ORLANDO, Fla. – Just more than a year ago, a new state law went into effect, requiring nursing homes and assisted living centers to have emergency power plans, backup generators and enough fuel in place to run those generators for four days.
The new regulations came after a dozen people died in Hollywood Hills after their nursing home lost power during Hurricane Irma, creating sweltering conditions for several days.
But a News 6 investigation revealed that, more than a year later, not every facility has the crucial equipment in place.
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News 6 visited three of more than 3,000 assisted living facilities currently licensed in the state to see which ones had their emergency power plans and equipment in place.
Of the three, only one -- Alabama Oaks of Winter Park -- did.
"We have been approved, as of March 11, and you will see that this plan is in compliance with Orange County Emergency Management," said Jennifer Brown, the administrator at Alabama Oaks.
She said the assisted living facility can house up to 19 people and just reopened this month after undergoing a six-month renovation.
That project included buying a brand-new generator and creating a new emergency power plan to go with it.
"We are ready. We are 100 percent ready," Brown said. "And I am happy and proud to say that."
Brown said she has no problems with the state-mandated guidelines.
"Ultimately, the safety of your residents is what's your priority," Brown said.
At Excellence Senior Living in Orlando, the administrator refused to talk on camera, but confirmed the 185-bed facility is still missing a permanent backup generator. State records show the facility was approved for an extension.
Employees at Oasis National Assisted Living Facility in Apopka allowed News 6 in without a camera to see the facility's emergency power plan and new generator, but the staff admitted they are still waiting for a transfer switch to go in.
According to the Agency for Health Care Administration, 100 percent of the state's nursing homes and almost 98 percent of the state's assisted living facilities are in compliance with the new state law. That means those facilities submitted an emergency power plan or extension. It does not guarantee they have all the equipment in place. AHCA's website shows only about 86 percent of the state's nursing homes and assisted living centers have been approved.
“Plan approval means the local emergency management office has approved a facility’s implementation plan and the facility has provided notification to the agency,” said Patrick Manderfield, a spokesperson for AHCA. “Compliance indicates an emergency power plan has been implemented, meaning the facility has fully implemented its plan or an extension to implement the plan has been approved based upon valid delays in implementation.”
Manderfield confirms the Agency’s Office of Plans and Construction is meeting requests to survey generators at nursing homes as requested, but adds no agency approval is required for assisted living facilities. The agency’s assisted living inspection staff does review compliance issues during routine inspections.
Manderfield listed these key reasons for delays in implementation:
• Availability of proper equipment. Many of these facilities are very large and require custom generators to provide proper cooling.
• Installation scheduling of custom generators and appropriate electrical wiring and connection.
• Mechanical engineering plan reviews and approvals. Facilities must work with engineers, and in some cases architects to develop implementation plans, which require review and approval by local or state officials.
Manderfield said any facility with an approved extension must have an adequate plan to protect patients during a power outage, such as having a temporary generator on site, a plan to obtain a generator within 24 hours of a power outage or a full evacuation plan.
Emergency management consultant Bob Misko has helped hundreds of assisted living facilities write their emergency power plans.
He said smaller facilities are struggling as they try to meet the new power plan guidelines, since both the cost of the equipment and installation can add up to tens of thousands of dollars.
"It's tough out here. It's tough," Misko said. "They're not making any money. They're living from paycheck to paycheck. When the state dropped this on them, it was catastrophic."
Misko said that, during some of his follow-up visits, he's discovered a few facilities taking matters into their own hands, while potentially putting their residents at risk.
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He showed News 6 a picture he submitted to the Orange County fire marshals office two weeks ago, showing a gas generator placed too close to a facility, putting residents at risk of inhaling dangerous carbon monoxide fumes.
That's not all he's seen.
"Some of these transfer switches that we've seen haven't been permitted," Misko said. "They are actually jerry-rigged, where you throw this switch here and flip this one over to 'on' and then turn it off, and my concern is that somebody is going to miss a step. They're going to back-feed the panel and there's going to be a fire."
Brown said she's heard of several smaller assisted living facilities closing their doors because of the cost and backlog associated with these new power plan measures.
Brown said it's not worth it for a facility to take a shortcut.
"They are going to find a lot of it is going to be rejected, and they're going to have to start the process over again," Brown said. "So I think doing it right the first time is the best way to go."
Brown said she has the following advice for anyone who has a loved one in a Central Florida facility:
"They should be asking to see the equipment and to know what the plan is and if the caregivers have been trained," she said.
The Orange County Office of Emergency Management confirmed to News 6 that it has approved plans for 82 assisted living facilities in its jurisdiction and has requested 11 facilities to resubmit their plans. A county spokesperson confirmed six facilities have not submitted plans and the agency has notified AHCA. It turns out Orange County emergency management personnel are required to approve the emergency power plans, but the submission of the approval letter to AHCA is the responsibility of the provider.
"Specific to Orange County, the approval of a plan requires a validated letter from a Florida-licensed electrician or Florida-registered electrical engineer that the alternate power equipment will handle all loads necessary or Florida-licensed HVAC (heating, ventilation and air conditioning) contractor/mechanical engineer that verifies the cooling systems will work as required by state statute," said Carrie Proudfit, a spokeswoman for the Orange County Fire Rescue Department. "This is an additional requirement that was adopted by the county in 2018 as a means to better ensure the safety and well-being of some of our most vulnerable residents. Last June and July, Emergency Management actually hosted 12 workshops within Orange County to assist our (assisted living facilities) and nursing homes through the emergency power plan process and remain available to (assisted living facilities) and (nursing home) providers in need of assistance."
But Proudfit said it is up to the state to confirm facilities are following their plans.
"While AHCA does oversee the emergency power plans in terms of compliance and implementation, but we, too, have an obligation to our citizens, especially those that we know are vulnerable," Proudfit said. "After the tragedy down south, there is certainly a heightened awareness in terms of the potential need for emergency services in situations where a provider is without power. OCFRD crews themselves have had to evacuate nursing facilities and assisted living homes during hurricanes, particularly Irma, and, if needed, are prepared to do again. We hope that this process better prepares our providers, so that an evacuation or other such emergency intervention can ultimately be prevented."
Alan Harris, Seminole County's chief administrator of emergency management, confirms AHCA is ultimately responsible for licensing the facilities.
"Emergency management has no jurisdiction or authority to require the facility to do anything. We can only require they have a plan and it meet the items inside of the Florida statute," said Harris." AHCA data will be slightly different than emergency management because they are looking at different things. The only place the data should be 100% consistent is if the facility has an approved emergency power plan. Other than that, emergency management doesn't track if they have implemented it because this is the responsibility of AHCA."