T

he Florida nursing home where overheating may have caused eight deaths and led to a mass evacuation of over 100 residents has a checkered history of safety inspections, including repeated problems with its generator, STAT has found.

Around 6 a.m. Wednesday morning local police officers responded to Rehabilitation Center at Hollywood Hills, a 152-bed facility located 30 minutes north of Miami, where they found patients in “varying degrees of medical distress,” three of them deceased, according to a police report. Five others later died, and “at least another dozen patients” are being treated at nearby Memorial Regional Hospital, according to Dr. Randy Katz, medical director of emergency services.

Investigators said they believe the deaths were heat-related in the wake of Hurricane Irma. Though the facility has a generator, it was unclear if it was operational, and Broward County Mayor Barbara Sharief told reporters that the residents died from the lack of air conditioning. Hollywood Police Chief Tomas Sanchez declined to share with reporters further details about the generator but noted “it was extremely hot on the second floor of the facility.”

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In recent years the facility has been cited twice for violations related to federal requirements about its backup power capabilities.

Early last year Rehabilitation Center at Hollywood Hills only had a temporary generator and couldn’t describe plans to replace it with a permanent generator, according to records from the Centers for Medicare and Medicaid Services.

During a February 2016 visit, a federal inspector who visited and spoke with staff there found that the facility “failed to maintain the emergency generator to manufacture and code requirements,” according to records reviewed by STAT. The nursing home’s maintenance director could not produce documentation to show that either the emergency generator “had been replaced” or that there were plans for a “permanent generator” to be installed, inspector records showed.

And in December 2014, inspectors noted that “when tested, the remote generator alarm located near the nurses’ station failed to function. An interview was conducted at this time with the maintenance director who acknowledged that the remote alarm was not functional. If not maintained, the emergency generator may fail without staff being aware.”

In both cases nursing home administrators said they would rectify the problems.

Local authorities have opened a criminal investigation into the deaths of the six residents staying at Rehabilitation Center at Hollywood Hills. Sanchez said authorities are now conducting inspections of 42 assisted living facilities in Hollywood.

Administrators have so far not responded to STAT’s calls or emails regarding the criminal investigation or prior inspection records.

Charlene Harrington, professor of sociology and nursing at the University of California San-Francisco’s School of Nursing, said incidents with generators at nursing homes are “pretty unusual” but not unprecedented. (She recalls multiple deaths at a nursing home in Burlingame, Calif., from a similar issue back in 2000.)

But, she said, looking at past inspection records of the Hollywood nursing home, this facility was “definitely a case where there was evidence” of problems without adequate follow-up. That potential negligence is a “symptom of broader problem,” she said.

“All over the country nursing homes are accidents waiting to happen due to weak regulations,” she said. “Advocates say there needs to be tougher penalties — [otherwise] there’s no incentive to take care of things [like generators].”

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