An Update on Nursing Homes in Terrebonne Parish | October 7, 2021

10/07/2021 07:47 AM

As a result of the landfall and projected path of Hurricane Ida, the nursing homes located in Terrebonne Parish evacuated pursuant to their emergency preparedness plans. The nursing homes that evacuated included Chateau Terrebonne Health Care, Heritage Manor of Houma, and The Oaks of Houma. Recently, the representatives of the above referenced facilities have sought guidance/approval from the Louisiana Department of Health (LDH), Health Standards Section (HSS) in order to reopen their facilities in Terrebonne Parish.

According to applicable LDH rules found in the Louisiana Administrative Code, if there was not any damage to the licensed nursing home location due to  the emergency and there was no power outage of facility's HVAC (either through regular service or generator) of more than 48 hours, the nursing facility may reopen at its licensed location. The nursing home must inform HSS within 24 hours of reopening. Further, the nursing facility shall comply with the Office of Public Health (OPH) and the Office of the State Fire Marshall (OSFM) and have clearance from the local Office of Emergency Preparedness (OEP). If the nursing facility does not fit the criteria mentioned above, the nursing facility is required to submit a written request to reopen to HSS. This request must include a damage report, the extent/duration of any power outages, the reentry census, staffing availability, access to emergency or hospital services, and availability and/or access to food, water, medications, and supplies.

After review of the request, LDH may approve the reopening without a survey, may require surveys from entities such as OPH, OSFM, or HSS, or may deny the reopening. If any of the above surveys are conducted, their purpose is to assure that the facility is in compliance with the licensing standards including, but not limited to, the structural soundness of the building, the sanitation code, staffing requirements, and the execution of emergency plans. Finally, it is incumbent upon the HSS, in coordination with the State and Parish OHSEP, to determine the facility's access to the community service infrastructure, such as hospitals, transportation, physicians, professional services, and necessary supplies.

As you may be aware, Terrebonne Parish, as well as the whole of Southeast Louisiana, suffered significant damage due to Hurricane Ida. Therefore, in order to help assure that the health, safety, and welfare of nursing home residents are protected as much as possible prior to reopening nursing homes in Terrebonne Parish, the LDH conducted an examination of the community infrastructure in coordination with the Parish of Terrebonne. This examination  began with a meeting that included, but was not limited to, officials from Terrebonne Parish, Hospital Providers in Terrebonne Parish, LDH personnel, including HSS and the State Health Officer, Acadian Ambulance, State OEP, and regional medical personnel. In addition, LDH received correspondence, dated September 28, 2021, from the Parish of Terrebonne outlining the non-medical infrastructure that was available to the applicable nursing homes of Terrebonne Parish. Finally, LDH made inquiries to other nearby hospitals, mainly Thibodaux Regional Medical Center (TRMC), to determine their ability and willingness to serve residents of any reopened nursing facilities should the need arise. These inquiries included questions into the inpatient capacity and services provided at TRMC, the capacity of the emergency department, including prior diversion and possible future diversion, staffing, and the ability to  provide critical care to a geriatric population.

As a result of this investigation, and via collaboration with the Parish of Terrebonne and other relevant entities, LDH has developed the attached fact sheet which details the existing infrastructure status in Terrebonne Parish. The purpose of this fact sheet is to provide full disclosure of current conditions to the nursing home owners, the nursing home administrators, and, in particular, the residents. The nursing home residents or their authorized representatives, as well as their family members, should utilize this fact sheet in order to make an informed decision as to whether to return to Terrebonne Parish with their former nursing home or to utilize their freedom of choice to decide against repatriation to Terrebonne Parish at this time.

Thus, before returning residents to the applicable Terrebonne Parish locations, it is incumbent upon each respective nursing home to ensure that each prospective resident has been provided a copy of the attached fact sheet and has made an informed freedom of choice decision to return to Terrebonne Parish. The nursing home must keep documentation in the resident's record that fully substantiates compliance with this process. To be clear, the nursing home resident, or their authorized representative, must clearly make a proactive decision on whether to return or not to the applicable nursing home reopening in Terrebonne Parish. In closing, all nursing homes must remember that they are responsible for the health, safety, and welfare of their respective residents at all times and they must ensure they receive any needed medical services.

