Nursing Home’s Failed Air Conditioning During Heat Wave Prompts Investigation by New Jersey DOH
In July 2019, a New Jersey nursing home’s air conditioning failed during a heat wave lasting several days and resulted in a NJ Department of Health (DOH) investigation. After a visitor became concerned about the high temperatures in the facility and the effect it was having on the residents, she notified the police. That call resulted in dozens of emergency responders arriving at the nursing home and helping to evacuate over 100 residents —some were taken by ambulance to area nursing homes that could accommodate them, and the remaining residents were taken in their wheelchairs across the street to a high school’s gymnasium that was serving as a temporary shelter.
How hot the inside temperatures got is unknown, but the DOH found that that the nursing home did not have a heat emergency response plan in place as required by both state and federal regulations.
In the Statement of Deficiencies report that was released, it was noted that 79 of the facility’s 195 self-contained air conditioning units—Packaged Terminal Air Conditioners (PTACs)—were not working and that some had been down for a year. Also, when the inspectors’ toured the facility they discovered 24 new PTAC units that had been stored in the facility’s basement since May.
The facility’s administrator told the investigators that they were the wrong type and could not be used as replacements; however, when an inspector asked the administrator when the facility planned to repair and/or replace the malfunctioning units, the administrator did not respond.
It was also noted in the report that the facility’s first-floor lobby heat pump had previously been written up for a defective compressor along with multiples issues with a rooftop air conditioning unit.
In a letter to the facility, the DOH recommended a civil money penalty of $7,660 for the federal deficiencies associated with the air conditioning. Notably, the Centers for Medicare & Medicaid Services (CMS) could impose higher or lower penalties.
Compliance Perspective
Failure to maintain and repair/replace malfunctioning air conditioning systems/units and failure to develop an Emergency Preparedness Plan that includes a Heat Emergency Response Plan may be considered provision of substandard quality of care as required by state and federal regulations.
Discussion Points:
- Review policies and procedures regarding the facility’s Emergency Preparedness Plan, including a required Heat Emergency Response Plan.
- Train staff to respond and report concerns regarding residents being overheated due to malfunctioning air conditioning systems. Staff should also be trained in the procedures for implementing the facility’s Heat Emergency Response Plan and the protocols for evacuating and relocating residents when such an emergency occurs.
- Periodically audit the facility’s maintenance protocol and records for documenting ongoing maintenance, repair, and replacement of the facility’s air conditioning system.
