Louisiana Voice

North Louisiana Medical Center in Ruston appears to be on life support following a devastating laundry list of deficiencies found during a five-day inspection tour of the center last month by an eight-person team from the Louisiana Department of Health.

The medical center, once the pride of north central Louisiana, was given until Wednesday (June 24) to submit a comprehensive plan of correction to the LDH Health Standards Section or face the prospect of losing its Medicare status and possibly even its hospital’s license and/or certification.

Among the findings included in the 87-page report by LDH:

• Staffing logs for the third-floor Progressive Care Unit revealed eight shifts where no RN was scheduled to work.
• Failure to ensure adequate numbers of RNs, LPNs, and support staff to provide nursing care to all patients.
• Failure to ensure a registered nurse was immediately available on each unit of the hospital at all times.
• Unsanitary conditions in the hospital kitchen, insects in the windows of some ICU rooms.
• Patient call bells that reportedly hadn’t worked for several months.
• Patients going unmonitored
• Dried red or brown residue and spatters on furniture and bedframes
• Clean and dirty equipment stored together because the hospital was out of tags to mark clean items.
• An emergency room patient who apparently slipped through the procedural cracks and suffered a medical emergency unsupervised because the LPN apparently assigned to the patient didn’t know anything about the patient or having been given her care.
• No specific policy regarding assessment or reassessment of patients in the emergency department
• Eight patients on telemetry monitoring, but only five who were actually being monitored. (Leads were off the other three.) 
• Failure to ensure that patients received care in a safe setting.

Federal Medicare Requirements for hospitals participating in Medicare require:  

• An adequate number of registered nurses, licensed practical nurses, and other personnel to meet patient needs.
• A registered nurse must supervise and evaluate nursing care.
• An RN must be immediately available for patient care needs.
• Staffing must be based on patient acuity and census.

Louisiana licensing rules similarly require hospitals to:

• Maintain sufficient nursing personnel at all times
• Provide qualified staff appropriate to patient needs.
• Ensure nursing services are organized and supervised by qualified nursing leadership.

To be assigned to ER, ICU or Labor and Delivery, one is required to be an RN.

Alluding to the ER patient who “slipped through the cracks,” one observer, a healthcare professional, said the surveyors would have likely asked a number of followup questions:

• Who assigned the patient?
• Why wasn’t the patient entered into the system?
• Why was there no documented RN triage assessment?
• Who was responsible for monitoring the patient?
• Why wasn’t the assigned nurse aware of the patient?
• What polity existed for reassessment of ER patients
• Was there adequate staffing that day?

“It seems that Bordelon would rather hire an LPN [and] pay a lower hourly rate of pay compared to that of an RN. It looks as though the LPNs at NLMC are practicing outside THEIR SCOPE OF NURSING,” the observer said.

It is particularly noteworthy that the LDH report cited the “governing body.” When surveyors cite governance failures, they essentially are saying that oversight failures occurred at the highest, or administrative, levels. At NLMC, those would be the CEO and CNO.

NLMC must submit a plan that is “specific, realistic,” detailing how the deficient practice[s] will be prevented from recurring, according to Interim Deputy Assistant Secretary of LDH’s Health Standards Section Cecile Castello.

The plan will be reviewed by the Health Standards Section which will then conduct an unannounced site visit to determine compliance. If found still out of compliance, a recommendation will be made to the federal Centers for Medicare and Medicaid Services that NLMC’s Medicare provider agreement be terminated effective Aug. 30.

That would mean a virtual death sentence for NLMC in that it would no longer be able to treat Medicare patients and could not receive Medicare reimbursement for eligible services.

NLMC is part of a widespread network of medical facilities headquartered in Bossier City and run by Allegiance Health Management. Most are in Louisiana.

The IRS has filed federal tax liens against NLMC for not paying about $9.4 million in payroll taxes. Vendors also have gone unpaid and the hospital currently has an occupancy rate of only about 25 percent with staff reportedly at a number insufficient to care for that many

IRS tax liens were filed against a number of other of the facilities run by Allegiance and its owner, Rock Bordelon, who claims the liens have since been settled.

Monica Adams was recently named to replace Kathy Hall as Chief Executive Officer (CEO). Also named to the hospital’s administrative positions were Jennifer Patton as Chief Nursing Officer (CNO) and Arnie Young, Chief Operating Officer (COO).

Left to right: Jennifer Patton, Monica Adams, Arnie Young.

Adams has run several facilities for Bordelon, most recently as CEO of Winn Medical Center in Winnfield. Winn Medical is another of Allegiance-affiliated entities.

The timing of the administrative shakeup at NLMC is especially interesting. The LDH team conducted its survey in late May. The new executive team at NLMC was publicly announced on June 8 and LDH released its findings on June 19.

Adams, as might be expected anytime there is a crisis of any kind, be it airline safety, worker safety issues or medical care, invoked the time-honored “HP clause,” in something of a 3-for-1 catch-all assurance, saying, “Patient safety, quality care and regulatory compliance remain our highest priorities.”

Though the future of NLMC is up in the air for the moment, it’s not like Rock Bordelon doesn’t have friends in high places. He does.

He hunts with Donald Trump, Jr., he’s generous with his campaign contributions, almost exclusively to Republican candidates, and in giving rides to key government officials.

He and his company, Allegiance Health, has given more than $380,000 in campaign money to Republican candidates, including more than $35,000 to Jeff Landry and his political action committee, Cajun PAC II.

In 2024, he provided FREE AIR TRANSPORTATION to and from Washington, D.C. for key state health care officials, including then-Surgeon General Ralph Abraham, Health Secretary Michael Harrington, Deputy Health Secretary Peter Croughan, Health Undersecretary Drew Maranto and health department general counsel Nicholas Gachassin (who should have known better).

The officials were in the Washington area for discussions with officials with the U.S. Centers for Medicaid and Medicare Services, the federal agency which has considerable sway over how much hospitals, doctors and other health care providers receive in payments for providing treatment of Medicaid patients.

Only a couple of weeks before that trip, Landry unilaterally INCREASED MEDICAID PAYMENTS by $22 million to seven hospitals, four of which are owned by Bordelon. The action came less than a month after the state health department said it might be forced to cut services for children and those with disabilities because of an impending budget deficit.

Landry’s decision to increase payments and the comped flights for state officials came six years after Allegiance agreed to PAY $1.7 MILLION to the federal government to avoid litigation alleging it had overcharged Medicare for unnecessary outpatient therapy services.