Exactly six months ago in this space I wrote that the trial of Sal and Mabel Mangano could turn out to be an excellent opportunity for them, and nursing homes in general, to shine. Dire circumstances often are the best proving ground for joyous turnarounds.

Blatantly borrowing from that jurisprudence pillar “Boston Legal,” I recalled how the television show staged a similar scenario. A physician was accused of “killing” patients in the aftermath of Hurricane Katrina. But because “up was down and down was up” in New Orleans at the time, the TV jury found the doctor not guilty.

The Manganos were found not guilty, and for much the same reason in the TV show. But I’m still not sure what they really won.
The trial clearly took a toll.
For the last two years, the Manganos have lived essentially in exile in Baton Rouge, far removed from the deadly plot that once was St. Rita’s nursing home. If you think their former neighbors are as thrilled with their ‘not guilty’ verdict as they are, you haven’t read the scathing reader comments on media Web sites.
The Manganos also still face more than 30 civil lawsuits. Remember that these are a lot harder to defend than criminal cases.
Yes, this was a case where the Manganos were not crucified but they also were not totally exonerated, despite jurors’ sympathy.
Due to sound lawyering, there were only five defense witnesses called, most of them technical experts. Nobody, except for one family member who also worked at St. Rita’s and an industry executive, put their hand on the Bible and staged an impassioned defense for the decision that cost 35 paying customers their lives.
No, this was the “everybody else messed up so don’t blame us” defense. Ultimately, it was a smart choice, but there was no chest thumping or joy afterward by the nursing home community.
The trial aired dirty laundry – including allegations of mega-salaries for the accused and operators’ self-serving statements in the face of adversity. And then there was the revelation that the Manganos’ pre-Katrina evacuation plan consisted of just a single nine-person van – one that would be leased from Sal Mangano.
Make no mistake, “not guilty” is a whole lot better than the alternative. But the outcome also indicates that nursing home operators need to do better than this. The next operator with a weak evacuation plan might not be able to rely on the nation’s worst natural disaster to get off the hook.

Reader Poll — “What is your reaction to the ‘not guilty’ verdict in the Manganos’ trial?”

“Hurrah for the Manganos and the jury that found in their favor! A sliver of justice in a screwed-up world!”
Claim Administrator, Jeffrey Christ, Britthaven Legal Department, Garner, NC

“As the DON of a nursing home that evacuated during Hurricane Rita, I am appalled that they are not being held responsible for the lives entrusted to them. I actually had one of the survivors from that facility in the group that I evacuated. He was traumatized beyond description.”
Director of Nursing, Brenda Kneisley, Bay Oaks Health Care, Texas City, TX (Former DON, Seabreeze Nursing & Rehabilitation, Texas City, TX)

“I think the whole situation was sad. I believe it should have been the federal government that was on trial instead of the nursing home. It would be difficult for anyone – except the government – to predict that a levee was unstable and could break. It is always sad that the nursing homes are always expected to perform miracles.”
Administrator, Vickie Judkins, Oak Creek Nursing and Rehab, Luling, TX

“I disagree with the ‘not guilty’ verdict in the case of the Manganos. Although I am extremely empathetic, I cannot condone the behavior, the actions and the excuses that resulted in the deaths of those elderly who were placed in their care. Owners and/or operators are responsible for those who cannot care for themselves. A proper disaster plan would have avoided the situation. Katrina didn’t hit unexpectedly. Government officials urged residents and businesses to evacuate and the nightly news cautioned of the Level 5 hurricane. It would have been prudent and proper for those patients to be moved to a safe facility prior to the hurricane.”
Owner/ Operator, Carol Gray, Generations Senior Living, Natrona Heights, PA

“I felt relief for them. It is difficult to understand the emotions and complications of having to make a decision of ‘evacuate or not’ until you live through it.”
Administrator, Barbara Howard, Queen City Nursing Center Inc., Meridian, MS

“In ’04 my staff evacuated, stayed with and cared for the residents of a 274-bed skilled nursing facility. Not one of my staff or myself would have abandoned any of our people. I have also lived in St. Bernard Parish. I cannot in any way understand this verdict.”
Administrator, Janet Keller, Bon Secours Maria Manor, St. Petersburg, FL

“From an ombudsman’s point of view, I would like to ask if the individual residents had any opportunity to say if they wanted to be evacuated? If we look at it from a residents’ rights aspect, the answer to that question would determine the guilt or innocence of the providers. In some ways the owners are not innocent because they made some poor decisions on behalf
of frail residents who were not allowed to make a decision about their own personal safety.”
Long Term Care Advocate Specialist, Dianne Croom, Cecil County, MD

“I really don’t think there was enough support from the state government
for the residents in this nursing home during (Hurricane) Katrina. I don’t think the owners of this home could have prevented these residents’ deaths. As a director of nursing that manages the daily lives of residents in a nursing home, the thoughts of trying to evacuate residents safely with their medications, their charts and all of
the necessary care items would be frightening even with ample notice.”
Director of Nurses, Debi Majo, Northwood Health Care Center, Marble Falls, TX

“Negligent behavior that caused the loss of lives of people entrusted to you for care, I would say, is unethical. In the ‘midst’ of an emergency with any facility, what happened to your emergency evacuation plan… or did you have an emergency plan? What happened to residents’ rights, abuse and neglect?”
Education Coordinator, Cheryl Jackson-Golden, Davis Life Care, Pine Bluff, AR

“I do not believe that the owners should have been charged or found guilty. Long-term care facilities are at risk. There are few places that could instantly house that group of fragile citizens with only a few days at
most of preparations. Also, there are
no avenues to actually transport this population. Many would not survive the quick transfers. More importantly, there are few equipped vehicles
that could handle that number of population.”
Nursing Services Administrator, Yvonne English, Davis Health Care Center, Wilmington, NC

“I’m not sure what I think about the verdict, but one thing I know for certain is the director of nursing [Carol Hare] at Wesley Enhanced Living at Heritage Towers in Doylestown, PA, would have drowned trying to save our residents.”
Director Clinical Admissions & Case Management, Ruth Monaghan, Wesley Enhanced Living at Heritage Towers, Doylestown, PA

“It is very hard to make a honest evaluation of the event. What I do know is that as an administrator, my place is with my residents and staff, and that everything possible to provide safety must be achieved. It is unfair to judge, but let the facts determine the responsibility.
It would appear that the verdict was influenced by the need to support the money-making part of society and not the frail elderly that need and deserve our protection.”
Licensed Administrator, V. Jean Morris, Pataskala, OH