of facilities who are trying, but you also have gobs that are thumbing their nose,” said Lee, executive director for Families for Better Care. “They are crackerjack artists at being able to slipshod the rules.”
Scott championed the generator requirement following the deaths of seniors at The Rehabilitation Center at Hollywood Hills last September after Hurricane Irma knocked out power to much of South Florida.
But trade groups pushed back, challenging his initial emergency mandate in court and then derailing lawmakers’ bills that would require stringent compliance and inspections, Lee said.
As a result, Scott loosened the rules initially rolled out. Nursing homes and ALFs now just need to have access only to alternative power sources, not just generators. Fuel requirements were also reduced so that ALFs need to have fuel for just two days for facilities with 16 beds or less.
On Friday, the Agency for Health Care Administration rolled out data that showed nursing homes and ALFs took full advantage of the provision in the new rule to request an extension until January 2019 to implement their emergency power plans.
Elder care facilities are required, under the extension, to keep AHCA apprised of its progress in installing emergency backup power. In the meantime, nursing homes and ALFs have made arrangements to bring in portable generators or moving residents to alternative housing, among other measures, officials said.
Emmett Reed, executive director of Florida Health Care Association, which represents 82 percent of all nursing homes, said the new data showed his “members have been working tirelessly to ensure the safety and well-being of our residents through diligent compliance with new state laws.”
AHCA granted 1,002 extensions for assisted living facilities, leaving 618 ALFs that had implemented their plan under the emergency power rule. . However, another 1,477 — 48 percent — were not in compliance with the power rule in any respect.
The Florida Senior Living Association, which represents larger ALFs in the state, said its members are dedicated to complying with the new requirement but were waylaid by the bureaucracy involved.
“I think it’s red tape and paperwork issues,” said Susan Anderson, a vice president for public policy and legal affairs with Florida Senior Living Association, which represent ALFs. “Some of the technical glitches have been what exact forms are due and how to complete those forms.”
For instance, Amazing Grace Assisted Living Home in West Palm Beach, installed natural gas generators at each of its three, six-bed ALFs but the owner was told by the county that some of her documentation had been lost. As a result, AHCA lists Amazing Grace as failing to comply with the generator law.
All nursing homes and 59 percent of ALFs in Palm Beach County complied with the power rule. Nearly half of all facilities in AHCA’s Region 9 — which includes Palm Beach County — asked for and received an extension.
AHCA launched an interactive webpage Friday for the public to find the status of compliance for nursing homes and assisted living facilities or to find out if an extension had been approved. The agency said Florida is the first in the nation to require nursing homes and ALFs to have emergency power.
The emergency power plan website can be accessed by clicking here.
“Families must have the assurance that the facilities responsible for caring for their loved ones have the resources needed to be fully prepared ahead of any potential storms,” AHCA Secretary Justin Senior said in a statement.
“These life-saving rules put safeguards in place and now, more than ever, facilities are prepared for an event that could knock out power.
Fines easier than compliance?
Senior vowed that the agency would do everything within its power to hold facilities accountable and strictly enforce the generator rules, which would include fines for facilities refusing to comply.
And therein lies the rub, says Lee, the elder advocate. He says some smaller ALFs may find it financially feasible to be fined rather than to install generators.
“What is AHCA going to do? Potentially fine them a few dollars? That is not going to incentivize them to spend thousands on new generators,” Lee said.
The Florida Senior Living Association noted, though, that AHCA has more power than just to levy a fine — it can close down an ALF that is flouting the new emergency power rule.
The man who has Lee’s old job says his office is dedicated to holding ALFs accountable to the new emergency power standard.
State Long-Term Care Ombudsman Mike Milliken says he has a mostly volunteer force out there ready to inspect. In fact, he is looking for more willing eyes to ensure seniors aren’t left in sweltering conditions at ALFs. The plan is to visit every ALF in the state this year.
“Elderly people in our population are more subject to the heat. It’s critical they are in a safe environment,” he said. “If a facility says, ‘I don’t care, I’m going to take the fine,’ maybe that facility shouldn’t be in business.”