By Julie O'Donoghue
Published: May. 28, 2024 at 12:55 PM CDT
BATON ROUGE, La. (Louisiana Illuminator) – Golden Meadow, Grand Isle and Lafourche Parish all want to see a 40-year-old nursing home in Cut Off reopen, but they have run into a roadblock: Louisiana’s powerful nursing home owners.
The Louisiana Nursing Home Association helped quash two bills in the legislative session to revive South Lafourche Nursing and Rehab. The facility was one of seven owned by notorious nursing home operator Bob Dean that closed after a botched evacuation for Hurricane Ida in 2021.
Rep. Joseph Orgeron, R-Cut Off, and Sen. Mike Fesi, R-Houma, sponsored House Bill 632 and Senate Bill 380 at the request of their local officials. The proposals marked the first significant effort to resurrect a shuttered Dean home under a new owner. Both failed early in the legislative process.
Orgeron blamed nursing home owners for derailing his bill. He said he ran into the “magnanimous buzzsaw that is the Nursing Home Association” because existing owners want to avoid competition from a new operator.
“Following Hurricane Ida, 600-plus individuals got distributed from certain homes into other homes that boosted their occupancy and boosted their profit,” Orgeron said during a committee hearing on his legislation.
The dispute renews focus on an unusual and controversial law in Louisiana that has capped the number of nursing home beds in the state for more than a decade and given existing nursing home owners control over the state’s industry.
Supporters of the nursing home moratorium say the state is already awash in long-term care facilities and doesn’t have demand for more bed space. Critics complain it stifles the free market and allows poorly-rated nursing homes to stay in business.
Nursing home owners tend to have the upper hand in this argument. They are among the most consistent and prolific political donors to legislators in both parties. Their businesses are particularly dependent on government buy-in because nearly all their funding comes from the publicly funded Medicaid and Medicare health insurance programs.
In the most recent election cycle, the Louisiana Nursing Home Association political action committee gave almost $350,000 to current legislators and their party delegations, according to a review of campaign finance reports by the Illuminator. That figure does not include large contributions made from individual nursing home owners and their families.
In his public testimony, Orgeron implied there was a direct link between the nursing homes political patronage and the current moratorium on nursing home beds.
“People who are supposed to be taking care of our infirmed and elderly are basically utilizing their position basically to be Medicaid and Medicare portals for profit,” Orgeron told the Louisiana House Health and Welfare Committee. “We need to work toward being a better group of legislators who stand up for morality and what’s right for people in your district.”
The moratorium on adding nursing home beds is in place until July 1, 2027, after a 2021 update to state law.
Representatives from the nursing home association did not respond to Louisiana Illuminator’s phone calls or texts requesting comment for this article. They also declined to speak to a reporter in person at the State Capitol earlier this month.
Moratorium exceptions doubtful
Advocates for seniors said Louisiana already has more nursing home beds than needed to serve the state’s population. They would like to see the state put more resources toward programs that allow them to stay in their homes with some assistance, rather than promoting institutional care, they said.
“Our state already has one of the highest counts of beds per capita as well as one of the lowest occupancy rates,” said Andrew Muhl, a lobbyist for Louisiana’s AARP, who opposed the proposal to reopen the Lafourche facility.
To that end, the Louisiana Nursing Home Association said it has worked with the Louisiana Department of Health to cut 8,300 nursing home beds from the state’s rolls over the past 20 years. This includes the 981 beds eliminated from Dean’s homes when they were shut down after Hurricane Ida, Nursing Home Association executive director Mark Berger said at a hearing on Oregeron’s bill earlier this month.Berger said opening another home would aggravate an existing worker shortage in the industry. Nursing homes have been struggling for years to hire and retain employees in their facilities.”There are staffing issues in this area, and adding another nursing home will continue to exacerbate staffing issues in the nursing homes,” he said.
Legislators also worried making an exception to the nursing home moratorium for Cut Off wouldn’t be fair to other communities who also want their own facility. During the hearing on Orgeron’s bill, state Reps. Rhonda Butler, R-Ville Platte, and Joe Stagni, R-Kenner, said there was interest in opening nursing homes in their areas as well.
“It has statewide implications should this bill pass,” said Rep. Dustin Miller, D-Opelousas, chairman of the House health committee.
South Lafourche Nursing and Rehab is in a different position, however. It presumably would still be open, but for Hurricane Ida and its owner’s decisions during the evacuation. The facility, which would be under new ownership, was operating for years when the moratorium was already in place.
Orgeron and Fesi also said the unique geography of South Lafourche, where residents can only travel north in the event of an evacuation, makes the nursing home a necessity. There are four other nursing homes in Lafourche Parish, and most are about an hour away in Thibodaux.
Those locations make it hard for people who work in Port Fourchon or live in Grand Isle to visit their loved ones during the weekdays, like they did when the Cut Off nursing home was an option, Fesi said.”My constituents have to travel two to three hours to go to where their family members are,” Orgeron said. “The visitation has changed from multiple times per week to pretty much once per month at best.”
