Poor leadership and disastrous decision-making are to blame for Florida’s nursing home deaths

An eleventh nursing home resident has died after an air conditioning failure following last week’s Hurricane Irma. The Rehabilitation Center at Hollywood Hills, located outside of Fort Lauderdale, was one of 160 nursing homes that had no electricity and no air conditioning, as power lines across the state were decimated by the storm. Yet, it was the only nursing home facility in the state of Florida where multiple deaths occurred as a result of power loss.

Overcome by heat as temperatures swelled, residents were forced to remain inside the facility for three days, despite being located directly across the street from the air-conditioned Regional Memorial Hospital. Body temperatures creeped upwards of 110 degrees by the time they were rescued by firemen and rushed to the hospital just steps away. Representatives from the nursing home say they requested help from state and county officials, as well as the power company, but their calls went unanswered. Still, the electrical failure was surely foreseeable, as the entire peninsula had been declared a state of emergency.

Florida Governor Rick Scott commented to the news media that it is the responsibility of the private nursing home and every health professional, clinical or otherwise, that it employs to have a plan in place and always maintain a state of readiness for emergency response. The governor is absolutely correct, having an emergency preparedness plan is a necessity because it provides guidance on a variety of threats, from bioterrorism to natural disasters. Continuing education on emergency preparedness is equally important, for example, participating in emergency drills, and having a communication and accountability strategy that is accessible to the entire team.

At Hollywood Hills, however, the official emergency plan was greatly lacking in detail. The most updated version from June 2017 appeared to have been copied and pasted from a previous year. Furthermore, the plan did not provide any details or guidance on what to do in the event of a power outage, which is both negligent and careless. A criminal investigation is currently underway, and the home’s license to operate has been revoked.

As the saying goes: Where there is smoke, there is fire. The rehab center, which was sold to Hollywood Property Investments two years ago, had received a rating of two stars, “far below average,” and “below average” from Medicare. Past inspections found that residents had not been bathed or groomed, there was evidence of improper food handling and storage, and a faulty call system in the patients’ rooms were just a few of the complaints. Furthermore, the previous owner, former CEO Karen Kallen-Zury, was sentenced to 25 years in prison and fined $40 million for running a Medicare fraud scheme.

The preventable, unfortunate and tragic loss of lives at Hollywood Hills is a classic example of the long-lasting effects of poor leadership and disastrous decision-making. Whether these are symptoms of the nursing home’s transition in management, a deeper corporate culture problem that exists at the leadership level, or both, is worth examining.

For health care entities, successful ethical turnarounds require changing policies, structure, behaviors, and beliefs. Strategies for leaders include clearly communicating ethical expectations, being present and visible to your team, offering ethics training to all employees that reinforces standards of conduct, focusing on skill building and problem solving, rewarding ethical behavior, punishing unethical behavior, and providing a system of support so that employees are comfortable addressing ethical dilemmas and reporting incidents without fear of reprimand or retaliation.

Changing the ethical culture of an organization is not impossible, but in this case, it was already too late.

Krysten Clark Wilkes is a nursing student and former health care manager.

Image credit: Shutterstock.com

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