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Thursday, June 21, 2018

Appeals court backs move to shutter Florida nursing home where 12 people died

Posted By on Thu, Jun 21, 2018 at 10:56 AM

A state appeals court Wednesday upheld moves by Gov. Rick Scott’s administration to shut down a Broward County nursing home that drew nationwide attention last year after the deaths of residents following Hurricane Irma.

A three-judge panel of the 1st District Court of Appeal, in a 15-page ruling, rejected challenges to Agency for Health Care Administration orders that suspended The Rehabilitation Center at Hollywood Hills’ license to operate; suspended the facility’s participation in the Medicaid program; and placed a moratorium on Medicaid admissions.

The ruling is part of a series of legal battles spawned by the deaths of residents after the Hollywood nursing home’s air-conditioning system was knocked out by Hurricane Irma. Authorities have attributed 12 deaths to problems at the nursing home after the storm.

Attorneys for the nursing home challenged the agency’s orders on a series of grounds. For example, in the challenge to the suspension from the Medicaid program, they argued the agency failed to detail facts that support “a finding of ‘immediate danger’ to the public health, safety or welfare. The order recites that residents of the nursing home ‘ultimately expired’ but fails to state any specific or particular acts or omissions of the appellant (the nursing home) or its officers, agents, or employees that are alleged to have caused the resident deaths.”

But the appeals court rejected such arguments and alluded to eight deaths that were quickly reported after the nursing home was evacuated Sept. 13 and residents went to a nearby hospital. An investigation later led authorities to attribute other deaths to the conditions.

“The (AHCA) order did not allege an isolated incident or a single mistake in judgment. Instead, it alleged that a total of eight patients died over the course of several hours, three prior to the arrival of first responders, in a facility so hot the first responders evacuated it,” said the ruling, written by appeals court Judge James Wolf and joined by judges Clay Roberts and T. Kent Wetherell. “The facility staff failed to evacuate the patients to the open hospital across the street even after multiple patients suffered medical distress and several died. This order sufficiently alleged an immediate, serious danger to the public health, safety, or welfare. AHCA was statutorily required to suspend the facility’s Medicaid participation upon evidence of patient abuse or neglect. Thus, the order could not have been more narrowly tailored.”

Similarly, the court rejected the nursing home’s arguments that the order suspending the facility’s license to operate was insufficient.

“It included facts alleging a causal connection between the heat and the patients’ deaths,” Wolf wrote. “Four of the residents died soon after being admitted to the hospital with body temperatures between 107 and 109.9 degrees. However, staff members went back and created ‘late entry’ notes reflecting that the patients had relatively normal body temperatures at a time when they were already dead or dying at the hospital.”

The court also ruled that the nursing home’s challenge to the moratorium on Medicaid admissions was moot because of the order suspending the facility’s license to operate.

Hurricane Irma knocked out the nursing home’s air conditioning system on Sept. 10 as the storm caused destruction through much of Florida. The cooling system remained out for three days, creating sweltering conditions, according to authorities.

Scott’s administration issued the moratorium and suspension orders within days of the evacuation. It also later moved to revoke the facility’s license – a decision that is being litigated in the state Division of Administrative Hearings. Meanwhile, another case filed by the nursing home against the Agency for Health Care Administration is pending in Leon County circuit court.

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