Part 1 Nursing Homes: Inside Louisiana system that values profits over patients

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Louisiana going wrong direction, spending more on nursing homes as rest of nation funds alternatives to institutionalization

State nursing homes frequently ranked 50th in the nation

Nursing homes have seen millions in increased funding, as hospitals, higher education, prisons see budgets slashed

30 percent fewer home and community based providers than 2012 because of budget cuts and tighter restrictions

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Louisiana's failure to properly support home- and community-based programs is unusual. It also puts the state at risk of violating federal laws that protect the civil rights of the state's most vulnerable people.

Virtually every other state has been investing an increasing share of taxpayer dollars into home- and community-based health care. Such programs are widely preferred by people who want to live independently — 90 percent of respondents in an AARP survey of Louisiana's voters — and most states have embraced them because they also are much less expensive than nursing homes.

Nationally, "there has been a shift away from institutional spending and institutional participation toward home- and community-based service spending and participation," said Steve Kay, a professor at the University of California, San Francisco's Institute for Health and Aging. "Louisiana is very much an outlier."

The root of the problem is a long list of financial policies and laws in Louisiana that heavily favor nursing homes. These special protections, many of them unique to Louisiana, are a testament to the strength of the state’s nursing home lobby, long a leading source of campaign cash for the state’s politicians.

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The funding increases for nursing homes are all the more eye-popping in the context of Louisiana's budget, which has seen year after year of cuts. Over the past eight years, state lawmakers increased funding for nursing homes by $245 million, even as they slashed aid to Louisiana’s universities by $542 million, cut the Taylor Opportunity Program for Students scholarships by $90 million and pared back spending on state prisons by $77 million.

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