La. Public Health and Safety § 40:2009.25

Current with operative changes from the 2024 Third Special Legislative Session

Section 40:2009.25 - Emergency preparedness plans for nursing homes; requirements; Nursing Home Emergency Preparedness Review Committee; rules and regulations

A. As used in this Section, the following terms have the meaning ascribed to them in this Subsection:

(1) "Department" means the Louisiana Department of Health.

(2) "Local office of emergency preparedness" means a parish office of homeland security and emergency preparedness established pursuant to R.S. 29:727.

(3) "Nursing home" means a nursing home or nursing facility as defined in R.S. 40:2009.2 which is licensed by the Louisiana Department of Health in accordance with the requirements of R.S. 40:2009.3.

B. Each nursing home shall continue to utilize its emergency preparedness plan that was in effect on March 1, 2022, until the process provided for in Subsection C or D of this Section, whichever is applicable, has been completed. However, during this period, if a nursing home updates or amends its emergency preparedness plan pursuant to nursing home licensing rules in effect at the time, then the nursing home shall utilize the updated emergency preparedness plan until the process provided for in Subsection C or D of this Section, whichever is applicable, has been completed.

(1) The provisions of this Subsection shall apply to each nursing home located in the parishes of Acadia, Ascension, Assumption, Calcasieu, Cameron, Iberia, Jefferson, Jefferson Davis, Lafayette, Lafourche, Orleans, Plaquemines, St. Bernard, St. Charles, St. James, St. John the Baptist, St. Martin, St. Mary, St. Tammany, Tangipahoa, Terrebonne, and Vermilion.

(2) Each nursing home located in a parish listed in Paragraph (1) of this Subsection shall develop an emergency preparedness plan that comports with the requirements of this Subsection. Each such plan shall include and identify, at a minimum, all of the following:

(a) A primary evacuation site and a secondary evacuation site, verified by one or more contracts or other written agreements, as well as any other alternative evacuation sites that the nursing home may have.

(b) Proof of transportation or a contract with a transportation company, verified by a written transportation agreement or contract.

(c) Staffing patterns for evacuation, including contact information for facility staff.

(d) Detailed provisions which address supply of emergency electrical power in instances when primary electrical power in the nursing home is lost but evacuation from the nursing home is not required.

(e) Any data, other information, documentation, or other content required by administrative rules of the department.

(3) Each nursing home located in a parish listed in Paragraph (1) of this Subsection shall submit a copy of its full, updated emergency preparedness plan to the department in electronic format. The emergency preparedness plan shall be signed by the nursing home's owner or owners, or any designee of such parties, and its administrator.

(4)

(a) The department shall conduct a review of each nursing home emergency preparedness plan submitted to it in accordance with Paragraph (3) of this Subsection.

(b) The departmental review required by this Paragraph shall include transmittal of each nursing home emergency preparedness plan to all of the following entities for review by those entities:

(i) The office of state fire marshal.

(ii) The Governor's Office of Homeland Security and Emergency Preparedness.

(iii) The Department of Transportation and Development.

(iv) The Louisiana Emergency Response Network.

(v) The local office of emergency preparedness of the parish in which the nursing home is located.

(vi) The local office of emergency preparedness of any parish in which an evacuation site, including any unlicensed sheltering site, as identified in the nursing home's emergency preparedness plan is located.

(c) The departmental review required by this Paragraph may include transmittal to any other local, parish, regional, or other state agencies or entities for consultation as the department deems appropriate. Each such agency or entity shall cooperate and contribute to the department's review and approval process.

(5) Each entity listed in Subparagraph (4)(b) of this Subsection shall review each nursing home emergency preparedness plan submitted to it and shall submit one of the following documents to the department within ninety days of receipt of the emergency preparedness plan from the department:

(a) A letter of preliminary approval of the nursing home's emergency preparedness plan.

(b) A letter detailing what changes, amendments, or revisions to the emergency preparedness plan are necessary.

