By Allan Schurr / Special to Healthcare Facilities Today

Talk with almost any healthcare or senior care executive about emergency backup power, and the conversation will invariably turn to Florida and the 12 nursing home patients who died following Hurricane Irma in 2017. In that case, patients at the facility were left in sweltering heat due to power outages and the lack of a functioning backup power for the air conditioning system. 

But ensuring operating HVAC is only one reason that senior and healthcare facilities across the nation are now looking beyond traditional “life safety” diesel generators to provide emergency backup power. For these organizations, the cost of outages is measured in the increased potential for disruptions to staff’s ability to provide patients with the levels of care and safety they need. 

The dangers in such situations have only been intensified by the COVID-19 pandemic.  Without appropriate backup power, facilities could lose access to electronic medical records or be required dispose of medical supplies that cannot be properly refrigerated. Cancelled procedures and emergency relocations of patients and personal medical equipment could also occur. 

Simply put, partial diesel generation sized only to cover a facility’s life safety functions is not enough to ensure adequate power during an extended outage. Under current federal and most state regulations, for example, healthcare facilities must have sufficient backup power to cover approximately 25 percent of their electricity demand. While a growing number of jurisdictions now also require emergency backup for heating and cooling -- upping total backup generation to about 60 percent of demand -- experts suggest that 100-percent backup is actually more cost effective.  

Such figures have triggered increasing interest in whole-facility solutions such as onsite microgrids, which can be fueled by natural gas or renewables. Executives in the healthcare sector have an immediate, almost visceral grasp of the business case for better, more comprehensive resilience and are especially interested in options that do not require large, capital budget investments in new equipment.

In addition to traditional combined heat and power applications, one option growing in popularity is “resilience as a service” -- that is, third party-owned, whole-facility backup power offered on a long-term contract. This approach guarantees full, reliable operation, and includes all maintenance over the term.

The company I work for, Enchanted Rock, offers such a solution. Our microgrids use modular, natural gas generators, sized to provide backup power for any commercial facility, and can also operate in “island” mode -- disconnected from the grid -- for hours, days or even weeks at a time. Plus, in certain electricity markets, when the generators are not providing backup power, they can be aggregated to sell power back to the grid, allowing us to price the systems at 10 to 20 percent of the upfront cost for comparable backup diesel generation. These savings significantly reduce the capital and expense budget burden for our customers. 

Named after the iconic pink granite outcropping west of Austin, Texas, Enchanted Rock currently has more than 130 systems deployed to customers including supermarkets, universities, utilities, hospitals, and senior care communities. One such senior community is Holly Hall in Houston.

Senior living -- with squirrels, the Astrodome and massive hurricanes

Founded in 1949, Holly Hall has evolved from modest beginnings as a home for Houston’s needy and aged into a 20-acre community with 91 independent and 54 assisted living units and a 60-bed skilled nursing facility. According to Amy Ward, senior director of operations, the main challenge for maintaining continuous power was not only the region’s occasional but fierce hurricanes -- Ike in 2008 and Harvey in 2017. The top culprits, she said, include squirrels and Holly Hall’s location across the street from NRG Park, formerly known as the Astrodome.

“We had several squirrels eating through the electrical connections, more often than we should, which took four to six hours to repair,” Ward said. She also explained that brownouts and outages have occurred due to large events at NRG Park because of the huge amounts of power they require. 

Like many senior living facilities, Holly Hall had a diesel generator that it used to provide emergency backup power for critical services only. As a result, during an outage, only limited areas of the facility had electricity, leaving many residents in the dark. Ward and other staff members even kept lanterns by their desks so they could quickly patrol the property during outages and ensure residents stayed safe.  

The lantern is still in Ward’s office, but since 2017 -- when Holly Hall installed an Enchanted Rock natural gas microgrid – she no longer uses it. The 1.2 megawatt system provides virtually seamless backup power for Holly Hall’s whole 200,000 square-foot facility.

“We had one outage within the last couple of weeks,” Ward said. “We were back to full operations in a matter of seconds. Our life safety diesel never comes on because Enchanted Rock’s microgrid comes on first.”

Ward had started looking for alternatives to diesel -- and connected with Enchanted Rock -- well before Hurricane Harvey. Squirrels notwithstanding, the immediate impetus was revisions to the Center for Medicare & Medicaid Services (CMS) disaster preparedness code for nursing homes, requiring rigorous advance planning for a full range of emergencies.

As Holly Hall worked to ensure compliance with the new code, access to residents’ electronic medical records became a priority. Without electricity, Ward said, “being able to pull up anyone's records, their history and especially their medication record, is challenging. If we didn't have the Enchanted Rock generators, we would have to double up -- documenting everything on paper and inputting it into the electronic health record.”

Another pressing concern for Holly Hall -- and any healthcare facility -- is keeping medical supplies properly refrigerated. During an outage, if condensation -- or “sweat” -- forms on any medicine containers, they must be discarded and replaced, and the operational costs and risks to patients can be considerable.

Faced with such challenges -- and a concerned and actively engaged board of directors -- Ward extensively researched and evaluated diverse options for whole-facility backup power. But, she said, Enchanted Rock kept coming out on top. Beyond price, she cited the flexibility of the system, which is specifically designed to work with, rather than replace, existing life-safety generators. 

Once installed, an Enchanted Rock natural gas microgrid can wrap around existing backup power sources, whether life-safety diesel or a renewable energy system. With diesel, for instance, during an outage, the backup generator kicks in, with our system following almost simultaneously, so the diesel can quickly ramp down to standby mode. Similarly, when electricity comes back on, our microgrid initially operates in tandem with the grid to ensure adequate power before ramping down. 

Each Enchanted Rock system also has a dedicated natural gas line to guarantee fuel supply in the event of an outage lasting from a few hours to days. Systems can also be designed to switch between fuel supplies -- for example, propane and natural gas -- and backup redundancy is built in. For example, Holly Hall’s system includes three natural gas generators of 400 kilowatts each. If one went offline for maintenance, the other two would still be able to provide whole-facility power for the community.

The value of peace of mind

Healthcare facilities must, of necessity, have a strong focus on the bottom line. To ensure the highest quality care and services, hospitals, nursing homes and other providers place an equally high value on reducing risk and optimizing organizational resources -- financial, operational and human.

Ward is emphatic on the point. Senior and healthcare facilities “are not in the energy business; that’s not our expertise,” she said. “Our expertise is taking care of residents; it’s not tracking what the power market is doing so we can manage the generators to sell energy back to the grid.”

But she and other industry experts also expect electricity demand and the value of whole-facility backup power to grow as hospitals expand services and acquire more high-tech equipment -- and as extreme weather events become more frequent and severe. Not to mention, having highly resilient, whole-facility backup power provides Holly Hall with a potent differentiator in Houston’s competitive senior care market.

“We had an influx of folks move in after Harvey,” Ward said. “It’s peace of mind for residents and their families that they are in good hands -- and for our staff that we will not have to evacuate residents from one place to another. You cannot put a dollar amount on that for any healthcare facility.”

Allan Schurr is the Chief Commercial Officer of Enchanted Rock. For more information, visit www.enchantedrock.com.