Hurricane Irma hit Florida two years ago. Twelve residents of Hollywood Hills nursing home died in the aftermath. The facility lacked an emergency generator. And staff failed to protect residents from the resulting excessive heat and humidity.

The State of Florida closed Hollywood Hills nursing home and filed criminal charges against the Administrators and select staff. Although legal consequences are still unfolding.

We shared our concerns about this tragedy in September of 2017: A Florida 1-Star Nursing Home Left Without Air Conditioning. At the time of this article, nine residents had died. Three more residents died in the following weeks.

After [Hurricane] Irma made landfall on Sept. 10, 2017, [Hollywood Hills Nursing Home’s] air conditioning system failed. In the following days, staffers set up portable cooling units, including fans and other devices, to keep the sweltering summer temperatures outside from rapidly heating the building.
But by the third day patients began to show signs of distress.
As NPR also reported then, police in Hollywood did not say how hot it was inside the building but confirmed that 158 patients were evacuated to local hospitals.
Staffers at the center came under intense scrutiny for not evacuating residents as temperatures inside the building continued to climb. Some critics point out that a hospital, which was fully functional in the days after Irma passed, was across the street from the facility.
On Sept. 13, 2017, eight patients died. The center was evacuated that same day. But in the weeks that followed, four more patients died.

12 Deaths and Criminal Charges: 1-star nursing home deaths

In 2017, Hollywood Hills staff failed to evacuate residents when the building temperatures climbed following a power outage. A criminal investigation into these deaths is still in progress. Charges of aggravated manslaughter and tampering with evidence were filed against some Administrators and staff.

“The judge concluded that ultimately the patients were dependent on Hollywood Hills to recognize the danger and to keep them safe.” – Florida nursing home employees charged with manslaughter in deaths of 12 in sweltering facility

“Fire Lt. Amy Parrinello said one of the female patients had a temperature of 107.5 degrees (42 Celsius), the highest she had ever seen in her 12-year career. Later that morning, she said, another patient topped that with a temperature so high it couldn’t be measured.” – Four Florida Nursing Home Employees Have Been Charged Over Hurricane Irma Patient Deaths

Medicare Star Rating

Medicare rated Hollywood Hills a 1-star facility at the time. One out of five. Five is the best. One is the worst. Medicare’s Star Rating system may not be perfect. But the nursing home’s 1-star rating indicates this facility is on the lowest rung of the system. Ratings say something bad about the quality and quantity of leadership, systems, and personnel. The tragic results at the Hollywood Hills suggest the same shortcomings. We don’t want to trust loved lives to a 1-star facility.

Medicare made these star ratings and additional tools available to help evaluate facilities. We need to use these tools. Medicare’s Star Ratings and Medicare’s associated materials are effective only if consumers enforce them through choice.

1-star nursing home deaths
Medicare online nursing home checklist

Nothing Beats a Site Visit

And remember, nothing substitutes for your personal tour of the facility. Medicare provides a checklist to use when touring and gathering information. Listen to your instincts informed by the rating system and personal observations. Follow this link for a copy of the checklist:

These 1-star nursing home deaths were tragic. And the deaths appear avoidable with proper training, procedures, and leadership. Unfortunately, twelve families today are without their loved ones.


As with medical errors, the systems for preventing poor-quality nursing home care should be overlapping, with multiple checks and balances to minimize potential gaps. Moreover, when poor-quality care, including abuse and neglect, is identified, the system of enforcement should be responsive, consistent, and effective.  

David G. Stevenson

Pushing Past The Status Quo To Protect Nursing Home Residents (10/10/2019)