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Deregulated & Unaccountable: For-Profit Nursing Homes in Florida Face Scrutiny After Irma Deaths

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Authorities in Florida have obtained a search warrant to investigate the deaths of eight elderly residents at a nursing home in Hollywood in the aftermath of Hurricane Irma. The victims ranged in age from 71 to 99 years old. They died in the Rehabilitation Center at Hollywood Hills after a transformer was knocked out following the hurricane, causing the nursing home’s air conditioning unit to shut down. Authorities say that the administrators of the nursing home were aware that the air conditioning unit had failed, and that they installed fans and portable air coolers inside the facility. But the remedies did little to protect the residents from the sweltering heat. At 3 a.m. on Wednesday morning, one nursing home resident was rushed to the emergency room of Memorial Regional Hospital, a Level I trauma center just down the street. By 5 a.m., when the hospital received a third rescue call, some hospital workers went down the street to check on the nursing home. They found a situation so critical, the hospital sent in more than 50 medical workers under a mass casualty protocol. At least 150 people were evacuated, many with severe dehydration and other heat-related symptoms. We speak with Dale Ewart, vice president of 1199SEIU, the United Healthcare Workers East union. We also speak with Stephen Hobbs, a reporter for the Sun Sentinel who has been covering the eight deaths.

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This is a rush transcript. Copy may not be in its final form.

AMY GOODMAN: We begin today’s show in Florida, where authorities have obtained a search warrant to investigate the deaths of eight elderly residents at a nursing home in Hollywood, Florida, in the aftermath of Hurricane Irma. The victims range in age from 71 to 99 years old. They died in the Rehabilitation Center at Hollywood Hills after a transformer was knocked out following the hurricane, causing the nursing home’s air conditioning unit to shut down. Beginning just this past Tuesday night, temperatures began to soar inside the center. Authorities say administrators of the nursing home were aware the air conditioning unit had failed, and that they installed fans and portable air coolers inside the facility.

But the remedies did little to protect the residents from the sweltering heat. At 3 a.m. Wednesday morning, one nursing home resident was rushed to the emergency room across the street at Memorial Regional Hospital, a Level I trauma center. An hour later, another elderly patient arrived. By 5 a.m., when the hospital received a third rescue call, some hospital workers went down the street to check on the nursing home. They found a situation so critical, the hospital sent in more than 50 medical workers under a mass casualty protocol. At least three people were found dead. One hundred fifty-eight more were evacuated, many with severe dehydration and other heat-related symptoms.

This is Hollywood Police Chief Tomas Sanchez announcing a criminal investigation.

POLICE CHIEF TOMAS SANCHEZ: So, this is very tragic. It’s very sad. Many of us have loved ones in assisted living facilities, and we expect that care to be there for those people. … We immediately started a criminal investigation into this matter and made sure that everyone was evacuated. And we took control of the entire building immediately thereafter.

AMY GOODMAN: New details about the nursing home emerged throughout the day Thursday, including the fact a number of safety violations had already been reported at the facility, including two violations about its backup power capabilities—this was before the storm. The main owner of the nursing home, Dr. Jack Michel, also has a history of running afoul of healthcare regulators. In 2006, the Justice Department fined another hospital that Michel runs, the Larkin Community Hospital, $15.4 million over civil fraud allegations. Florida Governor Rick Scott has now directed the Agency for Health Care Administration to terminate the nursing home as a Medicaid provider.

For more, we go directly to Florida to speak with two guests. In Fort Lauderdale, we’re joined by Stephen Hobbs, a reporter for the Sun Sentinel who’s been covering this story. And in Miami, Dale Ewart. He is a vice president of 1199SEIU, the United Healthcare Workers Union East.

We welcome you both to Democracy Now! Stephen Hobbs, you’ve been reporting on this story. I briefly outlined what happened, but why don’t you fill us in from the beginning?

STEPHEN HOBBS: Thank you for having me, Amy.

What happened, it sounds like, according to the reporting that we’ve done so far, is, after the storm hit, in the afternoon on Sunday, the transformer—there’s two transformers that feed power into the nursing home facility. The transformer that provides power for the air conditioning unit went out. The other transformer, that provides power to the rest of the building, kind of flickered, but remained on. So it was about Sunday afternoon that the air conditioning went out. And as it went on, administrators at the nursing home say that they tried to contact utility officials at Florida Power & Light and other officials in the state and in the county to let them know that they needed power. And as the days went on, they tried, as you mentioned, to use coolers and fans to try to cool down the residents there. They say that efforts were made on Monday and Tuesday, and that they were told by utility officials that people would come out. And that never happened.

