The Department of Health and Human Services (HHS) Office of Inspector General (OIG) has excluded a Louisiana man from participation in federal healthcare programs due to his ownership interest in seven Louisiana nursing homes that OIG previously excluded. The Louisiana Department of Health revoked the facilities’ licenses to operate as nursing homes due to multiple violations of state law that left seven residents dead and hundreds of others neglected and vulnerable following Hurricane Ida in August 2021. As a result, OIG has excluded the nursing homes and their owner.
As Hurricane Ida approached, the seven nursing homes had evacuated over 800 of their residents to a warehouse facility. According to the OIG, this was hundreds of residents greater than the facility’s capacity. After receiving reports that the warehouse’s generators and oxygen equipment were failing and the facility had several inches of water on the floor, state health inspectors made multiple onsite visits. They noted residents sleeping on floor mattresses less than a foot apart near standing water. Some of the residents were partially undressed or completely naked, and others were calling for help or left alone with heavily soiled incontinent briefs. The building smelled of urine and trash, and dirty linens were piling up. Inspectors also said that the owner attempted to threaten, intimidate, and interfere with their assessment of the site. In the end, seven residents died, and Louisiana revoked the nursing home licenses for multiple documented violations of state law, including cruelty and indifference to the residents’ welfare.
“Improving nursing home performance and the care they provide is my number one priority,” stated Inspector General Christi A. Grimm. “When those facilities and their owners fail to protect our most vulnerable populations, OIG will not hesitate to implement its powerful exclusion tool to safeguard HHS programs and the people they serve.”
Issue:
It is critical that facility leadership focus on emergency preparedness and response to ensure that facilities sustain preparedness over time, and effectively balance attention and resources devoted to emergency management with other competing priorities. The time to review your emergency preparedness plan is not during an emergency. Advance review and preparation are essential. This includes a plan on how a safe evacuation would be implemented should it become necessary. If an emergency does happen in your facility, it is critical that all are prepared and ready to take appropriate and swift action. A satisfactory emergency preparedness plan can truly mean the difference between life and death for residents and staff.
Discussion Points:
- Effective facility emergency plans should be practical, actionable, comprehensive, and designed to be specific to the facility and community. Developing plans that account for all hazards (emerging infectious diseases, natural disasters) improves facilities’ strength to perform under unpredictable and changing circumstances. As emergencies progress, evolving circumstances may require that facilities adjust or redesign their emergency plans to sustain operations, particularly when community resources become strained, or facilities must provide care for a greater number of patients than planned. Revising plans may also be necessary following an emergency, as the facility assesses the usefulness and adequacy of the plan in preparation for future emergencies. Compare your plan to the required Centers for Medicare & Medicaid Services (CMS) Emergency Preparedness standards. Update your emergency preparedness plan as needed.
- Conduct training across the facility departments, including both clinical and nonclinical areas of operations, so that all staff will learn about and understand the needs of each department, and to identify and address potential gaps in roles and responsibilities during an emergency. Conducting routine community-wide emergency drills and exercises using a variety of potential scenarios ensures that facility staff and other key players better understand their roles and coordination points under different circumstances. Document that these trainings and drills occurred and file the signed documents in each employee’s education file.
- Perform audits to ensure staff are aware of the facility’s emergency preparedness plan, and their roles during various types of emergencies. Taking the time to routinely test for facility, technology, and other problems prior to emergencies can help identify concerns in a controlled environment so you can train staff and recognize gaps in preparation and opportunities for improvement.
