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Report: Louisiana Nursing Homes Rank Among the Worst

The quality of care at Louisiana’s nursing homes is among the worst in the nation, with high rates of bed sores and physical restraints and low levels of nursing staff, according to a state legislative report released June 9.

The number of people who live in nursing homes in Louisiana is dropping, but the state still provides more long-term elderly care through the facilities than other states, according to the informational review by Legislative Auditor Daryl Purpera’s office.

“Louisiana ranks at or near the bottom when comparing quality indicators among states,” the report says.

Nursing homes are the largest private provider getting payments from the state’s Medicaid program. A recent state House budget analysis says nursing homes received $892 million this year for the care.

For quality metrics, the auditor’s office looked at 2011 federal data.

The report says Louisiana nursing homes were far from federal benchmarks on the rate of residents with pressure sores that come from staying in one position for too long.

It says that compared with federal benchmarks, Louisiana’s nursing home residents had higher levels of depression and anxiety, of urinary tract infections, of time spent in a bed or chair, and of physical restraints.

Nurse staffing levels, at an average of 3.6 hours spent on a resident each day, was the lowest level among all 50 states, according to the auditor’s report, which notes that the nursing homes meet state staffing regulations.

The federal Medicaid agency grades nursing homes on a five-star rating system. The auditor’s report says 14 percent of Louisiana’s 259 nursing homes got five stars and 21 percent had the lowest rating of one star.

Louisiana Health and Hospitals Secretary Kathy Kliebert said her department is working to offer people more options to stay in home- and community-based programs, rather than institutions like nursing homes. In a statement, she also said fines paid by nursing homes for health and safety violations are steered to programs that are designed to improve the quality of care.

Joe Donchess, executive director of the Louisiana Nursing Home Association, said that the facilities in Louisiana and other nearby states are graded at a harsher standard by federal officials than similar facilities in other Medicaid regions.

“We provide a high quality of care to the residents. The residents are happy and safe,” he said.

Donchess said the reviews don’t take into consideration the conditions that patients have when they enter nursing homes. He said there’s no way to judge that because the state doesn’t monitor quality of home- and community-based care programs. He said if the programs don’t provide quality care, nursing homes receive residents “in a weaker condition.”

Other findings in the auditor’s report:

• The number of Louisiana Medicaid patients receiving care at nursing homes fell from 26,563 in July 2011 to 25,335 by November 2013. But Louisiana still ranks in the top five states for nursing home use per capita for people over age 85.
• The average occupancy rate at Louisiana’s nursing homes is lower than the national average, at 72.5 percent in the 2011 budget year and growing to 75 percent by the 2013 fiscal year. The national average was 83 percent.
• Nursing home payments grew by 38 percent over three years. The daily rate average was $117.19 in June 2010 and $161.56 by October 2013. But the report says Louisiana’s rates were among the lowest when compared to 18 other states.