Florida House Backs Rule For Nursing Home Generators

Feb 28, 2018

A House committee has agreed to take steps to ratify a rule requiring nursing homes to have backup-power sources but didn’t endorse similar requirements for assisted living facilities because of concerns about the costs.

Gov. Rick Scott in recent months has pushed for nursing homes and assisted living facilities to have generators that can keep buildings cool if electricity goes out.

McKinley Lewis, Scott’s deputy communications director, told The News Service of Florida that assisted living facilities need to be “included” in the mix and that the governor’s office is “continuing to work with the Florida Legislature to make sure this gets done.”

The House Health & Human Services Committee voted unanimously Tuesday to introduce a bill that would ratify a rule issued by the state Agency for Health Care Administration, which regulates nursing homes. The proposed rule, which was hammered out by the Scott administration and the long-term care industry, would require nursing homes to have alternative power sources, such as generators, on site and 72 hours of fuel. The generators would need to be able to keep cool an area of no less than 30 square feet per resident at a temperature of 81 degrees Fahrenheit or lower for at least 96 hours.

The rule is estimated to cost nursing homes $121.3 million over the first five years, and about $66 million can be offset by Medicaid, according to a staff analysis. Agency for Health Care Administration Secretary Justin Senior told committee members that about $25 million of the $66 million Medicaid tab would be borne by the state.

Since 2010, Florida law has required legislative ratification of any rule that would increase the costs of doing business by more than $1 million over a five-year period.

House Health & Human Services Chairman Travis Cummings, R-Fleming Island, has repeatedly expressed concerns that requiring assisted living facilities to abide by backup power rules would result in an unfunded mandate on some of Florida’s smallest businesses.

The 2,951 assisted living facilities in the state would have to spend more than $243 million to comply with the requirements.

Scott’s administration has pushed for generators at ALFs and nursing homes since the deaths in September of residents of The Rehabilitation Center at Hollywood Hills, a Broward County nursing home that lost its air-conditioning system in Hurricane Irma. But long-term care providers have raised repeated concerns about issues such as costs and requirements to store fuel.

Assisted living facilities are designed to provide services in a less-restrictive and more home-like environment than nursing homes. They range from one resident to several hundred residents and offer various types of personal and nursing services.

Senior told members of the House committee that in the days following Hurricane Irma, the state emergency operations center had nightly phone calls with long-term care providers and that the Agency for Health Care Administration sent facility-surveyor staff across the state to get a gauge on what was occurring.

Senior said 1,677 assisted living facilities reported that they lost power during Hurricane Irma. Senior said facilities without backup power tended to have what he called employee abandonment, or staff not showing up for work.

He said that the “lack of staffing really put some frail elders at risk.”

Moreover, Senior said, the state “saw ALF residents, in particular, dumped inappropriately at special needs shelters and hospital emergency rooms.”

Cummings then asked Senior to focus what was in the bill and not on ALFs, which weren’t included in the bill.