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St. Johns County nursing homes adjust to law change

The St. Augustine Record - 6/17/2018

As Florida nursing homes and assisted living facilities comply with requirements for having backup electricity, about 10 St. Johns County facilities have asked for more time upgrading their facilities, according to the Florida Agency for Health Care Administration.

Heat-related deaths at The Rehabilitation Center at Hollywood Hills in 2017, which came after Hurricane Irma disrupted power at the nursing home, prompted changes in regulations. The changes required nursing homes and assisted living facilities to have a working generator or alternate backup power source by June 1 so that temperatures stay at or below 81 degrees for at least 96 hours after a power outage.

But the Agency for Health Care Administration, the state agency also referred to as AHCA which is responsible for regulating the industry, is granting extensions to facilities up to Jan. 1 as long as alternative plans are in place to keep residents cool during a power outage. Those interim plans can include arranging for backup power to be brought onsite in an emergency or, if the facility is in an evacuation zone, evacuating residents ahead of a storm.

About 10 out of more than 20 assisted living facilities and nursing homes listed in St. Johns County on the AHCA website had received an extension as of Friday. Some providers are listed both as an assisted living facility and nursing home. Ten facilities had already implemented their plans. Several facilities had no backup power plan approved and had not submitted an extension request, according to AHCA.

Officials from several facilities who spoke to The Record said they have already put generators in place even though AHCA's information hasn't reflected that yet.

Bill Maguire, administrator of Silver Treasures St. Augustine, said his facility has a generator. While AHCA records show that the facility hasn't submitted any plans for complying with new state laws, Maguire said things are up to standard and he would check with AHCA to make sure they weren't missing anything.

He said the facility will evacuate residents in a hurricane, and he said the South Florida facility should have evacuated.

"Making everybody put [in] a generator seems like putting a Band-Aid on a bigger problem — where was the oversight at the time?" he asked.

Five of the largest assisted living facilities in St. Johns County are Silver Creek St. Augustine, which is licensed for 138 beds; Brookdale St. Augustine, which is licensed for 115 beds; Starling at Nocatee, which is licensed for 103 beds; The Palms at Ponte Vedra Assisted Living and Memory Care, which is licensed for 94 beds; and Westminster Woods on Julington Creek, which is licensed for 80 beds

As of Friday, Silver Creek St. Augustine had not asked for an extension and had not implemented a backup power plan, according to the agency's website. Brookdale, The Palms and Westminster Woods on Julington Creek had received extensions from AHCA. Starling at Nocatee has already implemented its plan.

Amanda Birch, executive director at Westminster Woods on Julington Creek, said the facility plans to get a bigger generator. In the interim, they have an emergency generator that would support life-safety equipment in a power outage. Also, if a power outage were to occur, officials would monitor the facility's temperature and immediately start its evacuation plan if temperatures exceed 81 degrees, she said.

Brookdale will use generators to cool its local facility if a power outage happens before a permanent generator is installed, according to Heather Hunter, Brookdale senior public relations specialist.

Five of the largest nursing homes in St. Johns County are the Clyde E. Lassen State Veterans' Nursing Home, Moultrie Creek Nursing and Rehab Center, The Ponce Therapy Care Center, Samantha Wilson Care Center and St. Augustine Health and Rehabilitation Center, all of which are licensed for 120 beds.

The Clyde E. Lassen and St. Augustine Health and Rehab facilities have approved plans implemented, according to AHCA. The other facilities have received an extension.

Jason Davis, administrator at Moultrie Creek Nursing and Rehab Center, said the facility is in full compliance and has a generator at the building. He said the facility has notified AHCA.

As facilities across the county comply with new regulations, some have struggled with the cost.

"The new regulations were really hard for small facilities because our patients don't pay what they do in other facilities, larger facilities," said Barbara Jackson, owner and administrator of Loving Care Living Facility, an assisted living facility near Masters Drive in St. Augustine.

Gabriela Pellosmaa is the administrator at Golden House Senior Living on County Road 210, which is also called Golden House Assisted Living. She shared a similar story.

Following expenses from hurricane repairs and buying equipment for backup power because of state-law changes, Pellosmaa chose to shut down her Palm Coast facility because of the financial burdens, she said. Now she only runs the C.R. 210 facility, which has 11 beds and nine residents.

While AHCA records don't yet reflect the fact that Pellosmaa's backup power plans have been implemented, Pellosmaa provided a tour of Golden House and pointed out a generator and gas tank that have been installed.

She paid $15,000 to purchase and install the generator and related equipment, she said. She is outside of an evacuation zone, so she would keep her residents at the facility in a storm, she said.

"It's been tough to comply with this new rule. I have many days I don't sleep because I don't know how I'm going to meet all the needs," she said.

AHCA officials are in the process of inspecting facilities that say they have plans in place, according to AHCA. Facilities that don't install backup power could face fines and penalties from AHCA.

"Families must have the assurance that the facilities responsible for caring for their loved ones have the resources needed to be fully prepared ahead of any potential storms," Justin Senior, AHCA secretary, said in a statement released by the agency.

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