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Louisiana lawmakers promise nursing home reform, but produce few proposals

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Louisiana nursing homes

Louisiana lawmakers promise nursing home reform, but produce few proposals

Byline: Julie O'Donoghue

Apr 05, 2022

(Louisiana Illuminator: https://lailluminator.com)

The failure to protect nursing home residents from the squalid conditions of an evacuation center staged in an old pesticide warehouse in Tangipahoa Parish was arguably the biggest scandal from Hurricane Ida[1]. State health officials were eventually forced to rescue hundreds of elderly and medically fragile people from the site, and several died in the aftermath.

Yet Gov. John Bel Edwards and the Legislature's leadership have not yet prioritized fixing the legal loopholes that allowed for the transfer of nursing home residents to a building with little food, few toilets and inadequate staff during a natural disaster.

Last fall, legislators vowed to tighten regulations on the nursing home industry[2] after the botched evacuation of seven nursing homes owned by Bob Dean. But months later, only a few modest reforms have materialized, and there's been little talk among lawmakers of pushing for nursing home changes. The deadline for filing bills for the current legislative lawmaking session is Tuesday.

Edwards didn't mention nursing homes during his speech to lawmakers outlining his legislative agenda for the year last month. Senate President Page Cortez, R-Lafayette, hadn't read any of the nursing home reform bills filed before the session started.

'What, if any, effect will come from [the nursing home reform bills]? I don't know at this point,' Cortez said when asked about the legislation during an online forum in March[3].

Getting new regulations for the eldercare industry through the Legislature is nearly impossible without support from the Louisiana Nursing Home Association. The group did not respond to phone calls and emails requesting comments for this article, though its leadership has shown a willingness to endorse some reforms coming through the Louisiana Department of Health.

Nursing home owners are among the most prolific donors to legislators and governors in Louisiana. They contributed $400,000 to Edwards' first gubernatorial campaign in 2015, according to a 2017 investigation by The Advocate[4].

Dean himself contributed $42,500 to Edwards reelection campaign over two months in 2019 and $25,000 to a political action committee that supports U.S. Sen. John Kennedy last year. (The Kennedy PAC returned that money shortly after the botched evacuation.)

A few legislators also have personal stakes in nursing homes, according to their financial disclosure documents filed with the state. Sens. Bob Hensgens, R-Abbeville, and Fred Mills, R-Parks, are both partial nursing home owners as well as members of the Senate Health and Welfare Committee, which screens eldercare legislation and policy for the Legislature.

Nursing home industry representatives last month voted in favor of making changes to the homes' emergency plan process as members of the state's Nursing Home Emergency Preparedness Review Committee. The Louisiana Department of Health revived this dormant panel in December in order to revisit nursing home evacuation policies in the wake of the Dean scandal.

The Louisiana Department of Health included the committee's recommendations for change in a bill filed Monday night, the day before the final deadline to submit bills. Typically legislation that is considered a priority is filed in advance of the legislative session. In this case, lawmakers have been meeting for three weeks before this bill materialized.

House Bill 933[5], by Rep. Joe Stagni, R-Kenner, requires nursing homes' emergency plan documents to go through a more thorough vetting and be submitted to the health department and other agencies with more detail than they currently do.

It also requires a new 'after-action' report outlining each nursing home's response when a natural disaster takes place, though those reports would be private and not accessible through a public records request. If the bill passed, the state would also ramp-up requirements and inspections of 'unlicensed' nursing home evacuation sites, like the warehouse Dean used.

Independently, Sen. Kirk Talbot, R-River Ridge, has filed Senate Bill 167[6], which requires local parish offices of emergency preparedness to approve the emergency plans for nursing homes in their communities. Rep. Rick Edmonds, R-Baton Rouge, has a competing proposal in House Bill 291[7] to require the state health department to do the same. Currently, it's not clear who - if anyone - approves nursing home evacuation plans and is responsible for ensuring those plans are workable.

Neither Talbot nor Edmonds knows whether the nursing home industry would get behind their proposals.

'I'm not a big regulatory guy, but we've got to improve this,' Edmonds said. 'It is incumbent upon the nursing home association and all of us to come up with better solutions.'

Talbot and Mills have also filed bills to require nursing homes to have generators on their properties.

Senate Bill 166[8], sponsored by Talbot, is more stringent than Mills' proposal. It requires nursing homes purchase a generator that can keep power going for at least 96 hours at an indoor temperature of no higher than 81 degrees. The generators would have to be installed by the end of 2022, and facilities would have to store 72 hours worth of fuel on their grounds unless a local ordinance prohibits them from doing so.

Mills' proposal, Senate Bill 33[9], would require generators to power 50% of an existing facility's air conditioning or heating system for 48 hours with fuel or electricity on site, though they would need a contract in place with a fuel or electrical provider to service the generator for at least 168 hours after that point. Mills' bill would allow nursing homes until the mid-2023 to meet these requirement, but the health department would have the option of waiving the generator requirement for a nursing home if local ordinances and the size of the home's site didn't allow a generator to be installed.

Mills' described his legislation as 'an industry bill,' meaning it is a proposal backed by the nursing home association.

As chairman of the Senate Health and Welfare Committee, Mills said he wasn't sure whether other nursing home reforms beyond the generator bill were necessary, especially because Dean, as a nursing home operator, was an anomaly in the industry. He didn't think similar evacuation problems were likely to occur in the future.

'I just hate to take one outlier and change a lot of [nursing home] policy because of it,' Mills said.

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[ 1]: https://www.nola.com/news/healthcare_hospitals/article_c0e3fe6c-1001-11ec-904b-838ad8570726.html

[ 2]: https://lailluminator.com/2021/09/30/whos-responsible-for-vetting-louisianas-nursing-home-evacuation-plans-state-officials-wont-say/

[ 3]: https://www.youtube.com/watch?v=KzGtvYwh1Aw

[ 4]: https://www.theadvocate.com/baton_rouge/news/politics/legislature/article_b399f0dc-14ce-11e7-be73-9307a966036f.html

[5]: https://legis.la.gov/legis/BillInfo.aspx?i=243009

[ 6]: https://legis.la.gov/legis/BillInfo.aspx?i=242083

[ 7]: https://legis.la.gov/legis/BillInfo.aspx?i=241889

[ 8]: https://legis.la.gov/legis/BillInfo.aspx?i=242082

[ 9]: https://legis.la.gov/legis/BillInfo.aspx?i=241590

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Newstex Blogs - https://lailluminator.com/2022/04/05/louisiana-lawmakers-promise-nursing-home-reform-but-produce-few-proposals/

Louisiana Illuminator

April 5, 2022 Tuesday 4:40 PM ES


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