Eight dead at South Florida nursing home as state grapples with heat, outages after Irma

Police opened a criminal investigation Wednesday into the deaths of at least eight people at a South Florida nursing home that apparently was without air conditioning amid ongoing power outages from Hurricane Irma, according to local officials.

Three people died at the facility in Hollywood, Florida, and three others were pronounced dead after being taken to a hospital, said officials in the city between Miami and Fort Lauderdale. Two other deaths were reported later Wednesday afternoon.

Authorities evacuated more than 100 other people from the facility, the Rehabilitation Center at Hollywood Hills, including bringing some to nearby hospitals. Broward County Mayor Barbara Sharief said it was not immediately clear what caused the deaths at the nursing home, which is believed to have lost air conditioning after the storm.

"We're conducting a criminal investigation into the deaths that occurred here," Tomas Sanchez, the Hollywood police chief, said at a news briefing Wednesday. "It's a sad event."

Sanchez said that officials believe the situation at the nursing home "may be related to the loss of power" caused by Irma, but said they were not ruling anything out. He declined to say whether the electricity was entirely out at the facility or if only the air conditioning was out, saying that was still under investigation.

The rehabilitation center is located across the street from Memorial Regional Hospital, the flagship facility of the Memorial Healthcare System and one of the largest hospitals in the state. An official from Memorial said that the health-care network was helping with evacuating people from the rehabilitation center, which is not part of the Memorial system, and will take some to its other hospitals in the region.

The facility had a history of poor inspections and citations. The facility is rated "below average" on the Medicare website, which evaluates facilities based on performance in health inspections, staffing and quality measures. The facility's administrator, Jorge Carballo, said in a statement obtained by the Miami Herald that the center "evacuated this morning due to a prolonged power failure to the transformer which powered the facility's air conditioning system as a result of the hurricane. Unfortunately, early this morning several patients experienced distress and there were three fatalities at the facility and three at the hospital they were transferred to." Carballo did not return messages left by the Washington Post.

Randy Katz, chairman of the department of emergency medicine at Memorial Regional Hospital, said fire and rescue received a call early Wednesday morning about a patient in distress at the rehabilitation facility. The authorities quickly realized the facility had no air conditioning, Katz said, and transported the patient to the hospital. A nurse from Memorial Regional walked over to the rehabilitation center around 6 a.m. Wednesday and decided it was in the best interest of the patients to get them out of the building.

"There was no air conditioning," Katz said. "The temperatures, particularly on the second floor, were extremely hot . . . there were a number of patients who looked like they were in distress."

Katz said hospital staff went room to room in the facility, locating patients and evacuating the building. The most critically ill patients were put on stretchers and wheeled across the street to the Memorial Regional emergency room, he said. The hospital activated a mass casualty event. It is treating 115 patients who were taken to various hospitals in the system. They are being treated mainly for dehydration, respiratory issues including respiratory failure, heat exhaustion and high fevers.

"There's no reason patients that age with chronic medical issues should be in a facility without air conditioning," Katz said.

Florida Gov. Rick Scott, a former hospital chief executive, said in a statement that the situation is "unfathomable."

"I am going to aggressively demand answers on how this tragic event took place," Scott said. "Although the details of these reported deaths are still under investigation, this situation is unfathomable. Every facility that is charged with caring for patients must take every action and precaution to keep their patients safe – especially patients that are in poor health."

Scott said he directed two state agencies – the Department of Children and Family and the Agency for Health Care Administration – to work with local authorities on the investigation, and he warned that "if they find that anyone wasn't acting in the best interests of their patients, we will hold them accountable to the fullest extent of the law."

Scott said that the facility reported Tuesday afternoon that they that they had power and access to fans and spot coolers.

The deaths occurred amid the widespread power outages that have gripped Florida since Irma. At a news conference, Florida Power and Light, the state's largest utility, said it serviced portions of the facility.

Robert Gould, the utility's chief communications officer, said he understood that certain parts of the facility had power. He said Broward County did not list the facility as critical infrastructure – the places where restoring power is a top priority after a storm – in a hurricane planning meeting earlier this year.

"This facility was not listed as a top critical" by Broward County, Gould said.

"What we've seen is something extremely tragic that points to the need to having plans in advance when it comes to emergency preparation. I would be remiss if i didn't say our deepest sympathies goes out to the families of those lost their lives," Gould said.

