HOLLYWOOD, Fla. _ Hollywood police have a search warrant and can begin combing for evidence in the nursing home where eight seniors died in sweltering heat in the aftermath of Hurricane Irma.
Police now say the first person died Tuesday _ not Wednesday, as initially reported _ in The Rehabilitation Center at Hollywood Hills, across the street from Memorial Regional Hospital.
That individual had a Do Not Resuscitate Order (DNR) in place when they died and their remains were taken to a funeral home, city spokeswoman Raelin Storey said at a news conference Thursday outside the nursing home.
Officials were not called about that death at the time, she said.
After the investigation commenced, the Broward Medical Examiner's Office picked up the body from the funeral home so that an autopsy can be conducted.
At this early stage in the investigation, there appears to be some confusion over details.
Officials at the Broward Medical Examiner's Office said their understanding is that the first victim, Albertina Vega, 99, was "discovered deceased at the facility at 02:55 (Wednesday) by staff."
Dr. Craig Mallak, Broward's Medical Examiner, said that information came from family members and other officials.
According to preliminary information provided to his office, these are the victims and the time and location where they were pronounced dead _ all on Wednesday:
_ Albertina Vega, 99, discovered dead at the facility at 2:55 a.m. by staff
_ Carolyn Eatherly, 78, pronounced dead at the hospital at 5 a.m.
_ Manuel Mario Mendieta, 96, pronounced dead at the nursing home by Fire/Rescue at 5:46 a.m.
_ Gail Nova, 70, pronounced dead at the hospital at 6:49 a.m.
_ Bobby Owens, 84, pronounced dead by Fire/Rescue at the nursing home at 6:57 a.m.
_ Miguel Antonio Franco, 92, pronounced dead at the nursing home by Fire/Rescue at 6:59 a.m.
_ Estella Hendricks, 71, pronounced dead at the hospital at 7:53 a.m.
_ Betty Hibbard, 84, pronounced dead at the hospital at 3:09 p.m.
Mallak said he could not release any further details because of Hollywood's ongoing investigation.
Storey said the nursing home had some power but the air conditioning was not fully functioning.
Authorities now say that a total of 145 residents were evacuated from the nursing home after they became aware "that a crisis was unfolding at the facility" after receiving multiple phone calls on Wednesday.
Police said they will allow family members to go into the nursing home and retrieve former residents' personal belongings.
Detectives and state and federal regulators are investigating what happened in the center during and after the storm.
"We are looking at the temperature in the facility, the staffing in the facility ... in the hours leading up to the incident," Storey said.
Officials are still figuring out what happened when and said they do not want to speculate or prematurely release incorrect information.
The Agency for Health Care Administration (AHCA) on Wednesday put an immediate stop on all admissions to the nursing home at the direction of Gov. Rick Scott.
Staff at The Rehabilitation Center at Hollywood Hills knew that its air conditioning was not working on Sunday and put eight coolers throughout the nursing home and set up fans to try and cool residents, according to an AHCA complaint outlining the emergency action.
Several residents between 1:30 a.m. and 5 a.m. Wednesday were under respiratory or cardiac distress, according to the complaint.
The home had a backup generator but it did not power the air conditioning, the nursing home's administrator Jorge Carballo said through a representative.
The building has two transformers _ one for the building and another for the air conditioning. The transformer for the building came back after the storm. However, the one to power the air conditioning was damaged and was not back up as of Wednesday morning.
Police have launched a criminal investigation into the deaths.
Already, serious questions are emerging:
_ Why doesn't the state require nursing homes to have generators? A total of 150 homes, out of 700 statewide, were still without power Wednesday.
_ Who truly was responsible? The nursing home says it contacted Florida Power & Light immediately when it lost power to its air conditioning. The county says FPL refused to speed up its response to senior living facilities. And FPL said the county never listed nursing homes as critical facilities in power outages.
_ Why aren't nursing homes considered critical?
The nursing home lost power at some point Tuesday, when a wind-whipped tree branch knocked out a transformer that powered the air conditioning unit at the center. Nursing home officials said they called the Broward Emergency Operations Center to report the problem, which was relayed to FPL as a "mission critical" emergency.
And then, the home's administrators say, they waited.
The center's generator powered electricity and other systems, but not the air conditioner.
Elie Pina, who went to visit her 96-year-old mother at the nursing home earlier this week, said the heat was oppressive.
"It felt like 110, 115 degrees in there," Pina said. "They had patients in the hall, they were trying to take care of them."
Pina said she called FPL to report the outage four times, the last time at 11 p.m.
Four hours later, the calls started coming in to Hollywood Fire Rescue, one after another.
Rescue workers evacuated all 158 patients of the two-story facility to Memorial Regional Hospital.
Owens, whose room was on the second floor, was aware of his surroundings but unable to speak, said his granddaughter, Tynisha Owens, of West Park.
"We checked in on him before the storm, on Wednesday, and they told us everything was gonna be OK and that they didn't have to evacuate, that they would be fine," she said. "He was probably aware of the situation Tuesday and Wednesday. He definitely knew what was going on but couldn't call for help, because he didn't speak."
Officials expressed outrage. Scott said he was demanding answers and accountability, and ordered an investigation by the Department of Children and Families. The Florida Agency for Health Care Administration, acting on the governor's orders, placed an emergency moratorium on Hollywood Hills, preventing the facility from accepting new patients until further notice.
Broward Mayor Barbara Sharief acknowledged that center officials reported the outage to the county Tuesday, but she said they gave no indication that a loss of life was imminent.
"At that time the emergency team asked Hollywood Hills if they had any medical needs or emergencies," she said in an interview with the Sun Sentinel. "And they said they did not. And they did not request assistance or indicate that any medical emergency existed.
The center is currently rated two stars in Medicare's five-star ranking system. It has one star regarding health inspections.
The owner and the administrator of the center issued a statement Wednesday evening denying any negligence.
Jorge Carballo, the nursing home administrator, said the center's staff "set up mobile cooling units and fans to cool the facility. Our staff continually checked on our residents' well-being _ our most important concern _ to ensure they were hydrated and as comfortable as possible."
Owner Jack Michel was accused in 2004 of federal and state health care fraud charges, according to the Department of Justice. He and three others eventually settled the case.
He declined to comment on the deaths Wednesday, instead issuing a joint statement by email with Carballo.
FPL spokesman Ron Gould said nursing homes are not defined as critical facilities in the plan the county gives FPL for restoring power _ meaning they are not the first to have power restored.
"We met with Broward in early March. This facility was not listed as a top-tier critical infrastructure facility," he said.
Regulators do not require nursing homes like Hollywood Hills to have generators. In Florida, nursing homes can comply with licensing regulations as long as they have "alternate forms of power," said Kristen Knapp, spokeswoman for the Florida Health Care Association. That could include battery-operated fans, she said.
New federal nursing home regulations that will go into effect in November mandate, among other things, that safe indoor temperatures be maintained during power outages. But the rules _ which come 12 years after 35 elderly people died in a New Orleans-area nursing home during Hurricane Katrina _ also fail to specifically require generators.
State Sen. Gary Farmer, whose district includes the center, said the county is now checking with every nursing home and every assisted living facility every two hours to find out if it has power.
Patients from a behavioral unit of another nearby facility, the Larkin Community Hospital, were also evacuated, officials said.
Sharief said she's been concerned about the lack of power to facilities that are home to the elderly and others particularly vulnerable to the heat. The mayor said that she and County Administrator Bertha Henry pressed FPL on Tuesday to expedite power restoration to such facilities.
FPL, Sharief said, responded that there were too many facilities to do that.
