September 22,2005

Grassley receives reply from Inspector General regarding nursing home deaths

WASHINGTON -- Sen. Chuck Grassley has received a response from the InspectorGeneral for the Department of Health and Human Services to his letter of last week asking for aninvestigation of the nursing home deaths at St. Rita's Nursing Home due to Hurricane Katrina.

The Inspector General said that the office is taking "very seriously all allegations" itreceives concerning these issues and that it is "assisting the Louisiana Attorney General's Officeunder the theory that false claims were submitted to the Medicaid program for care that was notgiven" in the specific matter of the 34 deaths in St. Rita's nursing home.

The Inspector General's response is attached in a pdf file. The text of Grassley's request,which was also made of the Department of Justice and the Government Accountability Office,follows here.

For Immediate Release
Wednesday, Sept. 14, 2005

Grassley Requests Federal Investigations of Nursing Home Deaths Due to Hurricane Katrina

WASHINGTON - Sen. Chuck Grassley today asked the U.S. Department of Justice, theDepartment of Health and Human Services Inspector General, and the GovernmentAccountability Office to conduct thorough investigations of the deaths of nursing home residentsin the Gulf Coast states.

Grassley's letter comes on the heels of charges against the owners of St. Rita's NursingHome in St. Bernard Parish with 34 counts of negligent homicide. In one of the letters, he wrote,"There are no excuses for those who neglected and abused our most vulnerable and frail-whetherin a nursing home, hospital or another long-term care facility. Any individual that did not fulfillhis or her duty of care should be pursued to the fullest extent of the law and any health carefacility that failed its patients should have all appropriate legal and administrative actionsinitiated against it."

Here are copies of Grassley's letters.

September 14, 2005

The Honorable Alberto Gonzales
Attorney General
United States Department of Justice
950 Pennsylvania Avenue, N.W.
Washington, DC 20535

The Honorable Daniel R. Levinson
Inspector General
Department of Health and Human Services
Office of Inspector General
330 Independence Avenue, SW
Washington, DC 20201

Dear Attorney General Gonzales and Inspector General Levinson:

Since 1997, I have focused considerable attention on improving the quality of care in ourNation's nursing homes, which provide care for approximately 1.7 million elderly and disabledresidents in over 17,000 nursing homes. As former chairman of the Special Committee on Aging,and as current chairman of the Committee on Finance (Committee), I have held numeroushearings over the years to address the quality of care in nursing homes. In recent weeks, we haveall witnessed unspeakable tragedies on the Gulf Coast. None are more heart wrenching than theabandonment of nursing home residents in the midst of the evacuation from hurricane Katrina;the abuse and neglect visited upon the most vulnerable among us is shameful. The utterdisrespect for the life and dignity of the frail and elderly is nearly incomprehensible.

Yesterday, as you know, the Louisiana Attorney General charged the owners of St. Rita'sNursing Home in St. Bernard Parish with 34 counts of negligent homicide. Unfortunately, thisshameful event does not appear to be an isolated occurrence. Media reports suggest that residentsat two other New Orleans nursing homes-eight residents at Bethany Home and approximately 20residents at Lafon Nursing Home-also died because they were not evacuated. With more thanninety elder care (i.e., nursing home, retirement community, continuing care community orAlzheimer's Care) facilities within 50 miles of New Orleans, the extent of the criminality relatedto neglect and abuse is unknown. Undoubtedly, the vast majority of nursing homes fulfilled theirduty of care and for that I am grateful. However, every instance of abuse and neglect in a nursinghome should be closely examined and the death of any nursing home resident should be fullyinvestigated.

As chairman of the Committee, I request that the Department of Justice and the Office ofInspector General, Department of Health and Human Services, conduct a thorough investigationof the deaths of nursing home residents in the Gulf Coast states, including but not limited to the34 deaths of residents at St. Rita's nursing home. There are no excuses for those who neglectedand abused our most vulnerable and frail-whether in a nursing home, hospital or anotherlong-term care facility. Any individual that did not fulfill his/her duty of care should be pursuedto the fullest extent of the law and any health care facility that failed its patients should have allappropriate legal and administrative actions initiated against it.

Additional media reports state that in some instances hospital patients were notappropriately cared for either. Apparently, some helicopters available to evacuate victims ofHurricane Katrina took precious time to "rescue" hospital medical equipment rather thanfocusing exclusively on the human lives. No matter what the cost, I fail to see the logic in placinga machine ahead of any human life. The unnecessary loss of life in hospitals across the GulfCoast also must be thoroughly investigated.

Finally, as chairman of the Committee, I request that your offices keep the Committeeapprised of your review and investigation of the aforementioned matters. At the earliestopportunity, I would appreciate receiving a briefing from your respective offices. We mustensure that this nightmare NEVER occurs again.

Thank you in advance for having your staff coordinate with my staff about these mattersno later than close of business on September 21, 2004.

Sincerely,

Charles E. Grassley,
Chairman

September 14, 2005

The Honorable David M. Walker
Comptroller General
United States Government Accountability Office
441 G Street, NW
Washington, D.C. 20548

Dear Mr. Walker:

The Senate Finance Committee (Committee) is extremely concerned about nursinghomes, emergency preparedness, and natural disasters in light of Hurricane Katrina. Yesterday,the Attorney General charged the owners of St. Rita's Nursing Home in St. Bernard Parish with34 counts of negligent homicide. Unfortunately, this shameful event does not appear to be anisolated occurrence.

With more than ninety elder care (i.e., nursing home, retirement community, continuingcare community or Alzheimer's Care) facilities within 50 miles of New Orleans, the full extent ofcriminality related to neglect and abuse is unknown. Likewise, the full extent of heroic efforts bynursing home staff and administrators is unknown, and certainly not receiving equal attention.

Nonetheless, attention must be given to what we know. There are reports that residents attwo other New Orleans nursing homes-eight residents at Bethany Home and approximately 20residents at Lafon Nursing Home-also died because they were not evacuated. In addition, thereare reports of patients that were euthanized to avoid a more gruesome death. Undoubtedly, thevast majority of nursing homes fulfilled their duty of care and for that I am grateful. However,every instance of abuse and neglect in a nursing home should be closely examined and the deathof any nursing home resident should be fully investigated. As chairman of the Committee, I haverequested that the Attorney General and the Inspector General conduct a thorough investigationof the deaths of nursing home residents in the Gulf Coast states, including but not limited to the34 deaths of residents at St. Rita's nursing home. (Attached)

In the midst of all this, according to several sources, the Veteran's Administration (VA)successfully evacuated its most critically ill residents, including patients dependent uponventilators.

In contrast, there are numerous media reports of elderly men and women in non-VA siteswho were left in beds and wheelchairs to fend for themselves. As the Gulf Coast mends itswounds, our Federal government must: 1) identify what went wrong and what went right; 2)define short-term and long-term solutions; and 3) implement the appropriate safeguards and bestpractices to prevent future tragedies.

As chairman of the Committee, I request that the Government Accountability Office(GAO) conduct a full review of the failures and successes of Gulf Coast nursing homes inHurricane Katrina. The GAO's review should focus on nursing homes, emergency preparedness,and natural disasters. For example, among other considerations, please evaluate how nursinghomes and other long-term care facilities (i.e., retirement community, continuing care communityor Alzheimer's Care) differed in responding to Hurricane Katrina, as well as other historicalnatural disasters. More specifically:

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 thatsituations like this are NEVER repeated again.

Sincerely,

Charles E. Grassley
Chairman