Nursing homes in Louisiana are rated at or near the bottom in terms of quality of care compared to the rest of the nation, according to a recent state legislative report. The report is the result of an audit of utilization, cost, and quality of care in Medicaid nursing facilities as Louisiana considers privatizing its Medicaid long-term care program and votes on whether to lock-in nursing home prices.
The Louisiana Legislative Audit concluded that, while the number of nursing home residents decreased from 26,563 in July 2011 to 25,335 in November 2013, according data from the U. S. Agency for Healthcare Research and Quality (AHRQ), Louisiana is “far from the benchmark” for several quality of care indicators.
Long-stay nursing home residents in Louisiana have a higher incidence of pressure sores, increased depression or anxiety, are more likely to be physically restrained, and spend more time in bed or in a chair compared to the national nursing home average.
Caregiverlist® Nursing Home Star Ratings lists Louisiana’s average star rating at 2.5, with only 1 out of 303 nursing homes receiving a 5-star rating. Compare that to neighboring Arkansas whose nursing homes have an average 3.0 rating with 17 of its 268 nursing homes earning a 5-star rating, or Mississippi, whose average 2.8 rating includes 5 of its 225 nursing homes in the 5-star category.
Cited nursing home deficiencies, however, were predominantly for violations categorized as “no actual harm with potential for more than minimal harm.” These included:
- Failure to implement care plan interventions, such as oral care, reporting skin changes to nurses, or providing showers according to plan of care. Failure to reassess the care plan and include the resident and/or their family in this process.
- Failure to ensure wheelchairs have footrests or securing dangerous chemicals in the shower rooms.
- Failure to develop a care plan to address pressure ulcers, hospice care, or foot care for diabetic residents.
- Failure to conduct an accurate initial or ongoing assessment of resident's activities of daily living, dental problems, or transfer needs.
Prepared by legislative auditor’s staff using January 2014 Nursing Home Compare data and information provided by DHH.
In response, Associated Press’s Melinda Deslatte writes: Joe Donchess, executive director of the Louisiana Nursing Home Association, said Monday 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 home- and community-based care programs for the elderly. He said if the programs don't provide quality care, nursing homes receive residents "in a weaker condition." The Louisiana Legislative Auditor plans future reports that will examine home and community-based services.
However, quality nursing home care can be found in Louisiana, especially according to Patrick D. McCarthy, a Lafayette CPA who, in a letter to the Advocate, writes about Southwest Louisiana Veterans’ Home in Jennings. “...An incomparable staff of qualified, caring personnel, delivers service with efficiency, professionalism and competency but, most importantly, with genuine affection and good humor. I am so sick of Louisiana being categorized at the bottom of most important lists. Truly we have a gem in Jennings. I invite you to visit. I guarantee that your chest will swell with pride for what we, Louisiana citizens, have at SLVH.”
Because many of us (or our senior loved-ones) may find themselves needing to choose nursing home care, it's up to us to do the due diligence and choose nursing home care wisely. Caregiverlist® provides a Nursing Home Checklist that can help you choose the right nursing home.