But as you mentioned, as well, temperatures started to rise. And when people were sent to the hospital on Wednesday morning, hospital staff realized that they had a real situation. And that’s something that we’re still trying to figure out, as to why the administrators were saying—they never sounded the alarm saying that we have a incredibly serious event where people could die. And then, when hospital staff showed up on Wednesday, they realized that they had a mass casualty event and that they needed to send in people immediately.

AMY GOODMAN: And this was after the first patient was brought in, dead, then the second patient. This is just across the street, right? The nursing home right across the street from a trauma one center?

STEPHEN HOBBS: Yes, it’s right across the street. And what happened, a nursing officer from the hospital said yesterday that, yes, she was alerted. She was working in the command center for the hospital after the hurricane, and she was alerted by emergency room staff that three patients had been brought in with very high temperatures. And so she went over, because it was across the street, and investigated herself. And when she walked in, she said it was very warm. She couldn’t give an exact temperature, but she saw people in serious distress, people that looked dehydrated, people that looked like they were having respiratory problems. And she said staff inside were frantically trying to bring people into areas—into an area where they had coolers and fans to try to cool people down. So, she went in with fire rescue officials, and they realized that they had a very serious situation. And that’s when the hospital kicked into gear and started sending more people over, started sending wheelchairs and stretchers, to get people out of that home.

AMY GOODMAN: Now, the nursing home says they contacted Florida Power & Light. Florida Power & Light refused to speed up its response to senior living facilities, they say. They say the county never listed nursing homes as critical facilities in power outages. Is this true?

STEPHEN HOBBS: Yes, and the county said that they did that because Florida Power & Light guidelines don’t have nursing homes as critical infrastructure facilities. So, as you can tell, there’s a lot of kind of pointing back and forth as to maybe who should have stepped in here. But, yes, those are—those are the arguments that the sides are giving as to why something wasn’t done earlier.

AMY GOODMAN: I wanted to bring Dale Ewart into the conversation. I mean, so often a catastrophe like this, a climate catastrophe, in this case, lays bare the weaknesses of a system and also shows us the importance of government and regulations. But how is it possible nursing homes, where the most vulnerable people are, are not considered critical facilities in power outages?

DALE EWART: It really is a good question. This was a tragedy. And it raises questions and concerns, not just about what happened in this particular situation, but how all nursing homes in Florida are regulated, and whether we’re going to require accountability and transparency, and whether nursing home owners, like the owner of this particular facility, that have a history of abuse should even be allowed to operate healthcare facilities. Certainly, things like putting them higher up on the FPL list and requiring facilities to have standby generators that would run air conditioning systems would make a whole lot of sense in a place like Florida. But there are broader questions about what we’re willing to allow nursing homes to get away with and what kind of accountability we want to have for the billions of dollars in public money that supports this industry.

AMY GOODMAN: You know, you have these two states that are so hard hit by this climate catastrophe, two hurricanes, Irma and Harvey, two states that are headed by climate change deniers, but also, for some reason, part and parcel of that, two states headed by those who hail their states as states where regulation will not get in the way, let’s put it that way. I wanted to turn to Texas to talk about an image that went viral during Hurricane Harvey. It was a picture of elderly residents at La Vita Bella nursing home in Dickinson, Texas, sitting in waist-deep water. It’s this astounding picture. They’re in their wheelchairs—I think one woman is crocheting—and the water is up to their chests. Fifteen residents sit patiently, awaiting rescue, which came shortly after the image was retweeted more than 2,000 times. Interestingly, the photo was taken by the owner of the facility, who had reached out for help. And she sent it to her daughter in Florida, whose husband put it out on Facebook, calling for help. Some dismissed it. They said, “This has to be photoshopped.” Dale Ewart, can you talk about this case, as well?

DALE EWART: I’m not familiar with that particular case, but you started off by talking about the governors of both states being fans of deregulation, as is our Legislature. The problem is that nursing homes are funded by our tax dollars; 70, 80 percent of the revenue that supports this industry is our money through Medicaid and Medicare. And it is simply not appropriate to have an industry that’s on the public dole. I mean, I would say we should question whether it’s appropriate to have an industry that takes care of frail elderly people that is run by for-profit corporations. But if we’re going to do that, then we have to have appropriate regulation that makes sure that staffing levels are sufficient to provide quality care and that nursing home operators are accountable for the money they receive and for standards of care. And that’s a problem that, you know, is not—that’s a day-to-day, 365-day-a-year problem, not just in natural disasters like this.

AMY GOODMAN: Can you talk more about nonprofit nursing homes? And also, what efforts are there now to improve conditions in nursing homes? What political roadblocks do you face? And talk about your perch at the union and why unions are significant here.

