Document DvYmKK3VX81qeNp5g2b8QyZ7O

Message From: Sent: Subject: Governor's Press Office [Governor'sPressOffice@eog.myflorida.com] 9/19/2017 11:31:56 PM Information Regarding the Rehabilitation Center at Hollywood Hills Interested media - In response to multiple public records requests received by our office regarding the Rehabilitation Center at Hollywood Hills and Larkin Community Hospital Behavioral Health Services, see the below and referenced documentation which includes links to records such as emails, notes, call log information, and other relevant information. To view the referenced records, click HERE. Please note - at no time did the Rehabilitation Center at Hollywood Hills or Larkin Community Hospital Behavioral Health Services report that their patients were in dangerous conditions or that they needed to be evacuated. Every healthcare professional knows to call 911 if their patients' lives are in danger. In fact, facility management was advised by the state multiple times to call 911 if they had any reason to believe that any lives were in danger - something they failed to do. Thank you, John Tupps Governor Scott's Communications Director Please see a statement from Governor Rick Scott: Governor Rick Scott said, "No amount of finger pointing by the Hollywood Hills Rehabilitation Facility and Larkin Community Hospital Behavioral Health Services will hide the fact that this healthcare facility failed to do their basic duty to protect life. This facility is failing to take responsibility for the fact that they delayed calling 911 and made the decision to not evacuate their patients to one of the largest hospitals in Florida, which is directly across the street. The more we learn about this, the more concerning this tragedy is. Through the investigation, we need to understand why the facility made the decision to put patients in danger, whether they were adequately staffed, where they placed cooling devices and how often they checked in on their patients. The families of those who trusted the Rehabilitation Center at Hollywood Hills deserve answers and those responsible for this horrific behavior should be prosecuted to the fullest extent of the law." Governor Scott has taken the following action to hold the Hollywood Hills Rehabilitation Center accountable for their decision to not protect patient life: On Wednesday, September 13th, Governor Scott called for AHCA and DCF to conduct investigations into the facility. On Wednesday, September 13th, Governor Scott directed AHCA to issue an emergency moratorium for the Rehabilitation Center at Hollywood Hills that prevents the facility from admitting any patients until it is lifted. On Thursday, September 14th, Governor Scott directed AHCA to terminate the facility as a Medicaid provider, as this facility was responsible for providing their patients a safe environment and failed to do so. On Saturday, September 16th, Governor Scott directed AHCA Secretary Justin Senior and Florida Department of Elder Affairs Secretary Jeffery Bragg to issue emergency rules to keep Floridians safe in healthcare facilities during emergencies. Pursuant to the emergency action, within the next 60 days, all assisted living facilities (ALFs) and nursing homes must obtain Sierra Club v. EPA 18cv3472 NDCA Tier 1 ED 002061 00010754-00001 ample resources, including a generator and the appropriate amount of fuel, to sustain operations and maintain comfortable temperatures for at least 96-hours following a power outage. This is based on standards already in place at all hospitals in Florida. TIMELINE On March 21-22, 2017, AHCA confirmed that the Rehabilitation Center at Hollywood Hills had submitted a Comprehensive Emergency Management Plan (CEMP) to Broward County. Tuesday, September 5, 2017 On Tuesday, September 5, 2017 at 5:36 PM, the Rehabilitation Center at Hollywood Hills was notified by the state to report updates to the FL Health STAT Database on pre-storm Hurricane Irma preparedness. The facility was asked to provide updates to the database at least twice a day. However, if significant changes occurred, they would have to report additional updates. All ALFs, nursing homes and hospitals were asked to do this. (A-1) Thursday, September 7, 2017 On Thursday, September 7, 2017 at 3:30 PM, the Rehabilitation Center at Hollywood Hills had not reported any data through the FL Health STAT Database. (P-1, P-4, P-8, P-9) On Thursday, September 7, 2017 at 5:54 PM, the administrator of the Rehabilitation Center at Hollywood Hills reported through the FL Health STAT Database that everything was operational. (P-1, P-4, P-8, P-9) Friday, September 8, 2017 On