Senator Chuck Grassley, through his position on the Senate Finance Committee, has issued a press release regarding his request that the OIG investigate nursing home deaths during Katrina. Specifically, he has requested that the OIG look at the following:
1) Were long-term care facilities prepared to evacuate patients across State lines?
2) Were policies and procedures in place to evacuate residents?
3) Was care jeopardized in transporting patients?
and;
4) What mechanisms are currently in place for loved ones to find displaced residents?
I look forward considering the GAO’s work on these critical issues. We must ensure that
situations like this are NEVER repeated again.
Issue number 3 suggests that this may be one of those “damned if you do and damned if you don’t” situations.
The press release can be read by clicking here. The OIG response can be read by clicking here.
This is a reminder that tomorrow, Friday, September 23, I will be Mychal Massie’s guest on talk radio at about 1:06 ET on WDEL 1150 AM in Delaware. I will be discussing the issue of St. Rita’s nursing home in New Orleans.
You can listen to it through the internet by clicking here. The call in number is 302-478-9335 .
General Honore takes no guff from the reporters in New Orleans(HT Radioblogger):
Honore: And Mr. Mayor, let’s go back, because I can see right now, we’re setting this up as he said, he said, we said. All right? We are not going to go, by order of the mayor and the governor, and open the convention center for people to come in. There are buses there. Is that clear to you? Buses parked. There are 4,000 troops there. People come, they get on a bus, they get on a truck, they move on. Is that clear? Is that clear to the public?
Female reporter: Where do they move on…
Honore: That’s not your business.
Male reporter: But General, that didn’t work the first time…
Honore: Wait a minute. It didn’t work the first time. This ain’t the first time. Okay? If…we don’t control Rita, you understand? So there are a lot of pieces of it that’s going to be worked out. You got good public servants working through it. Let’s get a little trust here, because you’re starting to act like this is your problem. You are carrying the message, okay? What we’re going to do is have the buses staged. The initial place is at the convention center. We’re not going to announce other places at this time, until we get a plan set, and we’ll let people know where those locations are, through the government, and through public announcements. Right now, to handle the number of people that want to leave, we’ve got the capacity. You will come to the convention center. There are soldiers there from the 82nd Airborne, and from the Louisiana National Guard. People will be told to get on the bus, and we will take care of them. And where they go will be dependent on the capacity in this state. We’ve got our communications up. And we’ll tell them where to go. And when they get there, they’ll be able to get a chance, an opportunity to get registered, and so they can let their families know where they are. But don’t start panic here. Okay? We’ve got a location. It is in the front of the convention center, and that’s where we will use to migrate people from it, into the system.
Male reporter: General Honore, we were told that Berman Stadium on the west bank would be another staging area…
Honore: Not to my knowledge. Again, the current place, I just told you one time, is the convention center. Once we complete the plan with the mayor, and is approved by the governor, then we’ll start that in the next 12-24 hours. And we understand that there’s a problem in getting communications out. That’s where we need your help. But let’s not confuse the questions with the answers. Buses at the convention center will move our citizens, for whom we have sworn that we will support and defend…and we’ll move them on. Let’s not get stuck on the last storm. You’re asking last storm questions for people who are concerned about the future storm. Don’t get stuck on stupid, reporters. We are moving forward. And don’t confuse the people please. You are part of the public message. So help us get the message straight. And if you don’t understand, maybe you’ll confuse it to the people. That’s why we like follow-up questions. But right now, it’s the convention center, and move on.
Male reporter: General, a little bit more about why that’s happening this time, though, and did not have that last time…
Honore: You are stuck on stupid. I’m not going to answer that question. We are going to deal with Rita. This is public information that people are depending on the government to put out. This is the way we’ve got to do it. So please. I apologize to you, but let’s talk about the future. Rita is happening. And right now, we need to get good, clean information out to the people that they can use. And we can have a conversation on the side about the past, in a couple of months.
