Four nursing home residents died in Tangipahoa Parish at a mass shelter where about 800 residents were reportedly packed into a warehouse for Hurricane Ida. Efforts to evacuate them by ambulance and other vehicles are underway in Independence, Louisiana on Thursday, September 2, 2021. (Photo by Chris Granger | The Times-Picayune | The New Orleans Advocate) ORG XMIT: BAT2109021548340494
Arrested by: LA Attorney General
Charges: Eight counts of cruelty to the infirmed, five counts of medicaid fraud, and two counts of obstruction of justice - evidence tampering.
The warehouse owned by Bob Dean that was used to house nursing home residents during Hurricane Ida on Wednesday, June 22, 2022 in Independence, Louisiana.
Four nursing home residents died in Tangipahoa Parish at a mass shelter where about 800 residents were reportedly packed into a warehouse for Hurricane Ida. Efforts to evacuate them by ambulance and other vehicles are underway in Independence, Louisiana on Thursday, September 2, 2021. (Photo by Chris Granger | The Times-Picayune | The New Orleans Advocate) ORG XMIT: BAT2109021548340494
Hundreds of nursing home residents were growing sicker, and some were dying as they lay in a cramped, partially flooded warehouse after Hurricane Ida.
Bob Dean, the nursing home owner who ordered them all to be taken there from seven south Louisiana facilities, remained in another state, and he checked in by text with a top deputy on the evening of Aug. 30.
“How is everything going over there?” Dean asked Donise Boscareno, the director of operations for Louisiana Health Care Consultants, a management company that helped run the homes.
“It is not well. We can not do this,” came the desperate response from Boscareno. “People are dying. We need to send them somewhere they can be cared for medically.”
The warehouse owned by Bob Dean that was used to house nursing home residents during Hurricane Ida on Wednesday, June 22, 2022 in Independence, Louisiana.
But Dean brushed off her concerns, told her to “calm down” and said he’d get her the phone number for FEMA.
Dean wasn’t there to see that a few residents had already died, others were developing serious infections, trash was piling up and that the stench of urine and feces inside his warehouse was overpowering.
“I do not want any more patients to leave that building is a hospital open for 911 do they have power please let me know again I do not want anybody transferred to anywhere unless there’s a 911 life or death situation do you understand say yes or no,” Dean texted Boscareno on Aug. 31.
The texts are part of the evidence that Louisiana Attorney General Jeff Landry’s office used to secure a warrant for Dean’s arrest last week on eight counts of cruelty to the infirm, five counts of Medicaid fraud and two counts of obstruction of justice.
The 19-page arrest affidavit and warrant, obtained by The Times-Picayune | The Advocate, includes previously unknown details about the instructions Dean gave to staff during the Ida evacuation. They show that Dean repeatedly acknowledged he was ultimately responsible for taking care of his residents, but refused to give staff the help that they needed to take care of the 843 vulnerable people sheltering in his Tangipahoa warehouse.
The charges also include allegations that Dean billed taxpayers for a level of care that his patients never received at the warehouse.
Arrested by: LA Attorney General
Charges: Eight counts of cruelty to the infirmed, five counts of medicaid fraud, and two counts of obstruction of justice - evidence tampering.
Dean’s refusal to allow his staff to take residents elsewhere was driven by fear that he would lose the residents to other nursing homes, depriving him of a steady source of income, according to the affidavit.
But that decision had deadly consequences. The arrest affidavit describes in detail the suffering at least eight of his nursing home residents endured in the ill-fated evacuation.
Among them: a 54-year-old woman who was evacuated from West Jefferson Health Care Center and placed in a hospital bed without side rails at the warehouse.
She tumbled out of it and was sent to the hospital, where doctors diagnosed her with sepsis, a chin hematoma and blood clots in both legs. She died less than a month later.
Dozens of residents of Dean’s nursing homes died in the aftermath of the Ida evacuation. Coroners have ruled five of those deaths “storm-related.”
“Although Tangipahoa Parish was severely devastated by Hurricane Ida, Dean intentionally ignored his employees’ requests for assistance and the need to move the residents,” the affidavit reads. “Dean’s employees had to seek their own arrangements to start moving the residents” out of the warehouse.
The affidavit says special agents from the state’s Medicaid Fraud Control Unit and the Office of Inspector General visited the packed evacuation site after hearing about heat-related deaths. When they arrived, Boscareno told them five residents had already died since the evacuation began.
A couple days earlier, on Aug. 30, Dean had texted the administrator of his Houma nursing home asking for an update. Dean said he heard a resident “coded,” going into cardiac arrest.
“Yes sir been tough we have had multiple codes with death and the water situation on the floors last night,” responded the administrator, William Daigre. “We are able to feed and clean residents but it takes all of you team 18 to 20 hrs a day to do those task.”
Daigre told Dean the situation was “not sustainable.” But Dean did not appear alarmed.
“Under normal circumstances you have at least 4 to 5 deaths of a day DAY Do you realize it takes 125 admits a month to keep you guys going,” he responded. “No worries whoever that woman is is on the federal investigation by the FBI and the CIA blow it all.”
After the evacuation, Dean also instructed his employees to bill Medicaid for more than $29,000 in reimbursements of the services given to some nursing home residents at the warehouse. But Dean should have only billed Medicaid if his residents had received a basic level of services in return, which they did not, the Attorney General’s Office alleged.
“Not all patients received essential, adequate and basic care while at the evacuation site, yet the facilities billed and were reimbursed by Medicaid,” the affidavit says.
While Dean was seeking Medicaid reimbursements, his residents suffered. One was diabetic, but did not receive proper medication, have her blood sugar checked or receive diabetic meals. She spent her time at the warehouse sitting in her wheelchair and wound up with sepsis, gangrene on her left foot and required multiple blood transfusions. She was already missing a leg, and the other had to be amputated after the evacuation.
Dean’s attorney, John McLindon, said after his arrest that Dean’s actions during the evacuation did not rise to the level of a crime. After his arrest last week, Dean was released from the Tangipahoa Parish Prison on a $350,000 bail.
His lawyer also said Dean’s health — including his mental state — is likely to become a major factor in his criminal defense.
The case is one of several criminal and civil matters targeting Dean, who has been arrested twice in Georgia in the past few months. In March, he was booked after showing off a gun and shooting off his thumb. Police arrested Dean again June 8 when they attempted to detain him over a contempt charge. Dean fought back, trying to slam his car door shut while a police officer was reaching inside of it, according to the arrest documents. Police booked him on new obstruction counts.
Meanwhile, Dean is facing several lawsuits from former nursing home residents.
Dean’s attorneys have said in court filings that he has dementia. He recently started treatment at the Mayo Clinic in Minnesota, and medical records from there include a physician’s diagnosis that Dean has a major neurocognitive disorder, alterations of his brain function and personality changes. His lawyers said in court filings that Dean’s mental state has rendered him incapable of appearing in court.
“The only question is whether or not an elderly gentleman, who has no hands on involvement with any of these issues, who is in serious health conditions, needs to fly here, and whether or not there is an appropriate reason for him to be ordered to come here,” attorney H. Minor Pipes said during a May 19 hearing, according to the transcript.
Dean had dental surgery in June 2021, and his lawyers have sought to blame that for his medical problems. Dean and his wife have both said his behavioral changes — and memory issues — started after the surgery. But his oral surgeon testified in a deposition that dementia is not a potential side effect of the procedure, and that Dean’s dental surgery went as planned.
Staff Writer John Simerman contributed to this report.
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