Nation & World

Florida nursing home warned about loss of air conditioning

'Catastrophe' predicted in 2015 court filing

Police surround the Rehabilitation Center at Hollywood Hills, which had no air conditioning after Hurricane Irma knocked out power, on Sept. 13 in Hollywood, Fla. (Sun Sentinel)
Police surround the Rehabilitation Center at Hollywood Hills, which had no air conditioning after Hurricane Irma knocked out power, on Sept. 13 in Hollywood, Fla. (Sun Sentinel)

FORT LAUDERDALE, Fla. — Representatives of the Hollywood, Fla., nursing home where 12 people were fatally stricken after days without air conditioning have said they acted prudently in not evacuating the building. Such a move can be dangerous to the frail and elderly, they said.

But the owner had a different view. In a court filing in January 2015, Dr. Jack Michel’s lawyers said an air conditioning failure at the Rehabilitation Center at Hollywood Hills would be a “catastrophe” and “the facility would have to be shut down and the patients evacuated.”

The assertion was made in Broward Circuit Court in a foreclosure case. Michel and his South Miami Larkin Hospital held the loan on the building and were working to take over the nursing home and an adjacent psychiatric hospital from a family facing Medicare fraud charges.

Michel was willing to front the cost of repairs and upgrades, including replacing “deteriorating” air conditioning chillers and a new generator. But he wanted to recover the money out of the proceeds from any foreclosure sale and needed judicial approval.

Michel’s lawyers said they wanted to make the repairs to head off a “prospective catastrophe.”

The judge did not agree to Michel’s proposal. Later that year, Michel bought the building and upgraded the air conditioning, replacing a key component, the cooling tower, though without the proper permits, according to the City of Hollywood.

tragedy strikes

This past September, the air conditioning did fail because Hurricane Irma knocked out a transformer supplying power to the system. Nursing home staff, however, did not evacuate the 141 residents as suggested in the 2015 court filing. Instead, they tried to manage the situation for three days with spot coolers and fans.

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Administrators said they did not evacuate the home because they repeatedly called the governor’s office, state regulators and FPL and were assured that the electrical power would soon be restored. By the time it was, however, it was too late.

Twelve residents died of heat exposure in what the Broward County medical examiner’s office has classified as homicides. No one has been charged, but a criminal investigation is ongoing.

In a statement Thursday, an attorney for the nursing home said there is no contradiction between the assertions made in the 2015 court filing and the actions taken by the Rehabilitation Center to respond to Hurricane Irma.

“The proper plans were made for this storm, with the commitment of full support and backup of the state emergency response officials,” the statement from Tallahassee attorney Geoffrey Smith said. “Nobody advised that the power would not be restored promptly and that the facility should evacuate all residents. In short, the facility was assured that help would arrive, but it never came.”

The nursing home now is closed and is challenging the state’s revocation of its operating license. Hearings before an administrative law judge are scheduled to start in late January.

The state contends that the Rehabilitation Center failed in its duty by not evacuating residents sooner, especially given that it is directly across the street from Memorial Regional Hospital. The nursing home also did not transfer residents to another nursing home under existing emergency agreements.

Lawyers for the Rehabilitation Center maintain that the center’s nurses were monitoring residents and they were not showing signs of distress before the crisis on the morning of Sept. 13, documents filed with the Division of Administrative Hearings show. That day, one person after another had trouble breathing or went into cardiac arrest.

The nursing home plans to offer evidence showing that excessively high body temperatures can occur in as little as 10 to 15 minutes in frail, elderly people. Its representatives also will argue that Florida Power & Light and Broward County are at fault for not ensuring that nursing homes were given top priority for power restoration, along with hospitals, airports, police departments and other critical facilities.

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“No one ever informed nursing homes that they were not considered ‘critical facilities’ with regards to emergency planning,” the nursing home’s lawyer wrote in a brief last month.

But court records from 2015 show that the nursing home’s management knew a prolonged power outage could occur.

In the 2015 foreclosure case, attorneys for Michel told the judge that in a hurricane “it is not unreasonable to expect the FPL will not be able to restore electrical service for several days,” and that services such as air conditioning, laundry and computers may be unavailable to the residents. “This may ultimately cause residents to be relocated.”

“A modern health care facility must be self-sufficient in a disaster situation until help can arrive and power can be restored,” the nursing home wrote in the 2015 court filing.

Michel was asking the court to replace the air conditioner and a temporary generator capable of running some lights and basic electrical system. That generator had been jury-rigged to the electrical panel and was “woefully undersized to meet the needs of the residents and patients in the event of an outage,” the request to the judge said.

The Florida Agency for Health Care Administration had cited the home in late 2014 for having a temporary generator that was not properly installed and approved by city officials.

When the hurricane hit in September, the nursing home still had a temporary, standby generator, tied into the building’s electrical system without the proper permits, according to the city of Hollywood.

After Hurricane Irma, the governor issued an emergency order requiring all nursing homes to immediately install generators capable of running air conditioners. The order has faced court challenges but is being enforced. Legislators are considering bills to put the requirement in law.

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According to a lawsuit filed in Broward County, not only did the Rehabilitation Center at Hollywood Hills not evacuate residents when the air conditioning failed, it admitted a new resident in the midst of the crisis.

Assured by staff at Hollywood Hills that the nursing home was “up and running,” a case manager at Memorial Regional Hospital transferred Clarice Damas to the Rehabilitation Center on Monday Sept. 11, the day after the air conditioning failed, the suit claims. Damas had Alzheimer’s disease and used a feeding tube, according to the lawsuit. She survived the ordeal but became severely confused, agitated, short of breath and lethargic.

When her family asked when the “dire” conditions would improve, the suit says, nursing home staff told them they were “working on it” and could not transfer Damas out because all area hospitals were full.

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