Friday, September 8, 2017 at 5:00 PM, the Rehabilitation Center at Hollywood Hills' previously provided update was counted as their current status in the FL Health STAT Database since they did not report any changes. Per this report, everything remained operational at the Rehabilitation Center at Hollywood Hills. (P-1, P-4, P-8, P-9) On Friday, September 8, 2017 at 8:30 PM, Governor Scott, AHCA Secretary Justin Senior and Surgeon General Dr. Celeste Philip hosted a call with hospitals, nursing homes and assisted living facilities. The Rehabilitation Center at Hollywood Hills participated in this call and did not report any issues. (B-3, T-1) Saturday, September 9, 2017 On Saturday, September 9, 2017 at 7:30 AM, the Rehabilitation Center at Hollywood Hills' previously provided update was counted as their current status in the FL Health STAT Database since they did not report any changes. Per this report, everything remained operational at the Rehabilitation Center at Hollywood Hills. (P-1, P-4, P-8, P-9) On Saturday, September 9, 2017 at 10:30 AM, the Rehabilitation Center at Hollywood Hills' previously provided update was counted as their current status in the FL Health STAT Database since they did not report any changes. Per this report, everything remained operational at the Rehabilitation Center at Hollywood Hills. (P-1, P-4, P-8, P-9) On Saturday, September 9, 2017 at 1:30 PM, the Rehabilitation Center at Hollywood Hills' previously provided update was counted as their current status in the FL Health STAT Database since they did Sierra Club v. EPA 18cv3472 NDCA Tier 1 ED 002061 00010754-00002 not report any changes. Per this report, everything remained operational at the Rehabilitation Center at Hollywood Hills. (P-1, P-4, P-8, P-9) On Saturday, September 9, 2017 at 3:19 PM, the Rehabilitation Center at Hollywood Hills reported to the state through the FL Health STAT Database that everything was operational. (P-1, P-4, P-8, P-9) On Saturday, September 9, 2017 at 7:45 PM, Governor Scott, AHCA Secretary Justin Senior and Surgeon General Dr. Celeste Philip hosted a call with nursing homes and assisted living facilities. The Rehabilitation Center at Hollywood Hills participated in this call and did not report any issues. (B-6, T-1) Sunday, September 10, 2017 *Tropical storm force winds arrived in Broward County on Sunday, September 10, 2017 at approximately 8:00 AM. * On Sunday, September 10, 2017 at 12:00 AM, the Rehabilitation Center at Hollywood Hills' previously provided update was counted as their current status in the FL Health STAT Database since they did not report any changes. Per this report, everything remained operational at the Rehabilitation Center at Hollywood Hills. (P-1, P-4, P-8, P-9) On Sunday, September 10, 2017 at 7:30 AM, the Rehabilitation Center at Hollywood Hills' previously provided update was counted as their current status in the FL Health STAT Database since they did not report any changes. Per this report, everything remained operational at the Rehabilitation Center at Hollywood Hills. (P-1, P-4, P-8, P-9) On Sunday, September 10, 2017 at 10:30 AM, the Rehabilitation Center at Hollywood Hills' previously provided update was counted as their current status in the FL Health STAT Database since they did not report any changes. Per this report, everything remained operational at the Rehabilitation Center at Hollywood Hills. (P-1, P-4, P-8, P-9) On Sunday, September 10, 2017 at 1:30 PM, the Rehabilitation Center at Hollywood Hills' previously provided update was counted as their current status in the FL Health STAT Database since they did not report any changes. Per this report, everything remained operational at the Rehabilitation Center at Hollywood Hills. (P-1, P-4, P-8, P-9) On Sunday, September 10, 2017 at 2:30 PM, Governor Scott, AHCA Secretary Justin Senior and Surgeon General Dr. Celeste Philip hosted a call with nursing homes and assisted living facilities. The Rehabilitation Center at Hollywood Hills participated in this call and did not report any issues. (B-9, T-1) * Per the timeline released by the Rehabilitation Center at Hollywood Hills, their air conditioning lost power on 9/10/17 at 3:00 PM. This was not reported to the state. * On Sunday, September 10, 2017 at 6:46 PM, the Rehabilitation Center at Hollywood Hills was again notified by the state to report updates to the FL Health STAT Database on post-storm Hurricane Irma response. The facility was asked to provide updates to the database at least twice a day. However, if significant changes occurred, they would have to report additional updates. All ALFs, nursing homes and hospitals