Louisiana House votes unanimously to weaken nursing home evacuation plan enforcement

The Louisiana House of Representatives voted 103-0 Tuesday to allow nursing homes to continue to operate even if their emergency preparedness and evacuation plans fail to meet state standards.

House Bill 123 eliminates a provision added to state law just last year that forces the state to automatically shut down a nursing home if state officials reject its emergency plan.

Under this legislation, the Louisiana Department of Health – historically sympathetic to nursing homes – would now have discretion to keep a nursing home open, even if the home’s emergency plan was deemed inadequate by state officials. 

The sponsor of the bill, Rep. Joseph Stagni, R-Kenner, said nursing homes need more flexibility than the current law allows. Louisiana implemented a more stringent vetting process for nursing home evacuation plans just a few months ago, and the homes need more time to respond to their new set of mandates, he said Tuesday. 

But the legislation doesn’t just give nursing homes more time to develop their evacuation plans. It effectively removes teeth from the new emergency plan review process approved last year in the wake of the nursing home owner Bob Dean’s evacuation scandal.

Lawmakers implemented significant consequences for nursing homes with weak evacuation plans in large part because the state was forced to rescue 800 nursing home residents from an evacuation site at an old pesticide warehouse after Hurricane Ida in September 2021. Dean owned all seven nursing homes in southeast Louisiana that sent residents to the warehouse. 

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 there. 

Fifteen people evacuated to the warehouse died in the immediate aftermath of the storm, and others sustained life-altering illnesses and injuries. The estate of Dean – who was forced to shut down all of his homes – has been ordered to pay survivors of the evacuation and their attorneys over $12 million, according to The Times-Picayune. 

Legislators questioned why state health officials didn’t stop Dean from using a warehouse with no air conditioning or a working kitchen as an evacuation site in the first place. When the new law passed last year, they insisted government agencies besides the health department – from the fire marshal to local emergency operations staff – be involved in vetting nursing home evacuation plans moving forward.   

Stagni’s bill would return essentially all authority for overseeing the home’s evacuation plans back to the health department.

State health officials said they wouldn’t hesitate to shut down nursing homes that have significant problems with their evacuation plans if Stagni’s bill passes. Instead, the agency would use the flexibility offered by the bill to resolve “minor” issues with the evacuation proposals, said Kevin Litten, the agency’s spokesman, earlier this week.  

“If a nursing home receives a rejection letter and cannot adequately resolve its issues and, therefore, is not able to ensure patient health and safety in the event of a storm and evacuation, LDH would issue a license revocation notice,” Litten wrote Monday.

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

Nursing home owners contributed about $400,000 to Gov. John Bel 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, also backs Stagni’s bill.

The Louisiana Senate will now take up Stagni’s bill for consideration.