Credit state Rep. Stephanie Berault for having the temerity this year to take on the Louisiana Nursing Home Association, a fearsome lobbying power in Baton Rouge. She didn’t win the day, but she made some headway.
Or perhaps the better term is “bed-way.” Berault, R-Slidell, contends that Louisiana needs substantially more nursing home beds, and her efforts now should provide reliable information to test that contention.
For years, Louisiana has imposed a bizarre moratorium on new nursing homes or additional beds within existing ones. The LNHA argues that eliminating “excess” capacity keeps costs down by reducing the need to monetize all the supposedly unused space.
Never mind that in almost every other earthly endeavor, costs rise when the supply of a good or service is limited. Louisiana’s moratorium defies both common sense and the economic law of supply and demand.
At the beginning of this year’s legislative session, Berault reported that hospital administrators, or other evidence, indicated that serious shortages of nursing home beds exist. She that would set a numerical benchmark — a national average per capita — that would trigger exemptions from the current restrictions. Six southern Louisiana parishes would initially qualify for additional beds or homes.
It was an eminently reasonable proposal, one that essentially would have provided a six-parish test case for reform without immediately upending the current policies statewide.
For years, though, the nursing home industry has been one of the biggest donors to state political campaigns, and its lobbyists — surprise, surprise! — tend to get their way on legislation. So it was on Berault’s bill, which, facing industry opposition, remained bottled up in committee. Opponents said Berault’s reports of bed shortages weren’t accurate, and they stopped her bill cold. The anti-competitive oligopoly of nursing home operators remains intact.
Still, Berault’s bill sparked enough discussion that doors are open to potential reforms down the road.
As it was, the moratorium on new beds was scheduled to expire this year. Reps. Dustin Miller, D-Opelousas, and Tehmi Jahi Chassion, D-Lafayette, had introduced House Bill 199 to extend the moratorium for five years. With Berault’s prodding, though, the extension’s duration was reduced to four years.
Far more importantly, Berault successfully attached an amendment that should help solve the dispute about whether bed shortages exist. The amendment directs the Louisiana Department of Health to “collect and analyze data” from all licensed hospitals and nursing facilities in the state, including the total capacity of nursing homes “delineated by payor source” and “the number of denials or refusals to admit patients who are eligible for nursing facility care and the reasons for any denials or refusals.”
No longer will either side rely on disputed numbers or anecdotal evidence. Hard data will reign.
“I’m trying to take the politics out of it and just base it on metrics — on true, demonstrable need,” Berault said when I called her.
Good legislating, after all, requires good data.
With that data in hand, legislators four years from now — if not sooner — should have the courage to listen to the evidence rather than the lobbyists. And, if the numbers do indicate a need, to allow approval of more beds or facilities.
Last month, Gov. Jeff Landry signed the amended bill, now , into law. For infirm and elderly Louisianans desperately looking for a home, the welcome sign may not yet be on display, but at least it has been taken from storage and dusted off.