I think that the Long Term Care profession needs a spokesman like General Honore. Wouldn’t you love to hear the General say something similar to a regulator berating you about a problem you’ve already fixed?
“Hey Mr. Surveyor, don’t get stuck on stupid.”
Hurricane Rita is on its way and it’s time for Coastal areas to think about their evacuation plans. The word on the street is that FEMA is starting to grab buses to evacuate the Katrina evacuees out of Houston. I have heard that bus companies are requiring payment up front from nursing homes.
Things to be concerned about:
1. Chartering buses that end up being commandeered by FEMA or local authorities.
2. Are your local governmental entities working with nursing homes for Plan B in case your buses don’t show up because they’ver been commandeered or the drivers aren’t showing up for work? (this happened during Katrina)
Review your plan, get your buses lined up and check with local authorities. If the local authorities aren’t cooperating, please come here and fill out a comment to that effect.
Please note that my last post should read:
On Friday, September 23, (correction) I will again be Mychal Massie’s guest. He will interview me at about 1:06 ET on WDEL 1150 AM in Delaware. You can also listen to it through the internet by clicking here.
I am scheduled to appear on two talk radio shows this week to talk about Katrina and its effect on nursing homes, specifically about St. Rita’s in New Orleans.
I will first appear on Mychal Massie’s Straight Talk on Right Talk Radio at about 1:18 ET. It streams accross the internet and can be listened to by clicking here and then clicking on channel 1. It will be replayed on subsequent channels on the hour throughout the rest of the day.
On Friday, September 23, (correction) I will again be Mychal Massie’s guest. He will interview me at about 1:06 ET on WDEL 1150 AM in Delaware. You can also listen to it through the internet by clicking here.
Feel free to call in and give me heck!
Their odyssey began with the rest of New Orleans’ poor. They knew the hurricane was coming but had no cars to make their escape and no place to go anyway.
On Aug. 28, the day before the storm hit, the Abstract House caretakers hustled the 16 residents and Campos, a former resident who was visiting for the weekend, into vans headed for the Superdome, about a mile away.
Abstract’s director, Barrie Byrnes, said she was following instructions from city officials.”
They never was able to effectuate any kind of evacuation plan,” she said. “We were told the dome would be for special needs.”
Stress and disruption are as threatening to psychotics as the winds that peeled the Superdome’s roof like an orange. Once inside the dome, they barricaded themselves behind privacy curtains and packing crates.
One of the patients designated himself the holder of the meds:
Cogentin, Xanax, Paxil, Cibalith, and about a dozen more.
“I’m in charge of the medications because of my street knowledge,” he said. “That, and my mother was trained to be a nurse. Some of these guys need their pills four times a day.”
The group ended up in a group home is Houston. Go read the whole thing.
The media is reporting the following:
Authorities Wednesday began removing the remains of more than 30 people from a flooded nursing home in a suburban parish.
The discovery at St. Rita’s Nursing Home in lower St. Bernard Parish came as 25,000 body bags arrived at the Louisiana Department of Health and Hospitals. (Full story)
On Thursday, the official death toll from Hurricane Katrina stood at 294, but that number is expected to rise dramatically.
Mortuary teams with refrigerated trucks began arriving Wednesday at the nursing home, where St. Bernard Parish Sheriff Jack Stevens said “30-plus” bodies were found. Between 40 and 50 other people were rescued from the facility, Stevens said.
The way this story is written, one would assume that the staff just chose to run off and leave people. However, after talking with a source who has people on the ground in New Orleans, I believe that may or may not be the case. Apparently, each Parish has its own Emergency Director. For quite some time, some nursing homes in some parishes have been trying to work with the Director regarding evacuations–particularly focusing on the fact that some residents are so fragile that it is dangerous to evacuate them. The homes have been requesting that hospitals allow them to place such residents on higher floors out of the way of floodwaters. The hospitals have refused. (Can’t you just hear their lawyers talking?) They have refused even though most of their patients would be evacuated and space would, allegedly, not be a factor. My source, who is not affiliated with St. Rita, is unhappy that the Parish Emergency Directors would not require the hospitals to allow the nursing homes to place residents at those hospitals. After all, the government was, in some cases, willing to commandeer buses chartered by the facilities to move residents–why couldn’t they require hospitals to give up unoccupied floors?