TERREBONNE PARISH NURSING HOME REOPENING FACT SHEET

Electricity, Water, Gas, and Sewerage

In coordination with the Parish of Terrebonne, as of October 1, 2021, LDH can report the following:

Chateau Terrebonne Health Care

  • Electricity is available and verifled by Entergy.
  • Natural gas is available and verified by Terrebonne Parish Utilities.
  • Water is available and verified by Consolidated Waterworks District #1.
  • Sewerage is available and verified by Terrebonne Parish Pollution Control.

Heritage Manor of Houma

  • Electricity is available and verified by SLECA.
  • Natural gas is available and verified by Terrebonne Parish Utilities.
  • Water is available and verified by Consolidated Waterworks District # 1.
  • Sewerage is available and verified by Terrebonne Sewerage System.

The Oaks of Houma

  • Electricity is available and verified  by Terrebonne Parish Utilities.
  • Natural gas is available and verified by Terrebonne Parish Utilities.
  • Water is available and verified by Consolidated Waterworks District #1.
  • Sewerage is available and verified by Terrebonne Parish Pollution Control.

In general, the Parish of Terrebonne has reported and represented that access to water, electricity, sewerage, and gas is not an area of major concern and  that any mandatory evacuation has been lifted.

Medical (Hospital) Services

In regards to medical services available in Terrebonne Parish and nearby, LDH reports as follows:

Leonard J. Chabert Medical Center (Chabert)

Chabert has reported that they currently do not have any inpatient adult medical/surge capacity. Chabert has represented that they have a functioning emergency department, some outpatient services, diagnostic capability, and clinics. They have indicated that some of their physicians and nurses have been redeployed to other areas. Chabert has indicated that, pre-Ida, they were treating approximately 60-120 individuals in their emergency room on average daily and that they occasionally had to go to "divert" status.

Terrebonne General Health System (TGHS)

TGHS has reported that they currently do not have any inpatient care or capacity. TGHS has represented they have the ability to provide diagnostic services but not treatment. TGHS has represented that they currently do NOT have a fully functional emergency room.

Thibodaux Regional Medical Center (TRMC)

All 3 of the nursing facilities mentioned in the attached memorandum have indicated they have a transfer agreement with this hospital. Further, Acadian Ambulance has stated that unless a patient status indicated otherwise, this hospital would more than likely be the location they would bring any residents of nursing homes in Terrebonne Parish. Upon information and belief, TRMC is serving residents of a much larger service area than normal, including Terrebonne Parish. The hospital has a fully functional emergency department, but they have been on diversion status according to LDH information at various times. If an incident requiring an emergency department visit were to occur during one of these times of diversion, delivery time to another hospital may be extended. Upon questioning, TRMC did represent that they believe they have adequate medical supplies and capacity to treat a geriatric population and would not have signed a transfer agreement with the applicable nursing homes if indications were otherwise. In response to a direct inquiry regarding emergency room diversion, the hospital responded that they have had to go on divert since IDA for their ED multiple times until they could clear out the ED and decompress. Diversion included diversion for critical care a couple of times when the ICU was full and they had ICU patients being held in the ED. The hospital did represent that access and/or capacity could be an issue if they see a spike in Covid-19 cases requiring hospitalization.

St. Charles Parish Hospital (30-35 miles away)

Upon inquiry, this facility did indicate they would be willing to accept patients from these nursing facilities.

Ochsner/St. Mary (30-35 miles away)

 Upon inquiry, this facility indicated they would be willing to accept patients from these nursing facilities.

Assumption Community Hospital (30-35 miles away)

This facility indicated they could accept patients from these nursing facilities in Terrebonne Parish. They did ask for some advance notice so they could increase staffing to needed levels.

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