(6) Any entity listed in Subparagraph (4)(b) of this Subsection that does not respond to the department concerning a nursing home emergency preparedness plan within ninety days of receipt of the plan shall be deemed to have granted preliminary approval to the plan.

(7) After review of a nursing home emergency preparedness plan and results of the review of the plan by the entities listed in Subparagraph (4)(b) of this Subsection, the department shall either approve the emergency preparedness plan or require changes, amendments, or other revisions to the emergency preparedness plan. The department shall notify the nursing home that submitted the plan in electronic format of the department's decision.

(8) Within fifteen days of receipt by the nursing home of an electronic notification from the department that requires changes, amendments, or revisions to the nursing home's emergency preparedness plan, the nursing home shall update and revise its emergency preparedness plan to incorporate the required changes, amendments, or revisions, and shall return a copy of the updated and revised emergency preparedness plan to the department.

(9) Upon receipt of a nursing home's updated and revised emergency preparedness plan, the department shall confirm that all required changes, amendments, or revisions have been incorporated into the updated and revised emergency preparedness plan and shall approve the emergency preparedness plan and issue an approval letter to the nursing home. If the required changes, amendments, or revisions have not been incorporated, the department shall reject the emergency preparedness plan and issue a letter of rejection to the nursing home. The department may revoke or deny renewal of a license to a nursing home that has received a letter of rejection of its emergency preparedness plan.

(10) Each nursing home shall transmit a copy of its final, approved emergency preparedness plan and a copy of the approval letter from the department to the office of state fire marshal and the applicable local office or office of emergency preparedness. The nursing home shall submit the final, approved emergency preparedness plan in electronic format, if available, to the recipients listed in this Paragraph. If the nursing home received a letter of rejection from the department, the nursing home shall transmit a copy of that letter to the office of state fire marshal and the applicable local office or office of emergency preparedness.

(11) The review and approval of nursing home emergency preparedness plans by the department and each entity listed in Subparagraph (4)(b) of this Subsection shall be performed pursuant to the department's and those entities' respective areas of knowledge, expertise, or jurisdiction.

(1) The provisions of this Subsection shall apply to each nursing home located in the parishes of Allen, Avoyelles, Beauregard, Bienville, Bossier, Caddo, Caldwell, Catahoula, Claiborne, Concordia, DeSoto, East Baton Rouge, East Carroll, East Feliciana, Evangeline, Franklin, Grant, Iberville, Jackson, LaSalle, Lincoln, Livingston, Madison, Morehouse, Natchitoches, Ouachita, Pointe Coupee, Rapides, Red River, Richland, Sabine, St. Helena, St. Landry, Tensas, Union, Vernon, Washington, Webster, West Baton Rouge, West Carroll, West Feliciana, and Winn.

(b) Proof of transportation or a contract with a transportation company, verified by a written transportation agreement or contract.

(c) Staffing patterns for evacuation, including contact information for facility staff.

(e) Any data, other information, documentation, or other content required by administrative rules of the department.

(4)

(a) The department shall conduct a review of each nursing home emergency preparedness plan submitted to it in accordance with Paragraph (3) of this Subsection.

(b) The departmental review required by this Paragraph shall include transmittal of each nursing home emergency preparedness plan to all of the following entities for review by those entities:

(i) The office of state fire marshal.

(ii) The Governor's Office of Homeland Security and Emergency Preparedness.

(iii) The Department of Transportation and Development.

(iv) The Louisiana Emergency Response Network.

(v) The local office of emergency preparedness of the parish in which the nursing home is located.

(a) A letter of preliminary approval of the nursing home's emergency preparedness plan.

(b) A letter detailing what changes, amendments, or revisions to the emergency preparedness plan are necessary.