were asked to do this. (C-1) Sierra Club v. EPA 18cv3472 NDCA Tier 1 ED 002061 00010754-00003 On Sunday, September 10, 2017 at 6:51 PM, the Rehabilitation Center at Hollywood Hills reported through the FL Health STAT Database that they were closed but that everything was operational, including heating and cooling. (P-1, P-4, P-8, P-9) *Tropical storm force winds ceased in Broward County on Sunday, September 10, 2017 at approximately 7:00 PM. * Monday, September 11, 2017 On Monday, September 11,2017 at 7:30 AM, the Rehabilitation Center at Hollywood Hills' previously provided update was counted as their current status in the FL Health STAT Database since they did not report any changes. Per this report, everything remained operational at the Rehabilitation Center at Hollywood Hills. (P-1, P-4, P-8, P-9) On Monday, September 11,2017 at 5:37 PM, the Rehabilitation Center at Hollywood Hills called the Florida Emergency Information Line, a toll-free hotline activated at the time of an emergency to provide an additional resource for those in Florida to receive accurate and up-to-date information. This information includes road closures and alternate routes, available/open shelters in host or impacted counties, shelters designed for special needs patients, hotels and motels that accept pets, boaters' instructions for moving watercraft to safer ground, and re-entry information once it is safe to return to the affected area. This line is an information line for Floridians and is not meant to replace 911. (D-2) The Rehabilitation Center at Hollywood Hills reported issues involving air conditioning but did not, at any time during the call, report or indicate that conditions had become dangerous or that the health and safety of their patients was at risk. (E-1) On Monday, September 11,2017 at 7:35 PM, an aide for Governor Scott received a voicemail left on the Governor's personal cell phone from Natasha Anderson, CEO of Larkin Community Hospital Behavioral Health Services, and referred the information to officials at AHCA and DOH. (F-7) * This was a personal cell phone which the Governor gave out to mayors, sheriffs, police chiefs, county and city officials, nursing homes, ALFs and fuel and utility providers. Governor Scott's cell phone does not have the capability to receive or send text messages. Additionally, Governor Scott's email is reviewed by the Governor's Office of Citizen Services during regular business hours. * On Monday, September 11,2017 at 9:40 PM, the state submitted a power restoration request regarding the Rehabilitation Center at Hollywood Hills to be referred to FPL for priority restoration. (H1) On Monday, September 11,2017 at approximately 9:50 PM, DOH Chief of Staff Alexis Lambert returned the call left on the Governor's personal cell phone by contacting Natasha Anderson, CEO of Larkin Community Hospital Behavioral Health Services. Chief Lambert advised Anderson to call 911 if there was any reason to believe that the health or safety of patients was at risk. The Rehabilitation Center at Hollywood Hills reported issues involving air conditioning but did not, at any time during the call, report or indicate that conditions had become dangerous or that the health and safety of their patients was at risk. (1-1) Tuesday, September 12, 2017 Sierra Club v. EPA 18cv3472 NDCA Tier 1 ED 002061 00010754-00004 On Tuesday, September 12, 2017 at 10:25 AM, an aide for Governor Scott received two voicemails left on the Governor's personal cell phone from Natasha Anderson, CEO of Larkin Community Hospital Behavioral Health Services, and Jorge Carballo, Rehabilitation Center at Hollywood Hills administrator, and referred the information to officials at AHCA and DOH. (F-4) On Tuesday, September 12, 2017 at 10:52 AM, AHCA confirmed the calls had been received and that follow ups would be made. (G-1) On Tuesday, September 12, 2017 at 12:50 PM, an aide for Governor Scott received a voicemail left on the Governor's personal cell phone from Natasha Anderson, CEO of Larkin Community Hospital Behavioral Health Services, and referred the information to officials at AHCA and DOH. (F-1) On Tuesday, September 12, 2017 at 1:30 PM, the Rehabilitation Center at Hollywood Hills' previously provided update was counted as their current status in the FL Health STAT Database since they did not report any changes. (P-1, P-4, P-8, P-9) On Tuesday, September 12, 2017 at 2:00 PM, as part of all impacted counties' daily submissions, Broward County submitted a situation report to the state Division of Emergency Management that included an update on all health and medical aspects of storm response in Broward