Florida’s seniors left vulnerable to hurricanes because generator requirements were not enforced
It was a situation that
After an initial 60-day deadline, the state set a final deadline of
Some complied, some did not.
Extension requests pile in
Nearly 60% of
Two days after Gov.
"The luck of the weather spared us from having a harsh test of the state of our nursing home preparedness," said
With
"There are going to be site checks, there are going to be phone calls to make sure that they have a plan to deal with folks that are in their care," DeSantis said in a news conference.
The site checks begin
As Dorian escalated toward hurricane status, and with the entire state in the cone of uncertainty, the
"We made hundreds of calls and site visits to support and verify their generator status," she said.
"There also were delays in ordering equipment, getting enough generators and staff to complete the work," Knapp said. "We do recognize that at the end of day, resident safety is focus, those that didn't have permanent generators tried to have temporary ones. Generators make a huge difference. It's the right thing to do and every one is working toward that," she said.
Although listed on the
"We have two generators -- one for the facility and a small one for the air conditioner, and we started both in front of them," she said.
Cost emerges as a factor in delays
"Some of the mom-and-pops who own assisted living facilities can't afford that cost," Marrinson said. "It's not that they don't want to ... it's that they can't afford to be compliant."
Knapp agrees: "Generators are a significant investment. The average cost for a nursing homes is
She said about 60% of nursing homes get state money through Medicaid to offset patient costs. "Most had to take out loans to pay for generators ... they are not funded initially by Medicaid," she said. The cost, and the permitting involved, led some long-term care providers to ask for multiple extensions.
"It wiped me out financially, but I think it will be worth it," she said. After the installation, no one from the state checked on its completion -- until
Along with cost, Bruns of the
"It's not an easy engineering challenge to solve. Getting a generator the size of a semi-truck and fuel supply to supply it for 96 hours of operation is not the kind of thing you can do in the snap of a finger. But acknowledging that challenge doesn't help you if you are 90 years old and bedridden in one of those facilities. At end of the day, this comes down to safety," Bruns said.
On
"We have made considerable progress," Bruns of
Mayhew said she is working to do that. On Friday, as Dorian moved north of the Carolinas, the
With even one facility for the elderly without cooling ability post-storm a concern, Mayhew said she is cracking down on those still who don't have a generators:
"I have conveyed that we have got to focus on compliance with this rule," she said. "I am going to be reluctant to extend and grant variances beyond this year, unless they are able to demonstrate good faith and due diligence that the circumstance is beyond their control."
Mayhew said she also is working on surveying the large nursing homes and assisted living facilities to better understand the barriers that caused delays.
Evacuations became the executed emergency plan
In total, 95 nursing homes and assisted living facilities along the east coast of
Some nursing homes and assisted living facilities saw the size and strength of the hurricane and chose to evacuate to sister or partner facilities.
"They knew if the storm came close they would have flooding, and they looked at the track and got started," said Knapp with
On Friday, Mayhew, reiterated that evacuation decisions were made locally with county emergency management officials based upon the storm's track, a buildings' ability to withstand a major hurricane, and whether it was in a surge zone -- not on whether a site lacked a generator.
Evacuations may be a health risk
Evacuations with the elderly are tricky -- and should be a last resort, research shows.
Research published in a journal for the
"We don't' know yet, will have to see what the emergency management analysis shows about the trauma that resulted," Bruns said.
Mayhew said her team has begun wellness visits to nursing homes and assisted living facilities as residents are moving back in. As of Friday, not every senior had returned home.
By year end, Mayhew said she wants every long-term care provider to be in compliance with the generator requirement. Along with fines already imposed to 287 facilities, she is notifying those still out of compliance that their license is at stake.
To its credit,
"Within this agency, I have created an internal list of opportunities for improvement," she said.
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