Although the 150 mile-per-hour winds and initial rain from Hurricane Michael had passed after walloping the Florida panhandle, Gov. Rick Scott (R) had a warning for nursing homes and assisted living facilities struggling with power outages: No excuses.

“If you’re responsible for a patient, you’re responsible for the patient. Take care of them,” Scott told CBS News. “That means you need to make sure that you have back-up generation power or you shouldn’t be taking care of the patients.”

On Thursday, emergency officials were working to evacuate more than 300 patients from damaged hospitals in Panama City. Four hospitals and 11 nursing facilities were closed in the state, along with a SNF in Georgia, the New York Times reported. It noted Michael is the worst storm the Florida Panhandle has ever experienced; there were at least six deaths attributed to the storm as of press time.

For the facilities that remained open, the pressure is on to maintain adequate cooling. By June 1, senior care facilities were required to have generators and other equipment to keep indoor temperatures below 81 degrees and to maintain power for 96 hours after an outage. Around 75% of the state’s 684 nursing homes, however, had applied for and received an extension on the new requirement in recent months.  

In the 35 counties threatened by the storm, about half of the area’s more than 400 nursing homes had not met the deadline to install or set up new generators, the Agency for Health Care Administration reported. Many had been given extensions.

Scott’s legislation was pushed after Hurricane Irma last year resulted in the death of more than a dozen nursing home residents. The deaths were not a result of direct storm damage, but rather from complications related to a lack of air conditioning at the residents’ Hollywood Hills facility.

Although Michael was downgraded to a tropical storm, it was expected to continue to move through the Carolinas and Virginia on Friday before heading back over the Atlantic. Early Friday morning, Virginia officials announced five people had died.

The Centers for Medicare & Medicaid Services issued several blanket waivers related to Medicare and Medicaid policies, including a pass on the requirement for a 3-day prior hospitalization for coverage of a skilled nursing facility stay.