Millions of people across Florida have lost power since Irma began lashing the state, and utilities have warned that some of the outages could extend for days or even weeks. This has cut off air conditioning for scores of Floridians, and it poses an acute danger for the particularly young or old in a state known for its sweltering temperatures.

Statewide, about 3.7 million customers – or more than 36 percent – remained cut off from power, emergency officials said. Florida's heat adds a perilous element to the ongoing outages. In Hollywood, where the nursing home is located, temperatures are expected to reach the 90s this week.

The storm has presented risks and challenges for the elderly population in Florida, where about 1 in 5 residents are 65 or older. People in that age range are more prone to heat-related health problems because they do not adjust as well as younger people to sudden shifts in temperature, are more likely to have chronic medical conditions and are likelier to take medications that impact the body's ability to regulate its temperature, according to the Centers for Disease Control and Prevention.

"As with millions of other Floridians, our centers are coping with the loss of power and infrastructure in the communities that were most affected by the devastation," the Florida Health Care Association said in a statement Wednesday. "Approximately 150 facilities out of the nearly 700 facilities in the state do not currently have full power services restored."

Earlier this week, another dangerous scene played out inside an assisted-care facility for patients with dementia and memory impairment in Cape Coral, Florida, on the state's Gulf Coast. For three days, the facility lacked power, and for three days, elderly patients suffered in rising heat.

Humidity made the hard-surfaced floors slick with condensation, while patients gathered in a small day room to catch a slight breeze from screened windows. A handful of small fans powered by a borrowed generator were all that kept the situation from devolving into a medical emergency, said Dan Nelson, Cape Coral Shores' chief operating officer.

A state official eventually said they found a generator and gas, but it was not needed: The power turned back on.

The people who died Wednesday in South Florida were part of a death toll that, while relatively low compared to other massive storms, has slowly climbed in recent days. That tally also included two people in Georgia killed when trees fell on them and a man in Winter Park, Florida, near Orlando, apparently electrocuted by a downed power line in a roadway.

Officials were investigating a number of deaths believed to be related to the storm, although it was not clear whether Irma was directly responsible in every case, which included reported car crashes and medical emergencies. The Associated Press reported that before the deaths at the Hollywood nursing home, Irma was blamed for a combined 19 fatalities in Florida, Georgia and South Carolina.

Even as Irma dissipated and moved inland, another danger emerged for those without power: generators. Authorities have warned that these devices can be deadly, noting they can easily sicken or kill people inside homes.

The Daytona Beach Fire Department said Wednesday morning that one person was dead and three others taken to a hospital for carbon monoxide poisoning from a generator inside a home there, and the department pleaded with people to keep their generators outside.

All across Florida and the American southeast, people have grappled with the aftermath of Irma, which slammed into the Sunshine State over the weekend and tore apart trees and buildings with slashing winds and pounding rain. Jacksonville, a sprawling city on the state's northeast coast, was deluged with historic flooding.

More than 6 million people were evacuated from their homes in Florida, and they have slowly begun to return, even as roadways remain littered with debris, homes lack electricity and traffic signals have gone dark.

Across Florida, authorities warned people returning that they could find poor cell reception, blocked streets and gas stations with no fuel. In Monroe County, which includes the Florida Keys, authorities have begun letting residents trickle in, though that region – where Irma made landfall early Sunday morning – was still assessing the storm's toll.

County officials said there were eight deaths "due to or during Hurricane Irma," although they also cautioned that some of these people died from natural causes. An additional 40 people were injured during the storm, they said.

Door-to-door search and rescue efforts in the Florida Keys so far have not turned up any new casualties despite serious damage across a 40-mile stretch that includes Big Pine Key and Cudjoe Key, county officials said Wednesday. These door-to-door searches included visits to sealed homes, but authorities believe most people who were in harm's way evacuated before Irma arrived.

Key West is still isolated from the mainland, as crews continue to test bridges, clear roads and restore power and water service. Military planes flew in some supplies, and officials hope that grocery stores will be able to open within a few days. Power has been restored to a senior center and hospital in the Lower Keys, and water has been restored from Key Largo to Marathon.

"Contrary to reports, no comprehensive assessments have been done to accurately determine percentage of damage or dollar figures," Monroe County said in a statement Wednesday.

Scott Unger in Key West, Fla., and Julie Tate in Washington contributed to this story.