Putting it all Together: The Technicalities, Finding Generators, and Equipping Nursing Centers

by Rick Christ
This is the final piece in our three-part series reporting on the Emergency Preparedness Summit held in Tallahassee on September 23rd. Read part one and part two here.
 
A panel of electrical engineers, generator contractors and power company executives next explained some of the technical decisions and processes in equipping a facility with a backup generator.

Did you know?

Generators are commonly required for safety systems (exit lights and smoke detectors), some overhead lights and some outlets, such as those that could power health devices. There are requirements about maintaining “Temperatures to protect patient health and safety and for the safe and sanitary storage of provisions.” (CMS Emergency Preparedness conditions (b)(ii)(A))
 
But the new Florida standard requires generators to power air conditioning that will “Ensure ambient temperatures will be maintained at 80 degrees or less for a period of a minimum of ninety-six (96) hours in the event of the loss of electrical power.”

The electrical requirements for air conditioning are considerably greater than for lighting and safety equipment.

Read more about preventing power outages here.
 
Depending on the size of the facility, the generator would be the size of an SUV or larger, with a correspondingly large fuel tank (550 gallons to over 1000 gallons). This equipment is expensive, custom-configured, and requires both space and its own safety plan.
 
Additional wiring would be required within the facility, to connect the generator to the air conditioning units. Including design, approval, construction, installation, and testing, this is generally a 9-18-month process. In other words, if every nursing home in Florida started now, few would be operational by NEXT hurricane season.
 
The costs associated with such a system are enormous, often exceeding $100,000 for a moderately sized facility. Some facilities will not be able to find the space to safely install a generator and fuel tanks due to their urban location or proximity to other buildings.

Regulations and Steps for Equipping Nursing Centers with Generators

Under current Florida law (and in most states) installation of a generator and large-capacity fuel tank (or gas lines) requires local building and fire code review and approval. This necessary step increases costs and delays construction beyond the requirements of the new emergency rule. The Secretary of Florida’s Agency for Health Care Administration said at the conference, “We may well see that there were more deaths during Irma from carbon monoxide poisoning than from heat stress,” it is imperative that safety rules be followed carefully.
 
In the final session, state lawmakers, an accountant, and others spoke about funding sources for the installation of generators. Apparently, when fire sprinkler regulations were enacted earlier this century, various loan guarantee programs and other funding mechanisms were put in place to balance the costs against the benefits. There are currently no such funding opportunities for compliance with the Florida law. At best, Lorne Simmons, CPA, from Moore Stephens Lovelace, said that facilities might be able to bill Medicaid $.75 per patient per day for this improvement, creating a 15- to 20-year payback on installation investment.
 
The elected representatives discussed their role in establishing a more permanent law than the governor’s emergency rule, and they spoke with candor about the political process and its fallout. State Representative Jason Brodeur from Sanford expressed this very reasonable concern: “The easy thing to do (politically) is to pass the Governor’s rule as law. But we need to do it right. If we increase costs of nursing home care, especially for smaller facilities, we’ll have many of them close, and we’ll have thousands more homeless seniors across the state. We have to seek balance.”
 
We’ll continue to follow this issue, tracking it across the country. If you hear of local or state efforts please let us know. We also created a special page with Florida regulatory information and CPR’s services for Florida healthcare facilities and coalitions.
 
Is your nursing home ready for the November 15th deadline? Contact us for a FREE consultation today.
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