Marco Rubio’s letter to committee Chairman Orrin Hatch, R-Utah, and ranking member Ron Wyden, D-Oregon, emphasizes the problems AHCA found at the facility. | AP Photo Rubio calls for congressional investigation of nursing home

Sen. Marco Rubio wants a congressional investigation into a troubled Florida nursing home where 14 residents died after Hurricane Irma knocked out power last month and shut off the facility’s air conditioning.

“This has shocked the state of Florida, and rightfully raised questions about the oversight of nursing homes, particularly the enforcement of existing emergency preparedness requirements,” Rubio wrote in his letter, released Thursday. The letter calls for an investigation by the Senate Finance Committee, which oversees Medicare and Medicaid, and by extension nursing home funding.


Rubio said the committee should examine what happened in nursing homes across Florida as well as Puerto Rico, which was devastated Sept. 20 by Hurricane Maria. But the thrust and substance of his letter revolve around the events at the Rehabilitation Center at Hollywood Hills after Hurricane Irma hit Florida Sept. 10.

“While this terrible tragedy is currently under investigation, it has been widely reported that these individuals were left in sweltering conditions,” Rubio wrote.

With his letter, Rubio is calling more political attention to a controversy that Democrats have highlighted to criticize the leadership of Florida Gov. Rick Scott, a fellow Republican who is considering a Senate bid against incumbent Democrat Bill Nelson.

Nelson wrote the Finance Committee Sept. 29 and requested an investigation. His letter noted that “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.”

Scott says the nursing home is to blame for the deaths and says Democrats are exploiting the tragedy for political gain. He issued an emergency rule requiring all nursing homes in the state equip themselves by Nov. 15 with generators to ensure adequate power to run air conditioners. The industry is challenging the rule Thursday in an administrative hearing. Scott also wants a state constitutional amendment guaranteeing safety for nursing home patients.

But Democrats say the state did not take safety precautions seriously enough at nursing homes until Irma, and they’ve pointed out that the state’s Agency for Health Care Administration had repeatedly cited the nursing home.

Rubio’s letter to committee Chairman Orrin Hatch, R-Utah, and ranking member Ron Wyden, D-Oregon, emphasizes the problems AHCA found at the facility. And he noted that federal regulations require that nursing homes have emergency preparedness plans that “address subsistence needs for residents, including alternate sources of energy to maintain temperatures and protect residents’ health and safety.”

In 2016, Rubio wrote, the agency found “the medication error rate during the observation period was nearly 26 percent, far exceeding the federal regulation requiring facilities to ensure that ‘medication error rates are not five percent or greater.’ Two years prior, AHCA found that the facility was not providing enough water to all patients in order to maintain proper hydration and health, contravening federal requirements. These violations are especially alarming since the facility’s personnel knew that they were being monitored by AHCA inspectors.”

Additionally, Rubio wrote, the nursing home was cited for failing to properly maintain the automatic fire sprinkler system.

“Not only is this a violation of federal regulations, but it is also indicative of the lack of seriousness with which the nursing home considered emergency response plans, as well as CMS’ oversight of those plans,” Rubio wrote. “Unfortunately, despite this requirement and the facilities’ close proximity to an operational hospital, residents were found to have temperatures exceeding 109 degrees, far above the level that puts seniors at risk for heat stroke.”

As Rubio was drafting his letter, the state Agency for Health Care Administration’s deputy secretary, Molly McKinstry, was explaining to state legislators in Tallahassee on Wednesday that there were pervasive problems related to power outages across the state after Hurricane Irma for nursing homes and assisted living facilities.

The majority of facilities never evacuated their residents during the storm and, of those that did, many residents returned before the facilities restored power because they couldn't stay at shelters, said the AHCA's deputy secretary.

"After several days of power outages, it was hot in these facilities," she said.

In all, residents in 79 of 683 nursing homes were evacuated and residents in 463 of 3,109 assisted living facilities were evacuated.

The 14 deaths at the Rehabilitation Center at Hollywood Hills in Florida were isolated in terms of their gravity, McKinstry said, but "the issues related to residents residing in locations for multiple days without power and hot temperatures was a pervasive issue in our experience after the storm."

In his letter, Rubio asked the Senate Finance Committee not to limit its investigation to Hollywood Hills.

“I implore you to investigate the failures that occurred at this nursing home and others throughout the country, particularly in Florida and Puerto Rico, to prevent similar tragedies from happening in the future,” he wrote. “Additionally, I respectfully request that you consider examining other ways in which Medicare and Medicaid beneficiaries were impacted by these storms and how better planning and coordination between the federal, state, and local government could mitigate harm caused by hurricanes.”