Louisiana Legislators Consider Weakening Standards For Nursing Home Disaster Plans

By Julie O'Donoghue, Louisiana Illuminator

- April 22, 2023

16:01
News Story

• Govt + Politics
• Legislative
• Social Services

Louisiana legislators consider weakening standards for nursing home disaster plans

A proposal advances to soften stricter rules for nursing home evacuations adopted just last year

By: Julie O'Donoghue - April 22, 2023 4:01 pm

Seven nursing homes owned by Bob Dean were shut down after it was discovered he had evacuated their residents to a warehouse he owns in Tangipahoa Parish. (Photo provided by WVUE/FOX 8 NOLA)

Gov. John Bel Edwards’ administration is backing a law change that could allow nursing homes to continue to operate even after state officials deemed their disaster and evacuation plans inadequate.

The Louisiana Department of Health, overseen by the governor, is pushing House Bill 123 to remove language that requires the state to automatically shut down nursing homes if their emergency preparedness plans are rejected.

Instead, the health department — historically sympathetic to nursing home owners — would have the discretion to keep nursing homes open even after they submit emergency plans that failed to get state approval.

The bill, sponsored by Rep. Joe Stagni, R-Kenner, would effectively remove oversight given to emergency response officials only last year to push back on disaster and evacuation plans for the facilities.

Last year, lawmakers had insisted that a wider swath of government officials, including people outside the health department, get involved in reviewing nursing home emergency plans in the wake of a botched evacuation of seven homes for Hurricane Ida in 2021.

State officials were forced to rescue more than 800 elderly and medically vulnerable nursing home residents from a warehouse in Tangipahoa Parish a few days after Ida. Fifteen of the evacuated people died in the immediate aftermath of the storm, and others sustained life-altering illnesses and injuries.

State inspectors reported the warehouse was too hot, overcrowded and smelled of human waste. They found nursing home residents lying in soiled clothing and bedding. There also weren’t enough showers, meals or staff to take care of the hundreds of people staying in the building, they said.

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The state ended up yanking licenses from nursing home owner Bob Dean, soon after the rescue operation. Last year, a Jefferson Parish judge ordered Dean’s estate to pay a $12 million settlement to the nursing home residents stranded at the warehouse and their attorneys, according to The Times-Picayune.

Louisiana imposes new nursing homes evacuation rules in wake of Bob Dean scandal

For their part, legislators vowed to stiffen requirements for nursing home emergency preparedness and evacuation. Starting this year, six new government entities were expected to review the individual nursing home preparedness plans in addition to the health department.

Those agencies include the State Fire Marshal, the Governor’s Office of Homeland Security and Emergency Preparedness, the Louisiana Emergency Response Network, the Department of Transportation and Development, the emergency preparedness office in the parish where the nursing home is located and the emergency preparedness office in the parish where a nursing home is supposed to evacuate.

Under the new law passed in 2022, any of these entities can now ask a nursing home for revisions to their emergency plan, and the nursing home owner is required to try to address those concerns or risk losing their license.

But the new legislation weakens that oversight. If it’s approved, the government entities could still ask the nursing homes for emergency plan changes, but the health department could keep the site open, even if the operators don’t adequately address the concerns raised.

Critics of the nursing home industry are always skeptical that the state health department will be tough and exacting on nursing homes. Nursing home owners are big political campaign contributors to governors and lawmakers.

Nursing home owners contributed about $400,000 to Edwards’ first gubernatorial campaign, according to The Advocate. Dean alone gave the governor’s reelection campaign $42,000 in 2019.

Two lawmakers also have financial interests in nursing homes. Sens. Fred Mills, R-Parks, and Bob Hensgens, R-Abbeville, are partial owners in different facilities and sit on the Senate Health and Welfare Committee that considers legislation dealing with nursing homes.

The Louisiana Nursing Home Association, which represents the owners, backs Stagni’s bill.

Over a dozen nursing homes could evacuate to facilities that failed state inspections

The legislation cleared its first legislative hurdle on Thursday, when the House Health and Welfare Committee sent it to the Louisiana House floor with no objections.

At the hearing before the committee vote, Stagni and Health Secretary Stephen Russo played down the proposal as being a minor change in the law. They characterized the legislation as a “clean-up bill,” typically used to describe proposals that make only technical or minor changes. Mark Berger, executive director of the nursing home association, sat next to Stagni as he presented the proposal.

In an interview after the vote, Stagni said he was concerned the new nursing home emergency plan law passed last year, which he also sponsored, wasn’t giving the nursing homes an opportunity for “due process.”

At the hearing, he and Russo said nursing homes didn’t have enough time to adequately respond to concerns the government entities raised about their emergency plans before their licenses were put at risk under the current law.

“We only gave some nursing homes about 15 days to respond when five or six agencies review their plans and ask them to make changes,” Stagni said.

“What we did find is that the timeline may have been a little too restrictive,” Russo said.

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The current law requires nursing homes to revise and resubmit their emergency plans 15 days after they get official notice of a request for changes from government officials. That notice comes toward the end of a months-long emergency plan review process — something not discussed at the legislative hearing.

Under the current law, nursing homes are required in future years to submit their emergency preparedness plans to the state government officials by Nov. 1, but the official request for revisions or changes from state entities doesn’t have to be sent until four months later, on March 1. Only then does the 15-day clock on nursing homes to address the request changes start running.

The law does not prohibit the health department or other government entities from communicating potential problems with each other or the nursing home owners before that March 1 deadline.

The health department also added flexibility into state regulations for homes already at risk of seeing their plans rejected. In state rules adopted last year, health officials gave themselves the option of holding a conference call with a nursing home owner right before they make a decision to approve or reject the home’s emergency plan.

This conference call would come after a nursing home’s 15-day revision period ended, when the final version of its plan had been resubmitted for review. This call could result in further edits to the proposal before a rejection might be handed down, according to the regulation.

Russo said Thursday one major challenge nursing homes had with the current timeline had to do with determining resiliency of their current structures. Nursing homes have had to track down architecture firms they used to build facilities decades ago or hire a new round of experts to perform new assessments on their buildings, he said.

Though the requirement for nursing homes to provide these “windloads” for their buildings has been around for at least a few years, health officials said the new vetting process calls for the nursing homes to provide more documentation than they had to in the past. So it’s more time consuming.

After Thursday’s hearing, Russo said he was too busy to answer follow-up questions from a reporter in person. The Louisiana Nursing Home Association did not respond to requests for comment made through email and a phone call to its office Friday.

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The Louisiana Illuminator is an independent, nonprofit, nonpartisan news organization driven by its mission to cast light on how decisions are made in Baton Rouge and how they affect the lives of everyday Louisianians, particularly those who are poor or otherwise marginalized.