Powered for Patients, a 501c3 non-profit created after Hurricane Sandy to better safeguard emergency power for critical healthcare facilities, said today that the extended power outages caused by Hurricane Ida will seriously challenge the ability of Louisiana’s hospitals and nursing homes to comply with new federal rules intended to prevent dangerous overheating of patient care areas within healthcare facilities.
The CMS Emergency Preparedness Rule, first proposed in December 2013 by the Centers for Medicare and Medicaid Services (CMS) and finalized nearly three years later, requires hospitals and skilled nursing facilities to ensure that temperatures in patient care areas not exceed 81 degrees during power outages. For most facilities, meeting this rule requires connecting a portion of the facility’s air conditioning system to emergency power, an expensive step that many facilities have yet to undertake. The use of portable cooling devices can also help lower temperatures but in larger facilities, these devices will likely be insufficient to ensure that temperatures don’t rise above 81 degrees in all patient care areas.
The requirement that hospitals and nursing homes maintain temperatures at or below 81 degrees during power outages reflects the deadly lessons of past hurricanes, including Katrina and Irma, both of which triggered patient deaths due to extreme heat in patient care areas. Following Hurricane Irma, twelve elderly residents of the Hollywood Hills Rehabilitation Center in Hollywood, FL died after an extended power outage drove temperatures inside the facility to dangerous levels. These deaths triggered new laws in Florida mandating that nursing homes install generators capable of supporting air conditioning systems during power outages.
As part of an ongoing emergency power resilience initiative being undertaken for the Los Angeles County Emergency Medical Services (EMS) Agency, Powered for Patients recently completed a census of the emergency power systems in Los Angeles County’s hospitals. The census revealed that many of the hospitals have not connected any of their air conditioning system to a source of backup power.
“Through our work in Los Angeles County, we’ve seen first-hand that many hospitals have not yet made the investments needed to connect portions of their air conditioning system to emergency power in order to comply with the new federal requirements,” said Eric Cote, Project Director for Powered for Patients. “It is likely that many of Louisiana’s hospitals and nursing homes face this same challenge and as a result, a number of facilities will find it difficult to keep temperatures in patient care areas below the required 81 degrees given the forecast for dangerously hot and humid weather.” Facilities that cannot keep temperatures in patient care areas below 81 degrees may need to consider evacuating, a move that would pose an added challenge to facilities already straining in the aftermath of Hurricane Ida.
Before the CMS Emergency Preparedness Rule was enacted, emergency power requirements necessitated that a hospital would need enough generator power to cover approximately 33% of a its normal electrical load. Experts suggest that to fully back up a hospital’s air conditioning system on top of its other emergency power requirements, most hospitals would have to double the size of their generator fleet, a very expensive step that many hospitals have been unable to take.
FEMA Generator Checklist Can Help Minimize Risk of Emergency Power Failures
Powered for Patients has posted a FEMA checklist of steps that should be taken when generators are operated for extended periods of time to reduce the likelihood of a generator failure.
“The likelihood of a long-term power outages represents a serious challenge and a potential threat to patient safety, but it’s important for hospital facility staff to know that there are steps they can take now to reduce the likelihood of a generator failure,” said Cote. “I encourage facilities to print the FEMA checklist and make sure it is distributed to all facility staff and adhered to closely.”
Cote also urged hospitals to notify their local emergency managers at the first sign of any threat to emergency power. “Facilities should not wait until a generator has failed to notify their local emergency manager that they are experiencing a problem with emergency power,” said Cote. “Instead, we recommend that a hospital notify their local emergency management agency at the first sign of any threat to emergency power. This can help expedite deployment of temporary generators.” FEMA announced yesterday that 200 generators have been deployed to Louisiana and more are expected in the coming days.
Aging Generators and Single Generator Hospitals Also Seen as a Potential Problem Amid Extended Power Outages
Among the findings of the recent Powered for Patients census of emergency power systems in Los Angeles County hospitals was a significant number of outdated generators. The useful life expectancy of a generator is approximately 30 years of age and the recent analysis showed that 30 percent of the generators among surveyed hospitals are older than 30 years of age, with 42 of these generators between 40 and 49 years of age and four generators older than 50 years of age.
In addition to an aging generator fleet, the recent census found that fifteen Los Angeles County acute-care hospitals rely on just a single generator, leaving these facilities, and the patients in them, with no source of redundant emergency power. Among these fifteen hospitals, 60 percent of their generators are over 30 years of age, with several generators over four years of age and two over 50 years of age.
“If our findings in Los Angeles County are representative of hospital generator fleet in Louisiana, there may be as many as 16 acute care hospitals in Louisiana operating with a single generator, many of which would be older than 30 years of age,” said Cote. “These are added risk factors that warrant close attention from state and local officials, especially as the power outage extends into days and even weeks in the worst-case scenario.”
Emergency management officials in Louisiana have been in touch with hospitals to determine their available generator fuel and the projected burn rates to help coordinate the fuel replenishment process.