(1)

(a) On or before October 31, 2023, and annually thereafter, each nursing home located in a parish listed in Paragraph (C)(1) of this Section shall review its emergency preparedness plan. In conducting the review required by this Subparagraph, a nursing home shall consider any changes in state licensing rules and regulations and any changes in federal rules and regulations for nursing homes adopted since the date of its last review of its emergency preparedness plan.

(b) On or before October 31, 2024, and annually thereafter, each nursing home located in a parish listed in Paragraph (D)(1) of this Section shall review its emergency preparedness plan. In conducting the review required by this Subparagraph, a nursing home shall consider any changes in state licensing rules and regulations and any changes in federal rules and regulations for nursing homes adopted since the date of its last review of its emergency preparedness plan.

(2) If a nursing home conducts a review in accordance with Paragraph (1) of this Subsection and determines that no changes, modifications, or amendments to its emergency preparedness plan are necessary, then the nursing home shall notify all of the following entities of this determination on or before November first:

(a) The local office of emergency preparedness of the parish in which the nursing home is located.

(b) The local office of emergency preparedness of any parish in which a sheltering site, alternative sheltering site, or evacuation site, as identified in the nursing home's emergency preparedness plan, is located.

(c) The office of state fire marshal.

(d) The department.

(3)

(a) Each notification required by Paragraph (2) of this Subsection shall be in the form of a written attestation signed by the owner or owners, or any designee of such parties, and the administrator of the nursing home submitting the notification. A nursing home may submit an attestation provided for in this Paragraph for no more than four consecutive years.

(b) If a nursing home has submitted an attestation provided for in Subparagraph (a) of this Paragraph for four consecutive years, then, in the year following its last submission, the nursing home shall furnish a full emergency preparedness plan in accordance with the procedures provided in Paragraphs (4) through (12) of this Subsection.

(4)

(a) If a nursing home conducts a review in accordance with Paragraph (1) of this Subsection and determines that any changes, modifications, or amendments to its emergency preparedness plan are necessary, or if a nursing home is required by Subparagraph (3)(b) of this Subsection to furnish a full emergency preparedness plan, then the nursing home shall submit its full emergency preparedness plan, inclusive of any updates and revisions, to the department on or before November first. The full emergency preparedness plan shall be signed by the nursing home's owner or owners, or any designee of such parties, and its administrator.

(b) Each emergency preparedness plan shall include and identify, at a minimum, the following:

(i) A primary evacuation site and a secondary evacuation site, verified by one or more contracts or other written agreements, as well as any other alternative evacuation sites that the nursing home may have.

(ii) Proof of transportation or a contract with a transportation company, verified by written transportation agreement or contract.

(iii) Staffing patterns for evacuation, including contact information for facility staff.

(iv) Detailed provisions which address supply of emergency electrical power in instances when primary electrical power in the nursing home is lost but evacuation from the nursing home is not required.

(v) Any data, other information, documentation, or other content required by administrative rules of the department.

(5) The department shall conduct a review of each nursing home emergency preparedness plan submitted to it in accordance with Subparagraph (4)(a) of this Subsection.

(a) The departmental review required by this Paragraph shall include transmittal of each nursing home emergency preparedness plan to all of the following entities for review by those entities:

(i) The office of state fire marshal.

(ii) The Governor's Office of Homeland Security and Emergency Preparedness.

(iii) The Department of Transportation and Development.

(iv) The Louisiana Emergency Response Network.

(v) The local office of emergency preparedness of the parish in which the nursing home is located.

(b) The departmental review required by this Paragraph may include transmittal to any other local, parish, regional, or other state agencies or entities for consultation as the department deems appropriate. Each such agency or entity shall cooperate and contribute to the department's review and approval process.

(6) Each entity listed in Subparagraph (5)(b) of this Subsection shall review each nursing home emergency preparedness plan submitted to it and shall submit one of the following documents to the department within ninety days of receipt of the emergency preparedness plan from the department:

(a) A letter of preliminary approval of the nursing home's emergency preparedness plan.

(b) A letter detailing what changes, amendments, or revisions to the emergency preparedness plan are necessary.

