(The Center Square) − A push to loosen Louisiana’s long-running moratorium on new nursing home beds has run into a deeper problem than simple politics: lawmakers are hearing two completely different stories about whether the state actually needs more beds.
Rep. Stephanie Berault, R-Slidell, has decided not to move forward with her bill to replace the moratorium with a parish-by-parish formula for determining need. Instead, she secured an amendment to legislation by Rep. Dustin Miller, D-Opelousas, aimed at studying the issue more closely. Miller’s bill extends the moratorium four more years.
At the center of the debate is a contradiction Berault has heard from her constitutents. Hospital leaders in her area have told her patients are getting stuck because they cannot be discharged into appropriate nursing home placements, while nursing home operators insist they have open beds.
“There is still disagreement about need,” Berault told The Center Square, recounting stories from hospital administrators who said patients were lingering in hospital rooms and even emergency rooms because they could not be moved into a facility. Berault worries that rapid growth in places like St. Tammany Parish has outpaced a moratorium that has blocked new beds for decades.
Berault had pitched her bill as a “controlled” way to reopen licensing, not a wholesale end to state oversight. Under her proposal, the Louisiana Department of Health would still have made the final determination of need. She said the current uncertainty may reflect more than a simple shortage or surplus: some nursing homes may be declining certain patients because of payer issues, while others may lack capacity for particular kinds of cases even if they technically have open beds.
But Miller, who wants to keep the moratorium in place, said lawmakers should not rush to expand institutional capacity while the state is trying to make it easier for seniors to receive care at home.
“When I was first elected 10 years ago, there was a big movement nationwide not to institutionalize people,” Miller told The Center Square. “There used to be a long wait list if individuals would choose care at home and so they would never get qualified, so they would be forced to nursing homes.”
He said Louisiana has reduced those wait times enough that more people can now choose home-based care, undercutting the argument for more beds.
Miller warned that lifting the moratorium could produce the wrong kind of growth at the wrong time.
“We don’t want a million nursing home beds and none are needed,” Miller told The Center Square. “If we open the moratorium, we’ll have more nursing homes opening, current homes expanding and getting bigger, costing us more money. There’s already a nursing shortage. I would rather someone have the option to stay home.”
Sen. Gerald Boudreaux, D-Lafayette, echoed that caution, saying any growth needs to go through an evaluation process and that state officials should rely on occupancy and sustainability data before allowing new licenses.
“It’s $25 million to get one of those up and running,” Boudreaux told The Center Square. “Before another license is awarded, we gotta make sure it is sustainable.”
He said he is comfortable leaving the moratorium in place while the Health Department continues gathering information on actual need.
Committee hearings suggest that there is some disagreement among lawmakers about the need for continuing the moratorium and for how long. Berault at one point offered an amendment to exempt St. Tammany Parish from the moratorium, arguing the area’s population has surged while nursing home capacity has not kept up. It was rejected.
Rep. Raymond Crews, R-Bossier City, offered another amendment to bring the extension from four years to three years. It was also rejected.
Rep. Peter Egan, R-Covington, motioned for the bill to be deferred. It was also rejected. In the end, the moratorium extension passed the Health and Welfare Committee unanimously, 11-0.
Opponents of the moratorium, including Americans for Prosperity and the Pelican Institute, say Louisiana is using government restrictions to choke off supply even as the state’s senior population grows. Laurie Adams of the Pelican Institute urged lawmakers to reject the extension, arguing the moratorium “restricts supply, prevents new providers, blocks addition of new beds even where demand is growing” and substitutes government control for competition. She said the policy creates scarcity, reduces choice and has failed to improve quality.
