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Majority of Florida Nursing Homes Aren’t Ready for Hurricanes

Facilities had to be up to new state standards by June 1 deadline, the start of storm season

man in wheelchair with caregiver

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Florida assisted living facilities scramble to meet the state's preparedness mandates.

En español | A majority of Florida's nursing homes and assisted living facilities, despite being required by a new state law to have generators to cool their facilities if the power fails, did not meet the June 1 deadline to report whether they meet the requirement, according to Florida officials.

During the devastating 2017 hurricane season, 12 residents of a Hollywood Hills, Fla., nursing home died after that facility went several days without air conditioning. In the aftermath of that tragedy, the Florida legislature passed a law requiring such facilities to have emergency power onsite during such incidents and to have a plan to move residents out if the facility is in an evacuation zone. The law also specifies that facilities must maintain a temperature of 81 degrees or below for 96 hours following a power outage.

As of the week before the deadline, only 102 of the 686 nursing homes in Florida met the requirements of the new law, with 348 having asked the state for an extension. Only 205 of the state's 3,102 assisted living facilities met the requirements, with 344 seeking an extension, according to the Florida Agency for Health Care Administration (AHCA). Those facilities that get extensions will have six months to meet the requirements, which would be after the 2018 hurricane season. But, any facility that asked for more time to comply had to show proof they have a plan in place to keep residents cool or evacuate them in the event of a power outage.

Kristen Knapp, director of communications for the Florida Health Care Association (FHCA), which represents 83 percent of Florida nursing homes, says that many facilities did file their plans with the state by the deadline, but there is a backlog in getting state approval. In Orange County, for example, more than 100 facilities filed plans that are still awaiting AHCA review, she says. "Many facilities have generators or other equipment on back order. There are also challenges with local zoning regulation delays," Knapp adds. "Our priority is keeping our residents safe. These regulations are just another part of that process.

Federal regulations already require facilities to conduct approved disaster drills, which must be reviewed annually by the federal Centers for Medicare and Medicaid Services (CMS), and to have up-to-date communications plans. Florida's new rules are even more stringent. The AHCA has warned facilities they may be cited or fined if they are not in compliance. While nursing homes can use Medicaid funds to pay for such upgrades, assisted living facilities cannot.

As facilities continue to scramble to meet the state's mandate, Florida has made progress in hurricane preparedness since the destruction of Hurricanes Katrina, Rita and Wilma in 2005 and last year's storms. Knapp says the FHCA has built relationships with local power companies to make power restoration of the state’s housing grid a priority, and that now the state has a more robust evacuation plan to get residents out of harm's way. 

Family members should have conversations with facilities where their loved ones reside, says Amy Berman, senior program officer at the John A. Hartford Foundation, whose mission is to improve the well-being of older Americans. "If the facility does have a generator, then you're in good shape," Berman says. If they do not, she recommends asking if the facility has an arrangement with an evacuation site or a plan to move to another location with a generator or other backup power source. "If that kind of plan is in place, then I'd have less of a concern," Berman says.