(7) Any entity listed in Subparagraph (5)(b) of this Subsection that does not respond to the department concerning a nursing home emergency preparedness plan within ninety days of receipt of the plan shall be deemed to have granted preliminary approval to the plan.

(8) After review of a nursing home emergency preparedness plan and results of the review of the plan by the entities listed in Subparagraph (5)(b) of this Subsection, the department shall either approve the emergency preparedness plan or require changes, amendments, or other revisions to the emergency preparedness plan. On or before March first, the department shall notify the nursing home that submitted the plan in electronic format of the department's decision.

(9) Within fifteen days of receipt by the nursing home of an electronic notification from the department that requires changes, amendments, or revisions to the nursing home's emergency preparedness plan, the nursing home shall update and revise its emergency preparedness plan to incorporate the required changes, amendments, or revisions, and shall return a copy of the updated and revised emergency preparedness plan to the department.

(10) Upon receipt of a nursing home's updated and revised emergency preparedness plan, the department shall confirm that all required changes, amendments, or revisions have been incorporated into the updated and revised emergency preparedness plan and shall approve the emergency preparedness plan and issue an approval letter to the nursing home. If the required changes, amendments, or revisions have not been incorporated, the department shall reject the emergency preparedness plan and issue a letter of rejection to the nursing home. The department shall issue the approval letter or rejection letter required by this Paragraph on or before May fifteenth. The department may revoke or deny renewal of a license to a nursing home that has received a letter of rejection of its emergency preparedness plan.

(11) On or before May thirty-first, each nursing home shall transmit a copy of its final, approved emergency preparedness plan and a copy of the approval letter from the department to the office of state fire marshal and the applicable local office or office of emergency preparedness. The nursing home shall submit the final, approved emergency preparedness plan in electronic format, if available, to the recipients listed in this Paragraph. If the nursing home received a letter of rejection from the department, the nursing home shall transmit a copy of that letter to the office of state fire marshal and the applicable local office or office of emergency preparedness on or before May thirty-first.

(12) The review and approval of nursing home emergency preparedness plans by the department and each entity listed in Subparagraph (5)(b) of this Subsection shall be performed pursuant to the department's and those entities' respective areas of knowledge, expertise, or jurisdiction.

F. With respect to emergency preparedness among nursing homes, the department shall do all of the following:

(1) After considering any recommendations provided by the Nursing Home Emergency Preparedness Review Committee, prescribe and publish, in accordance with the Administrative Procedure Act, rules pertaining to emergency preparedness by nursing homes. The rules shall include but not be limited to all of the following:

(a) Requirements for nursing homes relating to emergency preparedness.

(b) Requirements for the content of nursing home emergency preparedness plans.

(c) Requirements for the process by which the department reviews nursing home emergency preparedness plans.

(d) Procedures for addressing situations wherein a nursing home makes changes to its emergency preparedness plan on a schedule which deviates from that provided in Subsection E of this Section.

(e) Minimum requirements for nursing homes which serve as evacuation sites for other nursing homes.

(f) Minimum requirements for nonlicensed sheltering sites identified in nursing home emergency preparedness plans.

(g) Any rule recommended or proposed by the Nursing Home Emergency Preparedness Review Committee and approved by the secretary of the department.

(2) Review and approve nursing home emergency preparedness plans in accordance with its duly adopted rules and the applicable requirements of this Section.

(3) Prepare findings based upon its review of nursing home emergency preparedness plans, including any summaries of after-action reports as the secretary of the department deems appropriate, to present to the Nursing Home Emergency Preparedness Review Committee.

