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First Coast Long-Term Care Facilities Meet State's Backup Power Rules

Staff at the Westwood Nursing and Rehabilitation Center in Fort Walton Beach, Fla., and firefighters, load Hurricane Irma evacuees onto a bus on Wednesday, Sept. 13, 2017.

Headed into the 2021 hurricane season, which begins June 1, all First Coast area nursing homes and assisted living facilities are in full compliance with rules requiring them to have emergency backup generators and 72 hours of fuel on-site.

In Duval County, all 113 nursing home and assisted living facilities, with a total of 8,679 beds, now have generators, according to the state's Agency for Health Care Administration(AHCA) website.

The website shows that 17 nursing homes and eight assisted living facilities have not fully complied with the backup power requirements, but none of them are in Baker, Clay, Duval, Nassau, St. Johns or Putnam counties.

The 17 nursing homes, which account for about 3% of the overall nursing home beds in the state, are scattered across 11 counties, from Escambia County in the far western Panhandle to three nursing facilities in Miami-Dade County in Southeast Florida. The eight assisted living facilities that have not fully complied are in Miami-Dade, Broward and Pinellas counties.

That means that 681 nursing homes and 3,127 assisted living facilities are “fully compliant,” indicating that their emergency operation plans have been approved by the state and local governments and generators are “available.” 

The rules also require nursing homes to have sufficient fuel available for 96 hours after the loss of electrical power during a declared state of emergency. Nursing homes must have stored on-site a minimum of 72 hours of fuel. 

The amount of fuel that assisted living facilities must maintain on-site varies with the sizes of the facilities. Assisted living facilities with 16 or fewer beds are required to have 48 hours of fuel on-site, and larger ALFs are required to have 72 hours of fuel. But the rules also make clear that the generator and fuel requirements must be in accordance with the statewide building code and local zoning.

The state website includes nursing homes and assisted living facilities that have gotten a “permanent variance” from the rules. But the Agency for Health Care Administration did not post how many facilities had received permanent variances, and the information was not immediately available. Additionally, it’s not clear whether facilities with variances are considered fully compliant with the rule.

Former Gov Rick Scott mandated emergency backup power after Hurricane Irma in 2017 knocked out the air-conditioning system at The Rehabilitation Center at Hollywood Hills, a Broward County nursing home, leading to sweltering conditions in the subsequent days. Authorities attributed as many as 12 deaths to the conditions in the facility, with the deaths and a mass evacuation drawing national media attention. 

Scott, now a U.S. senator, initially imposed the power requirements through an emergency rule after the Broward County deaths, giving long-term care providers 60 days to meet the requirements.

The emergency requirements drew legal challenges from long-term care industry associations but eventually were replaced by a pair of permanent rules. Because the mandate to have generators was expensive, the Legislature had to ratify the rules. According to a legislative staff analysis at the time, the mandate was expected to cost $121,380,545 for the nursing-home industry and $243,912,720 for assisted living facilities in the first five years.

Bob Asztalos, a former lobbyist with the Florida Health Care Association who helped negotiate the rules with Scott administration officials, said long-term care residents are safer as a result of the generators.

“It took a long time to do it, but 60 days was really an extremely ambitious agenda that couldn’t be met,” said Asztalos, who now volunteers for the Florida Department of Veterans’ Affairs and is chief operating officer of a durable medical equipment company.

The 2021 hurricane season will begin June 1 and end Nov. 30.

- WJCT News' Bill Bortzfield contributed to this report.