TALLAHASSEE, Fla. — After 11 nursing home residents died in the sweltering heat of hurricane-induced power outages, Florida’s nursing home industry is now on a collision course with Gov. Rick Scott.

Days after Hurricane Irma ravaged the state, Scott used his emergency powers to put in place new rules that require nursing homes and assisted living facilities to have generators capable of providing backup power for four days. The Republican governor, who normally brags about eliminating regulations on businesses, gave nursing homes 60 days to comply.

Nursing home officials say they can’t.

They say it’s not just the multimillion dollar price-tag that will come with acquiring large generators for hundreds, maybe thousands, of homes. During a daylong summit by the industry Friday, engineers and contractors and others who operate nursing homes said it will be practically impossible to purchase, install and get permits to put generators and supplies of fuel in place by the November deadline.

“Compliance with the rule is impossible and time is running out,” said Steve Bahmer, president and CEO of LeadingAge Florida, an association that represents both nursing homes and assisted living facilities.

So far, the Scott administration isn’t backing down.

Justin Senior, the state’s top health care regulator, said the state will “aggressively” enforce the mandate, which calls for fines for those homes that fail to comply.

Senior showed up at the nursing home industry summit to explain the logic behind the rule. He said that Irma’s unpredictable path showed that is no longer acceptable for nursing homes to merely say they plan to evacuate patients when a storm is looming.

“Evacuation plans generally fell through,” said Senior, the secretary for the Agency for Health Care Administration. “There was no place to run; there was no place to hide.”

Police in Hollywood are currently investigating why the 11 patients died after Irma knocked out air-conditioning at a nursing home there, even though just across the street was a fully functioning and cooled hospital. The latest death reported is that of 94-year-old Alice Thomas, who died Thursday, and police said they are treating that as part of their criminal investigation of the Rehabilitation Center at Hollywood Hills and its employees.

Eight patients died on Sept. 13, three days after Irma knocked out the home’s air conditioning. Three have died this week. Overall, 145 patients were taken from the home. The dead have ranged from 78 to 99 years old. No one has been charged.

The state has suspended the home’s license. The home has filed a lawsuit trying to overturn the state’s actions.

Senior, who called the deaths “painful” and “haunting,” said he was aware of some of the industry’s complaints, but he had a strong warning:

“We think very strongly of the cost of not complying with this rule is greater than the cost of compliance,” Senior said.

Senior did tell the nursing homes that the generators do not have to be large enough to cool their entire building. Instead, he said, they need to be large enough to keep patients safe in a cooled environment.

The tough stance that the Scott administration is taking with the nursing home industry runs counter to the governor’s usual attitude toward regulation, especially in the health care field. Scott, a multimillionaire who never ran for office before getting elected in 2010, once ran the nation’s largest chain of hospitals before he was forced out of his job as the head of Columbia/HCA.

The industry could challenge Scott’s decision to put the emergency rule in place since it is not currently a requirement under state law. Kristen Knapp, a spokeswoman for one nursing home trade group, the Florida Health Care Association, said the group was “exploring all of its options.”

Bahmer called a possible legal challenge “absolutely the last consideration.”


Associated Press writer Terry Spencer contributed to this report from Fort Lauderdale, Florida.

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