(1) The legislature hereby creates within the department the Nursing Home Emergency Preparedness Review Committee, referred to hereafter in this Subsection as the "committee." The committee shall be composed as provided in Paragraph (2) of this Subsection and shall convene at least annually. The purposes and duties of the committee shall include reviewing the findings of the department with respect to nursing home emergency preparedness plans submitted to the department in accordance with the requirements of this Section. From its review of such findings and summaries of after-action reports, the committee shall develop and provide to the department recommendations for licensing regulations which address risks and threats; manpower issues for loading, transporting, and unloading residents; evacuation site locations; and evacuation site staffing in order to promote the health, safety, and welfare of nursing home residents.

(2) The committee shall be composed of the following members, all of whom shall serve on the committee without compensation:

(a) The secretary of the department or his designee.

(b) The undersecretary of the department or his designee.

(c) The state health officer or his designee.

(d) The emergency preparedness manager of the health standards section of the department, who shall serve as the chairperson of the committee.

(e) Five members appointed by the secretary of the department who are directors or managers of parish or municipal offices of emergency preparedness.

(f) The secretary of the Department of Transportation and Development or his designee.

(g) The executive director of the Louisiana Nursing Home Association.

(h) The chairperson of the emergency preparedness committee of the Louisiana Nursing Home Association.

(i) The executive director of LeadingAge Gulf States.

(j) Six members appointed by the secretary of the department who are owners or administrators of nursing homes. The secretary shall select such members in a manner that provides for geographic diversity among the facilities represented by this member cohort.

(k) The long-term care ombudsman of the governor's office of elderly affairs or his designee.

(l) The executive director of Disability Rights Louisiana or his designee.

(m) The director of the Governor's Office of Homeland Security and Emergency Preparedness or his designee.

(n) The director of the Louisiana Medicaid program of the department or his designee.

(o) The assistant secretary of the office of aging and adult services of the department or his designee.

(3) Any rule recommended or proposed by the committee shall be subject to review by and approval of the secretary of the department. If approved by the secretary, the department shall promulgate the rule in accordance with the Administrative Procedure Act.

(1) Each nursing home's emergency preparedness plan shall identify at a minimum a primary evacuation site location and a secondary evacuation site location for emergencies or disasters. Such evacuation site locations may include the premises of other licensed nursing homes, nonlicensed sheltering sites, or both.

(2)

(a) The local office of emergency preparedness of the parish in which a nonlicensed sheltering site is located shall inspect the site prior to October 15, 2022, and annually thereafter. The office shall inspect any new nonlicensed sheltering site identified after May 31, 2023, in a nursing home emergency preparedness plan within thirty days of receiving the plan and annually thereafter. The office may inspect the nonlicensed sheltering site at such other times as the director of the office deems necessary or appropriate.

(b) On an annual basis, and whenever requested by the secretary of the department, the office of state fire marshal shall inspect each nonlicensed sheltering site identified in a nursing home emergency preparedness plan to determine the suitability and capacity of the site. The office of state fire marshal may inspect the nonlicensed sheltering site at other times as it deems necessary or appropriate.

(c) On an annual basis, the department shall inspect and survey nonlicensed sheltering sites identified in nursing home emergency preparedness plans. The purpose of such inspections and surveys shall be to determine the appropriateness and suitability of the site and whether it can comply with requirements for nursing home evacuations before, during, and after an evacuation. Any refusal by a nonlicensed sheltering site to allow an inspection or survey of the site by the department may result in disqualification of the nonlicensed sheltering site. If such a refusal to allow an inspection or survey occurs when nursing home residents are being sheltered at the site, the department may revoke the license of the nursing home that evacuated residents to the site.

(d) Any nursing home that decides to evacuate residents to a nonlicensed sheltering site shall notify the department of this decision within one hour of the decision being made. Upon receipt of such notification, the department's licensing section and the office of public health shall conduct a site visit at the nonlicensed sheltering site unless time, weather conditions, or other factors do not allow for such visit. The department may conduct onsite inspections of the nonlicensed shelter site at any time deemed necessary or appropriate by the secretary of the department. Such authority of the department shall be in addition to its authority to conduct onsite surveys of the licensed nursing home, regardless of location.

