FORT LAUDERDALE, Fla.--Florida regulators have moved to permanently revoke the operating license of the Rehabilitation Center at Hollywood Hills after 14 people died when it lost air conditioning during Hurricane Irma.
The state Agency for Health Care Administration also wants the owners to pay a fine of about $43,000 for violations of health and safety standards and for inspection costs.
The agency licenses and regulates long-term care facilities. In September, it forbade the nursing home from taking in new residents or receiving Medicaid.
The rehabilitation center lost power to its central air conditioning after Hurricane Irma for several days. By Sept. 13, residents began suffering respiratory distress and cardiac arrest, one after another, in shockingly fast succession. Eight died that day and six more in following days.
Authorities evacuated the building, shut down the nursing home and launched a criminal investigation.
The nursing home is fighting its closure. It denies violating any regulations and has asked for a hearing before an administrative judge.
The home has also filed a lawsuit in Tallahassee claiming that AHCA cannot prove the residents -- who were old and sickly -- died because of the lack of air conditioning. The Broward Medical Examiner's Office is still determining the causes of death.
In Washington on Wednesday, the U.S. Senate Finance Committee announced that it is launching an investigation into the circumstances surrounding the nursing home deaths.
The panel has jurisdiction to examine the conditions in the facility because it oversees payments from Medicare and Medicaid.
U.S. Sen. Bill Nelson, D-Fla., has asked that the committee determine whether Florida properly certified that the nursing home met all the required emergency preparedness regulations to qualify for federal funding.
"As part of our oversight responsibilities, we want to ensure the safety of residents and patients in nursing homes and other similar facilities during natural and man-made disasters," the committee chairman, U.S. Sen. Orrin Hatch, R-Utah, and ranking member Ron Wyden, D-Ore., wrote in a letter to AHCA Secretary Justin Senior.
In the latest state action against the nursing home, the Agency for Health Care Administration revealed that 59 of more than 140 residents lived on the top floor, including each of the eight residents who died on Sept. 13.
The Sun Sentinel reported earlier this month that all the initial victims lived on the second floor.
The nursing home "failed to recognize the potential health risk of the rising internal facility temperatures and humidity, affecting vulnerable elderly residents," the state contends.
The home had fans in resident rooms and 10 rented portable air conditioners on site, though one malfunctioned, according to the state agency.
Two of the working portable air conditioners were placed in an adjoining psych hospital, four on the nursing home's first floor and three upstairs to cool 16,000 square feet.
In the early morning hours of Sept. 13, the facility had 12 nursing staff working to care for more than 140 residents, the AHCA complaint says.
Five were certified nursing assistants, who take vital signs and feed, bathe and dress residents. Four were licensed practical nurses and three were registered nurses.
The previous day shift was staffed by 24 people, including 15 certified nursing assistants.
None of the many documents released so far by the city of Hollywood, the state or the nursing home show any doctor in the building the previous evening or into the early morning hours Sept. 13.
Top managers also were not on hand during the morning crisis, having worked several days straight as the hurricane approached and landed. The facility administrator, Jorge Carballo, left slightly before midnight on Sept. 12, according to AHCA.
The director of nursing, Maria Colon, left the afternoon of Sept. 11 and did not return until the emergency broke. She'd instructed her staff to monitor residents frequently and offer water and ice every hour, according to the state.
The first paramedics to respond about 3 a.m. on Sept. 13 found the conditions in the building "untenable due to lack of functioning AC," the state complaint says.
The first resident who was hospitalized had an extraordinarily high body temperature of 107 degrees. Emergency room doctors diagnosed her with heat stroke, gave her IV fluids, put ice packs on her underarms and neck, and lowered the temperature in the hospital room to 55 degrees.
In another case, paramedics found a nurse performing CPR on one unresponsive man, then noticed his roommate had also stopped breathing.
In its case for closure, the state argues that nursing home officials on the evening of Sept. 10 reported to a Florida Health STAT information database that everything was operational "including heating and cooling." The nursing home, however, had been without air conditioning for several hours by then.
Throughout the ordeal, administrators from the nursing home contacted Florida Power & Light repeatedly and left several messages on the governor's cellphone, asking for help getting the power restored. They said they were assured by the utility and state regulators that the request was a priority and had been "escalated." Power was not reconnected, however, until after numerous residents had died.
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