It’s bad enough that Louisiana state policymakers allow the Louisiana nursing home industry to fleece the taxpayer. Worse will be if elected officials aid and abet the facilities in allowing callous treatment of clients.
Louisiana nursing homes receive lots of taxpayer dollars — over $900 million from Medicaid in fiscal year 2015. Their owners then donate a few of those millions each election cycle to keep it that way.
They’ve used this leverage over elected officials to lock in annually increasing reimbursement rates and to resist reforms that could save the state up to $200 million a year — while improving Medicaid care for their clients. The formula to determine nursing home rates also pays for empty beds, producing millions in bonus payments. Meanwhile, services for people with disabilities go without funding, higher education pinches pennies, and taxes go up.
The past 10 months have ticked away at a torturously slow pace for Kenny Johnson, who prayed every day he’d get the call telling him it was time to leave the nursing home.
Shamefully, policymakers such as Gov. John Bel Edwards and legislative majorities continue to let this gravy train roll. And if the politicians don’t have the courage to stop it, at least maybe they’ll act to prevent the industry from keeping families from discovering whether nursing home employees act unethically toward or injure loved ones.
Recently, Ann Graff and Lucie Titus sued Heritage Manor of Slidell, owned by Medico LLC, to install a camera in Graff’s room at the institution. Titus, Graff’s daughter, stated her mother could not communicate reliably, and neither Graff nor Heritage Manor personnel could shed light on mysterious severe injuries that she had received while under the institution’s care. In response, Titus petitioned management to let her install a camera in Graff’s room to record potential harm Graff could experience, whether self-induced or otherwise.
The request incorporated guidelines under law in the handful of states that legally permit placement of cameras in facilities. The family would pay for placing the camera and equipment needed to capture soundless footage of Graff’s bed area, that her relatives could review. Her family also would place signage informing staff or visitors of the camera’s presence; they had received consent from Graff’s roommate for recording.
A team of government experts and industry stakeholders spent more than two years painstakingly crafting a plan that would have reduced Louisiana’s expensive and unpopular reliance on nursing homes to house the state’s most helpless residents.
Yet Heritage Manor denied the request. The suit would enjoin the institution from stopping the action, arguing civil rights discrimination against Graff on the basis of her disability and violation of her rights as a Louisiana nursing home resident.
Nationally, the industry has argued against these kinds of laws by invoking the federal Health Insurance Portability and Accountability Act’s privacy provisions, but family ownership of the equipment and recordings and the placement of signage moot that concern. More legitimately, unions join nursing homes in complaining that cameras demean employees and can cause families to misconstrue actions. The same argument has been made about police body cameras.
However, those views mistakenly put too little faith in both employees and the justice system. Good-hearted employees who take pride in their work have nothing to fear from families reviewing their job performance, and prosecutors surely have the sound judgment to bring cases based on this kind of evidence only where any employee misconduct is unambiguous. By contrast, malicious and or lazy workers have everything to lose from cameras; the oversight could either deter them from bad behavior or guide them to leave this profession.
Year after year, Louisiana lawmakers gather in Baton Rouge and grouse about the unpalatable choices they face: Cut state services, raise taxes or do some of both.
In reality, nursing homes fear that cameras will expose employee misbehavior that creates legal liabilities, increase state corrective actions, and affect the bottom line by hiking personnel costs — through paying higher wages and dealing with staff turnover. The industry will fight any attempt to make camera installation a legal right.
Regardless, at the next available opportunity Louisiana policymakers should change state law to allow cameras in rooms of nursing home clients. If they won’t protect taxpayer resources, they at least need to allow families to protect vulnerable citizens.
Jeff Sadow is an associate professor of political science at Louisiana State University-Shreveport, where he teaches Louisiana government. He is author of a blog about Louisiana politics at www.between-lines.com, where links to information in this column may be found. When the Legislature is in session, he writes about legislation at www.laleglog.com. Follow him on Twitter, @jsadowadvocate or write to him at firstname.lastname@example.org. His views do not necessarily express those of his employer.
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