Quality control
Critics also allege the moratorium has kept the quality of nursing home care in Louisiana low by shutting out competition.
Well over half of Louisiana’s 268 nursing homes have only received one or two stars on the federal government’s five-star rating scale for the facilities, according to a review by the Illuminator. The 110 Louisiana homes with a one star rating are considered to be “very much below average,” according to the U.S. Centers for Medicare and Medicaid Services (CMS).
“You’ve got more than 50% that I wouldn’t want to put my loved one in there, but the moratorium keeps those people in there,” said Robert Chris Jordan, a real estate developer who wanted to buy Dean’s shuttered Lafourche nursing home. “So we’re basically propping up some industry that’s doing bad at the expense of your constituents.”
“Everybody wants to be part of a winner, not a loser,” Jordan told lawmakers. “But with your legislation, the moratorium, you are sticking people with losers.”
Jordan also said he was rebuffed when he tried to join the Louisiana Nursing Home Association. He was told the association members had to vote to accept him before he could be a member.
“They got to vote on me? That’s a club. That’s not an association,” Jordan told lawmakers.
At the hearing on Orgeron’s bill, Berger defended the state’s nursing homes by saying the federal star-rating system doesn’t account for client satisfaction.
“Our quality is good. Please visit a nursing home if you would like to see it,” Berger said. “Those metrics that were quoted are based on a CMS algorithm. It has nothing to do with consumer input.”
The rating of the four open nursing homes in Lafourche Parish ranges from poor to excellent. Thibodaux Healthcare and Rehabilitation Center has five stars; Audubon Health and Rehab has three stars; Broadway Nursing and Rehabilitation Center has two stars; and the Lafourche Home for the Aged & Infirmed has one star.
While it would be under different ownership if it reopened, South Lafourche Nursing and Rehab was also not performing well in the eyes of the federal government before Hurricane Ida. It had a one-star rating and was identified by federal officials in 2019 as one of 400 poorly performing nursing homes in the country that needed extra scrutiny.
The four remaining nursing homes in Lafourche Parish also have plenty of empty beds. Collectively, their occupancy is just 66%, Berger said.
Lawmakers ‘shocked’ by former Dean administrator’s hearing appearance
Even if the ownership was new, legislators had concerns an administrator who had worked for Bob Dean would be hired again to run a reopened nursing home in South Lafourche.
Bob Duet, who was overseeing the home at the time it was closed, has been one of the fiercest advocates for bringing it back online. He testified alongside state Rep. Joe Orgeron, R-Cut Off, on Orgeron’s legislation this spring.Duet and people interested in purchasing the nursing home never said Duet would run the nursing home again if it was opened back up, but legislators appeared to assume he might be involved if it moved forward.
House Health and Welfare Committee members were taken aback when Duet, while testifying, said he participated in Dean’s infamous evacuation of hundreds of nursing home residents to an old pesticide warehouse in Independence for shelter during Hurricane Ida.
The warehouse lost power and was later found to have inadequate food supplies, toilets, showers and staffing for nursing home patients sent there. A few days after the storm passed, state health officials and law enforcement forcibly rescued the nursing home residents from the location and ended up yanking Dean’s seven nursing home licenses, including the one for the South Lafourche facility.
Seven of Dean’s nursing home residents died at the warehouse or shortly upon being relocated. The health department attributed the deaths of at least five to the unsafe conditions. Dean now faces criminal charges and a large civil lawsuit settlement over the bungled evacuation.
While advocating for the Cut Off nursing home to be reopened, Duet told lawmakers he had been among the staff at the warehouse after Ida, leaving legislators incredulous.
”I’m just shocked you’re at the table,” said Rep. Dustin Miller, D-Opelousas, said during Duet’s introduction at the legislative hearing.
”I guess I’m more shocked,” state Rep. Joe Stagni, R-Kenner, added.
Duet told lawmakers he shouldn’t be held responsible for the problems at the Ida evacuation site.
“The nursing home evacuation facility we went to was the responsibility of the owner,” Duet said.
Duet said he spent the year after Ida trying to track down his 86 South Lafourche nursing home residents who were taken to Independence and then transferred to other nursing homes around the state during the rescue. The state had not told the residents’ families where they had been moved.
“No one knew where these residents were except the residents themselves,” Duet said.
“For the first year, I heard calls everyday saying ‘Mr. Bob: When can we come back home?’” he said.
Orgeron also defended Duet against lawmakers who questioned his role in the Dean home.”Despite the atrocities that happened after Hurricane Ida, you shouldn’t take it out on Mr. Bob,” Orgeron said. “I think it’s a little bit unfair to be judging him for what happened in Independence.”
Louisiana Illuminator is part of States Newsroom, a nonprofit news network supported by grants and a coalition of donors as a 501c(3) public charity. Louisiana Illuminator maintains editorial independence. Contact Editor Greg LaRose for questions: info@lailluminator.com. Follow Louisiana Illuminator on Facebook and X.