Apparently, what happened in some of these cases is that when the nursing homes started flooding, the staff could not move the residents (who had no where to go), as the water rose–the staff had to escape to save themselves from drowning. If this is true, it is a horrible scenario–but you can’t blame the staff.
Another problem according to my source, was that, although some facilities chartered buses, the bus drivers had fled the area and there was no one to drive them. I wonder how many residents were impacted by that?
Regardless, you may read many stories about dead residents found in nursing homes over the next few days. Just remember, the media may not be giving you all the facts behind these stories.
Update: I am updating this because I am extremely angry at the media for not adequately reporting about this. I think that they are setting up a situation where these nursing homes are going to be blamed. Perhaps some of them have fault. I doubt it. If you own one of these nursing homes, please ensure that you have documented every action your staff took to evacuate residents. If your buses were commandeered, document it. If the bus drivers didn’t show up, document it.
If you followed your emergency plan and were thwarted by the government, document it. If CMS moves against you–call your lawyer.
I received an e-mail with the following information from PPAT:
Private Provider and Family Assistance:
1.) Mr. Chris Tilly, Executive Director of CARSA (Community and Residential Services Association) in Louisiana shared that several thousand providers have evacuated New Orleans, and a number of their group and community homes were destroyed by the hurricane. Housing is the most immediate need, it is estimated that it will take 6-8 months to rebuild or relocate these individuals back into group and community homes. Chris said they are looking for individual or group home, facility, hotel, and/or camping ground accommodations for the dislocated special needs population. He knows where many of the providers and the families they served are located. If you can offer housing, or clothes, special needs equipment, etc., Chris would love for you to contact him at 225-343-8811 (his home - try this number first) then 225-346-8076. More information can be found on their website: carsa@aol.com.
2.) Richard Hernandez with Educare is working with their New Orleans contacts to find housing for staff and their families who will be assisting with the increased care demands that Educare’s ICF/MRs in Texas will experience due to enrollment of displaced consumers. If you have housing availability, especially in Austin or San Antonio, for ICF/MR staff and their families, please contact Richard Hernandez at (512) 569.4585
3.) The Arc of the United States will be serving as a conduit for donations to the chapters in need of our support. We will be accepting donations through our web site at www.thearc.org (click the red “Donate Now” button, fill out the requested information and be sure to select “The Arc’s Katrina Relief Fund” under the “My gift is in support of” section) and through regular mail sent to The Arc of the United States, ATTN: The Arc’s Katrina Relief Fund, 1010 Wayne Avenue, Suite 650, Silver Spring, MD 20910.
4.) Guidance for Texas NFs Assisting in the Louisiana Relief Effort
In the aftermath of Hurricane Katrina, several nursing facilities located in eastern Texas have been contacted by Louisiana nursing facilities who are seeking assistance in caring for their elderly residents. Specifically, these Louisiana providers are asking the Texas providers to admit and provide care for their residents until their operations can recover from the damage inflicted by Katrina. As could be expected, our Texas facilities are eager to assist their Louisiana counterparts, but have regulatory and reimbursement concerns in regard to this unique situation.
4a.) Regulatory / Payment Issues
THCA has contacted the Department of Aging and Disability Services (DADS) and has obtained some general guidance in regard to these issues:
· Reimbursement for services is an issue that is to be worked out between the two nursing facilities.
· Texas Nursing Facilities may serve Louisiana Nursing Facility residents in any vacant beds available in a Nursing Facility as long as the occupancy for the Texas License issued by DADS for that Nursing Facility is not exceeded.
