Audit raises concerns over La. nursing home care

Louisiana ranks near, or at the bottom in terms of quality care at nursing homes that treat Medicaid patients.

The legislative auditor issued a report Monday that highlights high rates of bed sores, the use of physical restraints which exceed federal benchmarks and the worst level of R. N. staffing per patient in the nation.

But despite that, costs to the government continue to soar.

"It is a concern. Health care dollars are shrinking," said State Sen. David Heitmeier (D-New Orleans).

Legislative Auditor Daryl Purpera said Monday that Louisiana had the lowest overall registered nurse staffing in the country, including the District of Columbia. The average was 3.6 hours per resident, per day.

"I think the public should certainly be interested in the fact that we're ranked 51 in the number of R.N., hours. Now in LPN hours we're ranked 10th, but when you look at the overall, the total quality of care we're at the bottom of the barrel on that one," said Purpera.

"Some of the staffing issues, I think, are some of the concerns that we should probably address," said Sen. Heitmeier.

Although Louisiana fell far short in overall nurse staffing at nursing homes, the report said all nursing facilities met state regulations regarding staffing.

Also on quality of care, nursing homes around the state fared poorly in meeting some other federal benchmarks. For pressure or bed sores, the benchmark is 7.1 percent. Louisiana was not close to that at 14.1 percent. The benchmark for residents in physical restraints is 1.35 percent. In Louisiana the percentage was 6.09 percent.

"The bed sore issue could be if patients are diabetics, so again, that has something to do with the acuity level of the patients in the nursing homes, restraints could be issues with mental health disease where we lead the nation in those instances," said Sen. Heitmeier who chairs the Senate's Health and Welfare Committee.

From 2011 through 2013, Louisiana nursing facilities were cited for 7,666 deficiencies, and assessed $4.9 million by federal and state government. However, only 3.7 percent of the deficiencies were for immediate jeopardy violations, meaning the violation was likely to cause serious injury, according to the report.

"Being chairman of Health and Welfare, it is a goal of ours to make sure that the greatest generation that ever lived has the best possible care because they deserve it," said the senator.

Last year, nursing facilities serving people with Medicaid insurance received $840 million, that's 24-percent of the state's total Medicaid budget for private providers, including hospitals.

"In Louisiana, the nursing facility's daily rate is now $161.56 per patient. On average, nursing facilities around the state treating Medicaid patients get about $3 million a year," states the report.

"We need to be sure that they're getting the best possible care that's available out there," said Senator Heitmeier.

The report did have some good news. Occupancy rates are lower than the national average.

For specific nursing home ratings go to: www.lla.la.gov

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