The U.S. Senate Finance Committee announced today that it is launching an investigation into the circumstances surrounding the deaths of 14 residents at The Rehabilitation Center at Hollywood Hills nursing home in the wake of Hurricane Irma.

The investigation comes following a request from Florida’s U.S. Sen. Bill Nelson, a senior member of the committee.

The residents of the nursing home were left without power and no air conditioning in the days following the Sept. 10-11 devastation by Hurricane Irma. Two days after the storm left, two residents were found dead in their beds and others were rushed to the hospital, where 12 more would die after apparently being baked in the sweltering facility.

Florida is investigating, and has revoked the home’s license, and the owners of the home are suing the state over that revocation.

“It is my understanding that it is the state’s responsibility to certify a nursing home’s compliance with all federal emergency preparedness regulations in order to receive federal payments under the Medicare and Medicaid programs,” Nelson wrote on Sept. 29 to U.S. Sens. Orrin Hatch, a Utah Republican, and Ron Wyden, an Oregon Democrat, who serve as the panel’s Chairman and Ranking Member respectively.

“Because the certification for a skilled nursing facility is subject to CMS approval, and the Senate Committee on Finance has jurisdiction over the Medicare and Medicaid programs, I urge the Committee to use its authority to conduct a complete investigation into the State of Florida’s certification of the Rehabilitation Center at Hollywood Hills to determine what led to the deaths of 12 seniors there in the wake of Hurricane Irma,” Nelson’s letter continued.

Responding to Nelson’s request, Hatch and Wyden sent letters Tuesday to the Centers for Medicare & Medicaid Services, requesting information about its new nursing home emergency preparedness requirements, and to the state of Florida seeking answers to questions regarding the state’s emergency preparedness plans and response to Hurricane Irma.

The committee also requested similar information from Texas, regarding nursing homes affected there by Hurricane Harvey.

“Similar reports after Hurricanes Harvey and Irma raise concerns about the adequacy of emergency preparedness and response at nursing homes and other facilities,” they wrote. “Our committee would like information about the federal requirements that were applicable during these events and the actions CMS has taken since.”

“We are writing to request information from Florida about its preparations for and responses to Hurricane Irma as it relates to nursing homes and other similar facilities,” the senators wrote in a letter to Florida’s Secretary of the Agency for Health Care Administration, Justin Senior. “The Senate Committee on Finance has jurisdiction over both the federal Medicare and Medicaid programs. 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 manmade disasters.”

In 2016, CMS finalized new national emergency preparedness requirements for Medicare- and Medicaid-participating providers and suppliers. This new rule requires long-term care facilities to develop emergency preparedness plans to ensure that staff’s and residents’ basic needs are met in the event of natural or man-made disasters, including hurricanes, wildfires, and flooding. It also explicitly requires facilities to have policies and procedures in place to address alternate sources of energy to maintain temperatures during these emergencies.

According to federal regulations, it is the state’s responsibility to certify that a nursing home is in compliance with all applicable federal rules and regulations, including the new rules put in place 2016.

Despite receiving state certification, the Rehabilitation Center at Hollywood Hills did not have an alternate source of energy powering its air conditioning unit and, as a result, was unable to maintain temperatures after the facility lost power.

At a hearing last week of the Florida Senate Appropriations Subcommittee for Health and Human Services, Molly McKinstry, deputy secretary of the Florida Agency for Health Care Administration said her agency and other state agencies were in constant contact before, during and after Hurricane Irma with all the state’s nursing homes.

McKinstry said that many nursing homes and assisted living facilities lost power and quite a few visited by state officials had interior temperatures in the high 80s and low 90s, despite meeting all the current state requirements. She said loss of power and heating issues were a “prevalent” problem.

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