Blame lawmakers' cowardice for nursing home deaths

The elderly residents who languished in sweat-box misery at a Hollywood nursing home after Hurricane Irma were the victims of sickening negligence – but whose?

Gov. Rick Scott blames the operators of the Rehabilitation Center at Hollywood Hills for waiting too long to dial 911, and for failing to evacuate suffering patients to the trauma-level hospital across the street.

Nursing home officials blame the governor, state emergency planners and the power company for a fatally sluggish response to their calls for assistance.

No matter what the investigations reveal, the frail and helpless that perished – now numbering 12 – were chiefly the victims of legislative cowardice.

It's not a mere oversight that Florida nursing homes and assisted-living facilities aren't required to have generators for air-conditioning units. That's how the industry wanted it. Generators, as you know, are expensive.

And it's not as if lawmakers didn't comprehend that a massive hurricane blackout might expose ailing seniors to life-threatening heat and dehydration. Everyone knew, but few had the spine to take on the Florida Health Care Association, the powerful nursing-home lobby.

Some tried, though. An autopsy of their past efforts was depressingly recounted in The Miami Herald following the tragedy in Hollywood Hills.

After Hurricane Wilma socked South Florida 12 years ago and caused prolonged power outages, concerned legislators proposed a bill that would have required some, but not all, nursing homes to have generators large enough to run air conditioners.

What a radical investment for a residential long-term care facility – back-up power so that your patients don't die of heatstroke.

Guess what happened to that idea in the halls of the Capitol. It landed D.O.A.

So supporters offered a modest compromise, a pilot program covering only five counties. It would have allocated $57 million in public funds to reimburse some nursing-home operators 50 percent of the cost of new generators, if they agreed to accept residents evacuated from other facilities.

In other words, taxpayers would be subsidizing these senior-care facilities to buy equipment that should have been mandatory before they opened their doors. A 50-50 payout seemed like a sweet deal for the industry, but evidently not sweet enough.

The legislation sailed through the state House of Representatives without a single dissenting vote, then crashed in the Senate.

One of the doomed bill's House sponsors, former Rep. Dan. Gelber, summed up that shameful episode bleakly. "The Legislature is horrible when it comes to everything that doesn't have a tragedy behind it," he told the Herald. "They have one now."

Big time. And it could have been much worse.

Florida has 685 nursing homes and 3,109 assisted-living facilities with widely varying levels of electrical capacity and backup equipment. Officials said 40 nursing homes and 195 ALFs evacuated thousands of people in the days after Irma hit.

Power outages and deteriorating living conditions prompted most of those evacuations. Five days after the hurricane passed, 56 nursing homes still had no commercial power.

Some critics have assailed Florida Power & Light for not prioritizing emergency line repairs to elder-care facilities, as it does for hospitals.

But it's hard to imagine a day when the utilities can magically flip a switch and restore electricity to all 3,794 nursing homes and ALFs, before any harm comes to aged residents and patients. Major hurricanes cause major blackouts, always.

The simple answer is generators. Senior facilities are required to have them for lights and crucial medical equipment, so why not for air conditioners?

What unfolded in Hollywood was a hellish ordeal for patients and their families. Now it's a hellish scandal for politicians and the long-term care industry that keeps shoveling them those campaign checks.

Gov. Scott, who usually opposes the smallest inconvenience on business, took action less than a week after Irma's departure. He announced an emergency rule directing all ALFs and nursing homes to install generators that can keep air-conditioners running for a minimum of 96 hours after the power goes out.

Meanwhile several lawmakers began drafting new bills to make the air-conditioning mandate for senior facilities a state law.

So all it took to awaken the dormant conscience gene in Tallahassee was the sight of dead grandmothers and dead grandfathers being wheeled out of a sweltering nursing home.

How does any legislator watch that video without horror and shame? Next time it happens, one of those victims might be someone they love.

They should think about that – not the check they got – when the bill comes up for a vote.

Carl Hiaasen is a columnist for the Miami Herald. Readers may write to him at: The Miami Herald, 3511 N.W. 91 Avenue, Doral, Fla. 33172; email: chiaasen@miamiherald.com.

The Miami Herald

Carl Hiaasen