DALE EWART: In some ways, we’re really, in Florida, unfortunately, going in the wrong direction. Back in 2002, Florida passed a series of nursing home reforms that, among other things, created some of the highest staffing standards in the nation, for Florida’s nursing homes. And in the 10 years that followed, the nursing home industry, using its political connections, has rolled those back significantly. A year from now, there are going to be reforms in the way nursing homes are paid by Medicaid, which will result in a transfer of money from high-quality, high-reimbursement nursing homes, who are predominantly, though nonexclusively, not-for-profit, precisely to the low-paying, low-performing nursing home facilities. It’s a real taking from the good actors and rewarding the bad actors. And there are real serious concerns in the industry about what this is going to mean for staffing levels, which are already in trouble.

Having a union is an important voice for healthcare workers. Most of the hands-on care that’s done in nursing homes is done by certified nursing assistants. And they, tragically, subsidize this industry through poverty-level wages and poor healthcare and retirement benefits. It’s a labor of love, but it is a crime that we ask our nursing home residents and our nursing home caregivers to subsidize the activities of for-profit corporations.

AMY GOODMAN: I wanted to go back to Stephen Hobbs. The owner of the Rehabilitation Center at Hollywood Hills in Florida, Dr. Jack Michel, has a history of healthcare fraud and violations. In 2006, Michel settled claims after he and five associates were accused of agreeing to send patients to the Miami hospital he owned for unnecessary treatment, according to the Department of Justice. Michel became president and CEO of Larkin Community Hospital in 1998 and became sole owner in 2006. He settled the case the same year for $15.4 million. The facility was cited for federal code violations on at least two occasions for issues related to its generators. And according to the Miami Herald, there’s at least one pending lawsuit against the Rehabilitation Center, alleging negligence, brought by a former resident. Stephen Hobbs, this record, its significance? And what is happening now to these nursing home residents?

STEPHEN HOBBS: Well, it’s obviously something that people are looking at very strongly now and just wondering, you know, with more scrutiny as to the status of the people in this facility. I think as we look into the record, we realize that there were issues in the past. They had rectified the generator issues. But obviously, it’s a larger issue in Florida, in that nursing homes aren’t required to have a backup generator to power them in a situation like this.

And officials in Hollywood, as you mentioned, they are trying to use a search warrant. They were either going to execute it last night or today to try to get more information. There’s an ongoing criminal investigation as to what was happening in the facility and what happened. And so that’s going to be something that will continue. I was there yesterday, and police had caution tape around the facility. There were police vehicles completely around it. And they were waiting to go in there and gather more evidence as part of their investigation.

AMY GOODMAN: Finally, let me put this question to Dale Ewart. Your governor—your governor, Phil Scott—Rick Scott, is the former chief executive of Columbia/HCA, overseer of the largest Medicare fraud of all time. Can you talk about his history?

DALE EWART: Yes. When the governor was head of what was then called Columbia/HCA, he was, as you said, at the helm when that company was charged with Medicare fraud. This is also—you know, Florida is sort of ground zero for Medicare fraud. There have been recent examples in the nursing home industry of Medicare fraud.

But again, for me, it gets back to the question of what kind of transparency—are we going to insist on knowing who is owning and controlling and operating these facilities? And what kind of accountability are we going to have to make sure that quality of care is being provided and that we hold nursing home operators, healthcare providers to the highest standards of care? I think we don’t do that effectively enough, and I’m concerned that in—with respect to funding of nursing homes in Florida, we’re actually, perhaps, heading in the wrong direction.

AMY GOODMAN: Very quickly—we just have 30 seconds—for people who are watching this in this country and around the world, what should they be concerned about right now, if they themselves are in a nursing home, if loved ones are in nursing homes? What should they be asking about? What kind of information do they need to demand to ensure that their loved ones, or they, themselves, are being treated well?

DALE EWART: Access to information isn’t as good as it should be. But I would recommend the Medicare.gov website Nursing Home Compare. It is a way of finding out ownership information, quality assessments. You’re able to compare nursing homes head to head, if you’re trying to choose. It’s probably the single best resource right now for people who are concerned either about where a loved one is currently placed or are looking to place a loved one in a nursing home, to try to make the best decisions that you can. Nursing Home Compare.

AMY GOODMAN: I want to thank you so much, both, for being with us, and we’ll continue to follow this story. Dale Ewart is vice president of 1199SEIU, based in Florida, speaking to us from Miami. And thank you to Stephen Hobbs, a reporter at the Sun Sentinel, speaking to us from Fort Lauderdale. We will link to Stephen’s articles at democracynow.org.

When we come back, the U.S. Virgin Islands. What’s happened? We’ll talk about the devastation with a native of one of those islands, Saint Thomas. Stay with us.


AMY GOODMAN: Cuban legend Silvio Rodríguez singing live at Central Park SummerStage here in New York last weekend. To see more of his songs, you can go to democracynow.org.

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Next story from this daily show

The Forgotten Americans: Why Did U.S. Media Ignore U.S. Virgin Islands Devastated by Irma?

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