· Texas Nursing Facilities that choose to admit Louisiana Nursing Facility residents will be required by DADS to provide Nursing Facility Care according to the requirements for Texas Licensure and Medicaid Certification.
4b.) What is needed
If you can help with any staff, supplies, transportation, or beds for relocation, contact Julie at the Louisiana Nursing Home Association, 225/927-5642.
4c.) Contacts
Relocation Issues: Dorthea Raiford, DADS, Region 4/5 (Tyler/Beaumont), 409/951-3236.
Reimbursement Issues: Larry North, DADS, Section Director for Institutional Services, Provider Services, 512/438-3543, larry.north@dads.state.tx.us
Regulatory Issues: Chris Adams, DADS, Director of Survey Operations, 512/438-5695, chris.adams@dads.state.tx.us
Finally, THCA applauds its member facilities that are able to assist Louisiana in this time of need. If you have any questions, please contact Dorothy Crawford at the THCA office, 512/458-1257.
Some area specific ways to donate to the overall relief effort:
Austin: The Red Cross needs volunteers and money, especially in the Austin office (Pershing Drive off of Airport Blvd.) They also need volunteers to go to the Tony Burger Center (south Austin) to help with the people who are being re-located there. Help is needed at all hours, and will be needed through the weekend. Contact Barbara at 512-929-1225 to volunteer.
United Way in Austin: 512.472.6267/ Hands on Central Texas/Volunteer Center: 512-323-1898.
Dallas: It’s been recorded that many people are being evacuated to Reunion Arena. They are asking for donations of shampoo, soap, lotion, blankets, cleaning supplies, etc. Organizations who want to make donations outside of monetary donations need to call the American Red Cross In-Kind donation at 214-678-4216. No items should be taken to Reunion Arena without a release from the In-Kind donation area first.
Houston
If you have any questions about the Arc’s Katrina Relief Fund, please contact Amy Curtis at curtis@thearc.org or call 301-565-5451
Red Cross - Also for information on volunteering at the astrodome.
Volunteer Houston/Harris County Citizen Corp.
281-564-6669
Houston United Way
713-957-4357
Houston Red Cross: 713-526-8300 /www.houstonredcross.org.
If you would like to make a donation to the Red Cross, please call 1-800-HELP-NOW or 1-800-257-7575 (Spanish).
Houston Food Bank:
www.houstonfoodbank.org
Statewide Assistance: You can contact any of these organizations to volunteer your time, or offer housing accommodations, food, or clothing.
Red Cross: 1-800-HELP-NOW or www.redcross.org
Americares.org
Salvation Army 1-800-SAL-ARMY or www.salvationarmyusa.org
FEMA Charity tips - www.fema.gov/rrr/help2.shtm
National Voluntary Organizations Active in Disaster www.nvoad.org
New Orleans Doctors Plead for Help
Sep 01 4:29 PM US/Eastern
By MARILYNN MARCHIONE
AP Medical Writernews://newsclip.ap.org/TXJK10309011912@news.ap.org
Doctors at two desperately crippled hospitals in New Orleans called The Associated Press Thursday morning pleading for rescue, saying they were nearly out of food and power and had been forced to move patients to higher floors to escape looters.
“We have been trying to call the mayor’s office, we have been trying to call the governor’s office … we have tried to use any inside pressure we can. We are turning to you. Please help us,” said Dr. Norman McSwain, chief of trauma surgery at Charity Hospital, the largest of two public hospitals.
Charity is across the street from Tulane University Medical Center, a private facility that has almost completed evacuating m/lore than 1,000 patients and family members, he said.
No such public resources are available for Charity, which has about 250 patients, or University Hospital several blocks away, which has about 110 patients.
“We need coordinated help from the government,” McSwain said.
He described horrific conditions.
“There is no food in Charity Hospital. They’re eating fruit bowl punch and that’s all they’ve got to eat. There’s minimal water,” McSwain said.