Louisiana Department of Health aware of plans for nursing homes to use warehouse for evacuation site

By Paul P. Murphy, CNN

The Louisiana Department of Health was aware of plans from seven nursing homes to evacuate their residents to a warehouse in Independence, Louisiana, to shelter during Hurricane Ida.

Seven residents died before state health officials transported hundreds of people from the warehouse to other nursing facilities on September 2, five days after the hurricane tore through the state.

Emergency preparedness plans and surveys from the seven nursing homes obtained by CNN designated the warehouse as an evacuation site. Those documents also reveal that the seven facilities planned to evacuate their residents to the warehouse, which had a listed capacity of 700 beds, despite the nursing homes having more than 1,000 combined licensed beds.

Under the Louisiana Department of Health’s formal rules, the nursing homes’ emergency preparedness information must be submitted to the state for annual review by the department, suggesting state health officials were aware that nursing home administrators intended to move their residents to the warehouse in the event of an emergency such as Ida.

Business licenses and court documents show that Bob Dean Jr. of Baton Rouge is the owner of all seven nursing facilities, in addition to the warehouse.

By the time the Health Department closed down the warehouse evacuation site, it was well over its planned capacity by at least 143 evacuees, according to the plans and surveys obtained by CNN through public records requests to four parish governments.

Two nurses described the conditions in the warehouse to CNN as horrific, saying that in addition to the unsanitary conditions, they also dealt with supply shortages and electricity cuts.

At least 30 calls to 911 from the facility requested emergency assistance for residents experiencing a variety of medical episodes, including heart attacks and seizures. Logs of the calls obtained by CNN show other residents had stopped breathing or were unresponsive.

Two lawsuits have since been filed against the nursing homes and Dean over the warehouse evacuation.

Fire Marshall had only cleared warehouse for storage

Louisiana state regulations require that nursing homes’ emergency plans adhere to minimum licensing standards, in addition to recommended guidelines outlined in Louisiana’s Model Nursing Home Emergency Plan.

While the model plan indicates that “business facilities” can be “converted into shelters in an emergency,” a company “must have the designated facility” inspected by the Office of Homeland Security and Preparedness in the parish or the American Red Cross to “to determine what must be done to make it acceptable as a shelter.”

A Louisiana State Fire Marshall inspection report dated September 1 shows that the building had been cleared only for use as a “warehouse (storage),” and not as “emergency evacuation shelters for nursing homes.”

But in a recent press release from the Louisiana Department of Health, the department noted that its employees had visited the warehouse twice prior to landfall, and “it did appear that from a facility standpoint the minimum necessary components to provide a safe sheltering environment for a very short period of time were met.”

According to the department, “there were plans for staffing, food service and laundry, potable water, portable toilets, and a working generator appropriately sized for the facility.”

Gov. John Bel Edwards told CNN on September 2 that 843 residents — well over the listed 700-bed capacity — had been moved from the warehouse. For at least two of the nursing homes, Dean was listed as the individual responsible for making the decision whether the facility would shelter in place or evacuate.

A letter, signed by Dean and included in some of the surveys, also laid out how each nursing home would pay his company, Plaquemine Plaza Holdings, $20,000 a month for access to the warehouse and other facilities as evacuation sites.

In some of the surveys from 2021, the primary function of the warehouse was listed as the evacuation site for the nursing facilities.

Dean did not return CNN requests for comment on the plans filed with the state.

Louisiana state regulations charge the Health Department with reviewing all nursing home emergency preparedness plans, allowing it to notify facilities if it decides they do not meet “current minimum licensing requirements or does not promote the health, safety and welfare of the nursing facility’s residents.”

Health Department won’t say how nursing homes deviated from plans

Louisiana Department of Health spokesperson Kevin Litten told CNN the department had revoked the licenses of the seven facilities, which took place after the attorney general’s office opened the investigation.

“The owner and administrators of the nursing homes that evacuated to Independence, Louisiana, failed to execute on the plans that they set forth in the emergency evacuation plan,” Litten told CNN in an email, saying that it resulted in, “grossly inadequate care.”

Litten confirmed that, “LDH reviews and confirms emergency preparedness plans,” but would not say whether the department approved the plan to evacuate to the warehouse or detail how the facilities failed to carry out their evacuation plans.

“Current law allows licensed facilities to evacuate to unlicensed facilities for a very short period of time,” Litten said. “Now, whether that should change will be part of a larger conversation many of us will be having in the future. And we hope our internal review of the event can help inform where we need to go from here.”

In addition to the Department of Health, the state’s health regulations also require facilities to submit their emergency evacuation plans to their local parishes, and the regulations say that “any recommendations by the parish…shall be documented and addressed by the nursing facility.”

Edwards’ office declined to respond to CNN’s questions, and instead sent along the same statement from the Health Department.

Parish governments rely on Health Department to review, approve plan

New Orleans Office of Homeland Security and Emergency Preparedness Director Collin Arnold told CNN he reviews evacuation plan set forth by nursing homes, but said it is “cursory to the state’s responsibility.”

“When I see that they have [an evacuation] location, I’m relying on the state that there’s due diligence on that as well,” he said.

Even if Parish officials issue recommendations during their review, both Arnold and a Jefferson Parish official, Sarah Babcock, told CNN, the nursing facility is not required to implement any of the recommendations.

“At least at the Parish level, there’s no teeth in this,” Babcock, the chief administrative assistant in charge of all things public health and emergency response in Jefferson Parish, told CNN by phone, saying that she and others can only make suggestions. “The parishes do not have any oversight or regulatory authority for nursing homes.”

In any case, the surveys completed by the seven nursing home facilities included verifications that their emergency plans were submitted to their local parish offices and indicated that the local parish offices had not given any recommendations.

Babcock did not remember reviewing the surveys for the nursing homes but said that the same evacuation facility popping up on multiple plans would be “a red flag for us.”

In a press conference on Tuesday, Stephen Russo, Louisiana Department of Health director of Legal, Audit and Regulatory Affairs, said that “there is no emergency-preparedness plan that allows for residents to be kept in such an unsafe, unsanitary, and unhealthy condition.”

“The lack of adequate care for these residents is inhumane, and goes against the rules, regulations, and applicable statutes,” Russo continued.

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CNN’s Isabelle Chapman contributed to this report.