County. Included in this report was a note that the Rehabilitation Center at Hollywood Hills is running on generator power without air conditioning, which is adversely affecting patients, and that a ticket had been put into FPL to ensure priority status. (J-1) * Per the timeline released by the Rehabilitation Center at Hollywood Hills to the media, Memorial Regional Hospital System provided spot coolers on 9/12/17 at 3PM. * On Tuesday, September 12, 2017 at 4:17 PM, AHCA Health Services & Facilities Consultant Susan Glass returned the call left on the Governor's personal cell phone by contacting Jorge Carballo, Rehabilitation Center at Hollywood Hills administrator. Carballo reported that the Rehabilitation Center at Hollywood Hills was open, that the chiller was not operational pulling outside air but that they had spot coolers and fans, and that power was partial. Elevators, generator, sewer, water, cell phones, computer/internet, refrigeration for food, refrigeration for medication and supplies, telephone, vacuum/suction systems, and water heater/boiler was operational, and gasoline was adequate. Carballo did not, at any time during the call, report or indicate that conditions had become dangerous or that the health and safety of their patients was at risk. Glass advised Carballo to call 911 if there was any reason to believe that the health or safety of patients was at risk. This report was added to the FL Health STAT Database after the call at 4:30 PM. (K-1, L-1) On Tuesday, September 12, 2017 at 4:41 PM, AHCA Government Operations Consultant Sharon Woodbery returned the calls left on the Governor's personal cell phone by contacting Natasha Anderson, CEO of Larkin Community Hospital Behavioral Health Services. Anderson reported that the Rehabilitation Center at Hollywood Hills was open, that the chiller was not operational pulling outside air but that they had spot coolers and fans, and that power was partial. Elevators, generator, sewer, water, cell phones, computer/internet, refrigeration for food, refrigeration for medication and supplies, telephone, vacuum/suction systems, and water heater/boiler was operational, and gasoline was adequate. Anderson did not, at any time during the call, report or indicate that conditions had become dangerous or that the health and safety of their patients was at risk. This report was added to the FL Health STAT Database after the call at 4:56 PM. (M-1, N-1) Every person who called the Governor regarding this facility received a call back. Sierra Club v. EPA 18cv3472 NDCA Tier 1 ED 002061 00010754-00005 * According to media reports, at approximately 3:00 AM on 9/13/17, the first patient was taken to the hospital from the Rehabilitation Center at Hollywood Hills. Shortly after, three patients were discovered deceased within the facility. A total of eight patients from this facility have tragically passed. * At no time during the night of 9/12/17 or the morning of 9/13/17 did the Rehabilitation Center at Hollywood Hills report to AHCA or DOH that emergency services had been called or that evacuations had been implemented. Wednesday, September 13, 2017 On Wednesday, September 13, 2017 at approximately 8:30 AM, following unconfirmed reports of an incident at the Rehabilitation Center at Hollywood Hills, AHCA Secretary Justin Senior contacted Sandra Sosa-Guerrero, CEO of Larkin Community Hospital, which is an affiliated hospital in Miami, who said she would instruct the facility to contact Secretary Senior to provide more information. (O12) Shortly after this call, Larkin Community Hospital President and Rehabilitation Center of Hollywood Hills owner Dr. Jack Michel contacted Secretary Senior and confirmed that while the facility had power, they did not have air conditioning but had about 20 spot coolers. Dr. Michel also reported three unconfirmed deaths at the facility and that he would add his Medical Director, Dr. Brian Ibrahim, to the call. (0-12) Dr. Brian Ibrahim joined the call with Secretary Senior and Dr. Michel and confirmed the initial three deaths of patients on the second floor of the Rehabilitation Center of Hollywood Hills and all patients had been evacuated to Memorial Regional Hospital. Dr. Ibrahim also noted that there were no major health issues between 11 PM and 12 AM the night before and that a physician's assistant went through the facility that night before and found no elevated temperatures after checking the core temperatures of all the facility's patients. He also reported that the facility believed the temperature had never exceeded 80 degrees. (0-12) ### Sierra Club v. EPA 18cv3472 NDCA Tier 1 ED 002061 00010754-00006