FORT LAUDERDALE, Fla. -- The temperature inside a Hollywood nursing home that became a death trap for a dozen residents soared to 99 degrees Fahrenheit -- a key detail previously not disclosed to the public.
With a criminal investigation under way, medical officials and police had not revealed just how hot it grew after Hurricane Irma knocked out the home's central air conditioning. A nurse who prompted a mass evacuation of the building three days later said at the time: "The temperature in the building was really warm."
The residents of the Rehabilitation Center at Hollywood Hills struggled for 62 hours in the oppressive heat. Twelve died in what the Broward Medical Examiner's Office ruled were homicides.
At least 10 of the 12 lived on the second floor. That's where temperatures climbed to 99 degrees, according to a new document filed by the Agency for Health Care Administration, which oversees nursing homes.
The document lays out just how widespread the problem became, revealing how many people were seriously sickened by the heat.
State health regulators reviewed the medical records of most of the building's 141 residents and found four out of every five who lived on the top story suffered dehydration or other effects of heat exposure.
Those living downstairs fared better but still many also fell ill from the extreme heat and humidity. State health regulators said 44 percent of the 71 residents on the bottom floor suffered from dehydration or other heat related symptoms.
The state cites the dehydration among residents in it's claim that "the facility failed to provide appropriate health care" and did not ensure that the 12 who died were "free from neglect." The state alleges that nursing home officials failed to recognize the risk of the rising temperatures and violated state law by not providing "comfortable and safe room temperature levels."
A lawyer and a public relations team hired by the Rehabilitation Center at Hollywood Hills were not working during the Christmas holiday and could not be reached for comment.
In legal papers filed with the state in its defense, the nursing home has said it "properly monitored, hydrated and provided care and comfort for residents," while it waited for the power to be restored. In addition, the nursing home said at no time "were any excessive temperatures experienced in the building."
An administrative law judge will consider all sides of the argument in hearings set to begin in late January in Fort Lauderdale.
A number of survivors and families of the dead are suing the nursing home, alleging that administrators did not properly prepare for the disaster or react to the dangerous conditions.
Some lawsuits claim the nursing home was understaffed and residents found their pleas for water went unanswered. At the time, the city of Hollywood was under a boil water advisory. The nursing home had limited power from a generator to run lights and some equipment, but not the air conditioning.
In one lawsuit, survivor Clarice Damas, 86, claims the facility was "severely understaffed" and residents "ignored" or "forgotten." She contended the nursing home did not have enough ice and she asked for water and a fan but did not get it.
The facility's director of nursing -- the top supervisor -- left the building Monday Sept. 11, the day after the hurricane, and did not return until Wednesday, Sept. 13, the day all the residents were being evacuated.
She told state regulators that she recalled the home having seven nurses on duty during the overnight shift when people began dying. Of those, three were highly skilled registered nurses and four were licensed practical nurses, or LPNs, who have lesser training.
But the home was short on nurses' aides. Only five were on duty for a building with more than 140 residents, the director told the health care regulators. Experts contacted by the Sun Sentinel said there should have been three times as many working then.
Nurses' aides provide most of the basic care to nursing home residents. They get them up, dressed, washed and fed. They reposition people to prevent bed sores and take basic vital signs. They have most contact with patients but are the least trained on the nursing team.
According to the state health care administration, before she left, the director of nursing told the nurses and aides to monitor the residents frequently and to "offer water and ice every hour."
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