(e) If any nonlicensed sheltering site is located outside of Louisiana, the office of state fire marshal and the department shall coordinate with their state agency counterparts in the state in which the site is located for inspection, review, approval, and surveys of the site.

(1) Neither the state, the department, the Department of Transportation and Development, the office of state fire marshal, nor the Governor's Office of Homeland Security and Emergency Preparedness nor, except in the case of willful misconduct, any employee or representative of such entities and offices, engaged in the emergency preparedness activities and responsibilities as established in this Section or in the rules and regulations promulgated pursuant to the provisions of this Section, shall be liable for the death of or any injury to persons or damage to property as a result of such activity. The state and all departments, employees, and representatives thereof shall be immune from any claim based upon the exercise or performance of, or the failure to exercise or perform, the duties as established in this Section or in the rules and regulations promulgated pursuant to the provisions of this Section.

(2) Except in the case of willful misconduct, no member of the Nursing Home Emergency Preparedness Review Committee engaged in the emergency preparedness activities and responsibilities as established in this Section or in the rules and regulations promulgated pursuant to the provisions of this Section shall be liable for the death of or any injury to persons or damage to property as a result of such activity. The members of the Nursing Home Emergency Preparedness Review Committee shall be immune from any claim based upon the exercise or performance of, or the failure to exercise or perform, the duties as established in this Section or in the rules and regulations promulgated pursuant to the provisions of this Section.

(3) Neither the local office of emergency preparedness, nor, except in the case of willful misconduct, any employee or representative of the local office of emergency preparedness, engaged in the emergency preparedness activities and responsibilities as established in this Section, or in the rules and regulations promulgated pursuant to the provisions of this Section, shall be liable for the death of or any injury to persons or damage to property as a result of such activity. The local office of emergency preparedness and its employees and representatives shall be immune from any claim based on the exercise or performance of, or the failure to exercise or perform, the duties as established in this Section or in the rules and regulations promulgated pursuant to the provisions of this Section.

(4)

(a) For purposes of this Paragraph, "LERN" means the Louisiana Emergency Response Network established and provided for in Chapter 34 of this Title.

(b) Neither LERN nor the LERN board, nor, except in the case of willful misconduct, any board member, employee, or representative of LERN or the LERN board, engaged in the emergency preparedness activities and responsibilities as established in this Section or in the rules and regulations promulgated pursuant to the provisions of this Section, shall be liable for the death of or any injury to persons or damage to property as a result of such activity. LERN, the LERN board, and the employees and representatives of LERN and the LERN board shall be immune from any claim based on the exercise or performance of, or the failure to exercise or perform, the duties as established in this Section or in the rules and regulations promulgated pursuant to the provisions of this Section.

(1) Nothing in this Section shall be construed to prohibit the department from taking action against a nursing home for a deficiency cited during an emergency or disaster.

(2) Implementation and execution of an emergency preparedness plan shall be the duty and responsibility of the nursing home.

K. The provisions of this Section shall be in addition to all other licensing and certification laws, standards, rules, and regulations for nursing homes.

La. Public Health and Safety § 40:2009.25

Acts 2006, No. 540, §2, eff. June 22, 2006; Acts 2014, No. 811, §22, eff. June 23, 2014; Acts 2022, No. 479, §1; Acts 2022, No. 522, §1, eff. June 16, 2022; Acts 2022, No. 597, §1, eff. June 18, 2022; Acts 2023, No. 3, §1.

Amended by Acts 2023, No. 3,s. 1, eff. 8/1/2023.

Amended by Acts 2022, No. 479,s. 1, eff. 8/1/2022.

Amended by Acts 2022, No. 597,s. 1, eff. 6/18/2022.

Amended by Acts 2022, No. 522,s. 1, eff. 6/16/2022.

Amended by Acts 2014, No. 811,s. 22, eff. 6/23/2014.

Acts 2006, No. 540, §2, eff. 6/22/2006.