It was 3 a.m. when a nurse at a Hollywood, Florida, nursing home called 911 one day last month.
“There’s a patient who’s in cardiac arrest,” she told the operator. “Code Blue. Respiratory failure.”
It was Sept. 13, four days after Hurricane Irma ravaged the state, knocking out electrical lines. The nursing home’s air conditioning systems had no power, and the heat inside had risen dramatically.
“I saw her slouch over,” the nurse said of Betty Hibbard, 84, who had been seated in the hallway on the second floor. “I realize that she’s not breathing, so I check her.”
The nurse told the 911 operator that the area around Hibbard’s mouth and fingers were turning blue. “We’re doing CPR on her now,” she said.
It was only the first of six emergency calls that day made by nursing home staff members over 3 1/2 hours. By the final call, multiple paramedics were on the scene, as well as staff members who had walked over from Memorial Regional Hospital, a short distance away, and were alarmed by the conditions of the patients who had begun to arrive into their emergency room with heat stroke and fevers upward of 109 degrees.
The audio of the emergency calls, released by the Hollywood Police Department on Monday, gives a sense of the growing crisis that unfolded that morning at the nursing home, Rehabilitation Center at Hollywood Hills. Eight residents, including Hibbard, died that day and six more died in the days and weeks that followed. More than 100 people were evacuated to hospitals and other nursing homes.
The callers, sometimes nurses or nursing assistants, attempted to remain calm, but often sounded pressured, exhausted and overwhelmed as they answered questions about the conditions of the patients. All were reported to be having severe difficulty breathing.
“Oh my God, this is crazy,” a woman making the fourth call said at around 6:15 a.m. as she struggled to find a patient’s age in the nursing home’s computer system, which had a separate power source. “We are initiating CPR at this moment,” she said. Then, sounding flustered, she gave the phone to another woman.
“They have a crash cart there, they’re working on her now as we speak,” the second woman said, referring to the wheeled supply cart used for resuscitations.
Gov. Rick Scott has criticized the nursing home for failing to call 911 on behalf of its residents, and the deaths remain under police investigation. The newly released audio demonstrates that the nursing home staff did indeed call 911 for patients that Wednesday morning, as well as for two patients the previous two days.
But by the time the calls were made, the residents were suffering respiratory distress, and in some cases dying.
According to information provided by the police, a call was made on Monday, Sept. 11, a day after Hurricane Irma made landfall in Florida.
That call was made for an 81-year-old woman on the second floor who was experiencing breathing problems. A second 911 call was made around midday Tuesday, on behalf of a 93-year-old man. “He had a fever,” a woman told the 911 operator. “We started, you know, ordering the tests for him and stuff, but he’s getting short of breath now.”
The 911 audio was released by the police after two local newspapers, The Sun-Sentinel and The Miami Herald, went to court to demand them under the state’s public records statutes.
“Investigators have now completed witness interviews related to the 911 calls and have determined that the audio can be released without jeopardizing the ongoing investigation,” the police said in a news release.
Several families of residents who died have sued the home. The governor, through the state’s health agency, moved to shut down the nursing home. The home has filed a legal challenge.
Hollywood Hills, one of many nursing homes in South Florida that lost power after the hurricane, has noted that state officials and the power company were repeatedly called for help in restoring electricity to the air conditioning. In one of the 911 calls made on Sept. 13, a worker at the Broward County emergency operations center noted that the day before, a psychiatric facility that shared the same building as the nursing home, and also had no air conditioning, had called the county for assistance.
On Monday, Geoffrey D. Smith, a lawyer for the nursing home, said the home could not comment on the 911 calls because it had not yet heard them. “We have been asking for these records since the incidents occurred,” he said in an email. “To date, we have not had access to the 911 calls and are still waiting for responses to our multiple public record requests.”
After the deaths, the governor released an emergency rule that will require all nursing homes and assisted-living facilities, by Nov. 15, to have generators and enough fuel to keep their facilities at safe temperatures. In the past, nursing homes have resisted similar measures, citing cost, and several industry groups have filed legal challenges to the new rule. Last week, the state’s health care agency said that homes could request extensions “under extreme circumstances.”
Inside the overheated nursing home that Wednesday, the calls, over the space of just a few hours, became more frequent and urgent as the situation turned dire.
“I have another patient that’s in respiratory distress,” one caller said.
“Make sure to check on the patient, please! I’m on this call,” she said to someone else in the home. “I’m on the phone for the next patient.”
“She’s not breathing!” she said to the operator, who told her to locate a defibrillator. “Yes, a defibrillator, get a defibrillator for her,” the woman told someone else, then returned to the phone.
She told the operator: “There’s another one at this moment, sir.”