Louisiana nursing homes rank among the worst nurses in the country, documenting high rates of pressure flames, concerns about overprescribing antipsychotics, and a disastrous shortage of staff.
But state lawmakers took their first step Wednesday night in litigation that cut litigation against management companies against nursing homes and other healthcare companies, determining staffing and spending levels.
Senate Bill 134 from Senator Thomas Pressly of R-Sreveport changes the definition of healthcare providers in Louisiana, focusing on management, staffing and administrative services under the term. It also expands the definition of medical malpractice to include administrative duties, staffing and care made in “support ability.”
The change in definition is to prevent lawsuits citing administrative negligence against nursing home management companies that have been hooked in recent years for multi-million dollar verdicts in favor of patients and their families. The proposed changes to the law will force patients to file a lawsuit on their behalf under the Louisiana Medical Malpractice Act. This will total damages to $500,000, limiting it to the provider's $100,000. In this case, it is a nursing home management company.
“If this bill had been a law in 2021 when Hurricane Ida hit Louisiana, Bob Dean would have definitely been fully protected due to his administrative negligence,” testified Dennis Bocker, the state director of AARP Louisiana. “This bill is a bad policy. There will be hundreds of thousands of families, caregivers, seniors, and voices.”
Dean owned several nursing homes in Louisiana and sent 843 elderly and frail residents into lukewarm warehouses during the storm. According to nurses who staffed the warehouse and the state inspectors they visited, residents there cried out for help but gave little attention. Urine and excrement were piled up in the facility, but the facility did not have enough bathrooms, but some residents spent days in wheelchairs without moving or receiving the correct medicine.
The state eventually closed its warehouses, evacuated residents, and closed the dean's nursing home. Dozens of patients were hospitalized, many died, and the coroner determined that five deaths were related to the storm.
Dean was arrested and faced a swarm of lawsuits, including class action lawsuits from patients in his nursing home and surviving families against his nursing home management company. The lawsuit led to a $12.5 million settlement from Dean's insurance revenue. He did not plead for a fight to count the cruelty of the weak, Medicaid fraud, and obstruction of justice.
Congress considered a similar bill for the final session, but dumped it in public blowbacks around the Dean case.
However, the Louisiana Nursing Home Association told lawmakers Wednesday to ignore comparisons between Dean's case and potential changes to the law, noting that Dean is not a member of the LNHA. They said that since the 2003 law “eroded” was changed in 2003, management companies are to be classified as healthcare providers under the Medical Malpractice Act.
And Wes Hataway, director of the Louisiana Nursing Home Association's Law and Policy, said electricity in the litigation against nursing homes threatened to overturn the industry. Pressly also testified that the law is intended to ensure that it floats within the state.
“We're going to flip the key because these health facilities can no longer do business in this state,” Hataway said.
The fight locked two powerful groups together for the second year in a row at the Capitol. The nursing home is a prolific donor to state legislators and has a strong shaking at the Capitol — claims trial lawyers use lawsuits to line up pockets. Meanwhile, lawyers representing patients say that if nursing homes focus on patient care as much as concerns about legal verdicts, there will be fewer complaints in court.
The patient's family explains inadequate care in the nursing home
The Louisiana Nursing Home Association has specifically identified one law firm, Garcia and Altilliere, and threatened to bankrupt the industry.
Matt Coman, the company's New Orleans lawyer, testified along with some clients about the horror he saw in a nursing home where the management company said it had squeezed staff to make a profit. Coman read the rows from the deposition of the management company, which admitted that despite potential definition changes, it did not provide healthcare.
He referenced how the Louisiana LTAC management company that his company sued had abolished the status of wound nurses from the company. There, Coman represents the man who died in flooring, and his family received a $2.2 million verdict for a long-term acute care facility.
Families of residents who were abused at Louisiana nursing homes waited all day to testify at the hearing.
Dorema Cambre testified about the infection and sepsis that her mother, Grace St. Pierre, was developed at Chateau St. James, Ratcher. Cambre said he discovered he collapsed 35 times at the facility after his mother's death.
Cambre sued the Priority Management Group. It operates nursing homes with dozens of others across Louisiana. At a trial in St. James' Parish last year, the judge found that the nursing home company had violated the discovery order by withholding emails related to the case. They included warnings that staff sent to management, saying residents were suffering because the nursing homes were not enough staff. A ju judge from St. James' Parish awarded Cambre $3.5 million in the case.
“When my mother lived there, Chateau St. James was quite understaffed,” Cambray said. “I understand that this bill will protect nursing home businesses like priority management of nursing homes in Fusteffech, in order to better care for the people who live there, like my mother.”
Jeffrey Stewart explained that she visited her mother Cynthia in a nursing home in the church point where she developed a pressure ulcer, as staff did not turn her every two hours. He said he paid $7,400 a month for her stay. Stewart is filing a lawsuit against Acadia Cent Laundry Nursing & Rehabilitation. It has yet to pass the Medical Review Board and has yet to reach the District Court in Lafayette.
“Every time we visited, employees had to come and search to turn our mother,” he said. “Every time I went to hand over the money and pointed my mother, I had to bring some cash. In the end, she was in terrible pain.”
What constitutes medical malpractice?
Other lawyers have also criticized the law.
Attorney Chip Wagal, who represents a patient with a medical malpractice case, referred to another case in the Ascension Diocese. Staff tied the elderly woman in a wheelchair and didn't check her, she slipped off and choked by the strap, he said.
The nursing home faced an administrative negligence lawsuit. These types of cases should not be covered by medical malpractice, he said.
“This would involve misrepresentation, fraud and action that has nothing to do with medicine, sweep it under that (medical malpractice) law and limit its nursing home to $100,000,” he said.
State Sen. Jay Renault, D-Alexandria, grilled nursing home representatives about how the bill works and reinstalled a series of questions that he began with the first version of the bill last year. He asked how creating such a vast definition of medical malpractice would affect someone's ability to sue if it was leaked on the nursing room floor.
“The simple fact is that medical malpractice covers unintended torts that occur while providing health care,” Hataway said. “If a person slips into a hospital and falls, I don't know how unintentional it's… Healthcare is being provided.”
Renault said the bill was the “most widely written bill” he has ever seen.
“The language of this is very broad and very besieged, and everything will be illegitimate,” he said.
In the end, Renault was the only member of the Senate Health and Human Services Committee to vote against the bill. The overwhelmingly favorable votes were Katrina Jackson Andrews and D. Monroe. Heather Cloud, R, Turkey Creek. Bob Hensgens, R-Aberville. Valarie Hodges, R-Denham Springs; Robert “Bob” Owen, R-Slidell. R-Covington Chairman Patrick McMath did not vote.
The bill is headed next to the senators.
