The Rehabilitation Center at Hollywood Hills/photo by J. Albert Diaz

Offering extensive details of what she described as a “catastrophe,” an administrative law judge has backed a state decision to revoke the license of a Broward County nursing home where residents died after Hurricane Irma.

Judge Mary Li Creasy, in a 94-page recommended order issued Friday, traced a three-day chain of events that started when the hurricane knocked out the air-conditioning system at The Rehabilitation Center at Hollywood Hills. The events ended with seniors dying or being evacuated from the sweltering facility, where Creasy said temperatures on a second floor were recorded at more than 100 degrees.

“Hollywood Hills' actions violated the rights of numerous vulnerable and medically fragile residents, particularly those who resided on the second floor of its facility, by failing to provide a safe environment,” Creasy wrote. “The evidence clearly and convincingly demonstrates Hollywood Hills failed to properly monitor and hydrate its residents as temperatures continued to rise in the building, thus failing to provide appropriate health care and protective services. Hollywood Hills also failed to evacuate the premises when it became clearly uncomfortable and dangerous to the well-being of the patients.”

But Creasy's recommended order also outlined how nursing-home officials had made numerous phone calls to Florida Power & Light, state emergency-management officials and even Gov. Rick Scott's cell phone seeking help as the air-conditioning system remained out and as temperatures rose. In the end, local fire and rescue crews and workers from a nearby hospital helped evacuate the 152-bed facility.

“Throughout this proceeding, Hollywood Hills argued that its responsibility, if any, for the patient deaths, should be mitigated by the inactions of others,” Creasy wrote. “As set forth in [an earlier order in the case], the focus of this proceeding is on whether Hollywood Hills met its obligation to provide a safe environment and appropriate health care to its residents. The efforts by Hollywood Hills to shift the blame by trying to point the finger at other entities is irrelevant to the issues before this tribunal.

“Hollywood Hills highlights FP&L's inexplicable failure to timely respond to its requests for prioritization and the governor's failure to return phone calls for assistance to his cell phone. Apparently, Hollywood Hills incorrectly assumed that power restoration to its chiller was imminent, and it was therefore lulled into inaction. However, this is belied by the fact that Hollywood Hills staff never discussed the risks to the patients versus benefits of evacuation, or the timing of a possible evacuation if the A/C was not restored.”

The deaths and evacuation of the Broward nursing home drew national attention in the days after Hurricane Irma, which made landfall Sept. 10, 2017 in Monroe and Collier counties and caused damage through much of the state. The nursing home lost power to its air-conditioning system, Creasy wrote, because a fuse to a transformer on a power pole was dislodged.

The air conditioning was out until Sept. 13, when residents of the nursing home was evacuated. Authorities have attributed as many as 12 deaths to conditions at the facility, though Creasy wrote that “clear and convincing evidence” was presented during the case that nine of the 12 residents “suffered greatly from the exposure to unsafe heat in the facility.”

Scott's administration last year quickly suspended the facility's license, effectively shutting down the nursing home, and then moved to revoke the license. That drew the legal challenge. Under administrative law, Creasy's ruling is a recommended order that must go to the state Agency for Health Care Administration for final action.

The ruling, quoting Agency for Health Care Administration Deputy Secretary Molly McKinstry, said 245 nursing homes lost power during the hurricane and that facilities without electricity and adequate cooling were a “pervasive” problem.

Creasy also provided a detailed timeline of how The Rehabilitation Center at Hollywood Hills tried to handle the lack of air conditioning, including using portable “spot” coolers and fans to try to keep residents comfortable. The judge, however, quoted one first responder as saying the facility was “ungodly hot” when crews went into the building early Sept. 13, 2017.

“It is a nursing home's responsibility to ensure its residents are provided a safe and comfortable environment,” she wrote. “Hollywood Hills failed to protect and ensure appropriate health care services to the residents in its care during the loss of A/C to the facility after Hurricane Irma.”

Jim Saunders reports for the News Service of Florida.