August 09, 2005

Louisiana Looks to Study Nursing Home Fines

A recent article in The Times-Picayune has addressed the issue of nursing home sanctions in Louisiana.

Louisiana has long been considered to be lax in its enforcement of federal regulations for health care. Louisiana's homes, which often rank toward the bottom on key quality of care indicators, are far less likely to be fined for violations, even those that cause serious injury or death, than their neighboring states. For example, in the last four years, Louisiana's 309 licensed nursing homes have been fined a total of approximately $1.2 million. Over that same time period, Mississippi's 204 homes were fined $3 million, and Texas's 1,137 homes were fined around $7.4 million.

Some officials in Louisiana are beginning to investigate whether more stringent penalties will lead to better quality of care. Governor Blanco's Health Care Reform Panel spent months studying the state's long term health care program, and recommended that sanctions be increased and that the issue receive more study.

The study will be headed by the state's ombudsman for long term care, Linda Sadden. The group will also include state health regulators, representatives from the nursing home industry, advocacy groups and elderly and disabled people receiving long term care. Sadden has said that they will look at other states for guidance and see if the increased sanctions lead to an increase in the quality of care.

Sadden has said that while relatively little research has been done on the relationship between penalties and quality of care, the few studies that have been conducted suggest that strict sanctions serve as a motivator for nursing homes to improve. In California, for example, the maximum penalty was raised to $25,000 in 1999, and then again to $100,000 in 2001. Following these increases, the number of homes cited for serious violations has dropped from 30 percent to 6 percent in the last six years.

Some have cautioned against stricter penalties, suggesting that higher fines levied will reduce the monies available to provide a high quality of care. Others have countered that if the home is already providing a high quality of care, the increased sanctions will not be an issue.

The group meets for the first time on August 18. It will be interesting to see if this study leads to any dramatic changes in enforcement in Louisiana.