LifeCare

LifeCare was a specialized long-term acute-care hospital organization whose patients and staff became part of the evacuation crisis at Memorial Medical Center during Hurricane Katrina. Its patients often needed ventilators, dialysis, or extended rehabilitation, and its leaders had to coordinate across separate campuses while the city’s transport and communications systems faltered. At Memorial, LifeCare’s efforts to get its patients evacuated met a competing hospital priority; later, the staff’s actions and testimony were caught up in the dispute over how the patients had been cared for and why some died.

Organization and Patients

LifeCare operated multiple campuses in the New Orleans area, including a single-story hospital on Virtue Street in Chalmette, in St. Bernard Parish, and leased space on an upper floor of Memorial Medical Center. The latter was a hospital within a hospital: LifeCare occupied three long corridors on Memorial’s seventh floor, while Memorial’s marketing department used the eastern corridor. The arrangement placed two distinct institutions under one roof without making them a single organization.

LifeCare maintained its own administrators, nurses, pharmacists, and supply chain. Its patients were often elderly or seriously debilitated and needed prolonged treatment, including mechanical ventilation. Rehabilitation was intended to help some regain the ability to breathe independently and return home or to a nursing facility. LifeCare was not a hospice, a distinction that mattered in the later dispute over the care and medication of its patients.

Gina Isbell, LifeCare’s nursing director at the Chalmette campus, moved among rooms and nursing stations at Memorial when patients were transferred there. She checked that they were registered and settled, and kept in contact with relatives, including the daughter of ninety-year-old Alice Hutzler, whom she knew from repeated admissions and called Miss Alice. The account presents the transfer not just as movement between facilities, but as a disruption to familiar care relationships: patients arrived with their illnesses and dependencies, while staff tried to restore some continuity in unfamiliar rooms.

Preparing to Move Patients

Before the storm, LifeCare’s leaders weighed whether to move patients from the exposed Chalmette building preemptively. The decision involved two kinds of risk: transporting very sick people if the danger proved to be a false alarm, or leaving them in a low-lying location if the forecasts were right and floodwaters rose over the roof. The organization decided to move most of its St. Bernard patients to its Memorial campus and the remainder to another nearby hospital.

The move concentrated a substantial group of LifeCare patients on Memorial’s seventh floor. As the emergency developed, its staff had to manage not only care there but also the needs of patients at another LifeCare campus near the New Orleans airport. Diane Robichaux, an assistant administrator seven months pregnant, had taken on the incident-command role for LifeCare’s New Orleans hospitals so the senior administrator could leave the city with his family, including a child with special needs. With backup power and limited telephone and internet service, Robichaux attempted to coordinate the separate facilities under increasingly difficult conditions.

Memorial’s leaders told Robichaux that the helipad was operational and that LifeCare could use it for helicopter landings. She relayed that information through a chat connection to Robbye Dubois, LifeCare’s senior vice president for clinical services, in Shreveport, and sent her a list of fifty-three LifeCare patients still needing evacuation from Memorial. Two of the original fifty-five had died. Seven of the remaining patients relied on ventilators, one used an assisted-breathing device, and five needed dialysis. These figures made the scale and medical complexity of the evacuation concrete: the patients could not simply be moved as a single, interchangeable group.

Evacuation Priorities at Memorial

LifeCare’s plans depended in part on access to evacuation arranged at Memorial, but the institutions’ priorities did not align. Robichaux was told that Memorial would evacuate its own patients first, beginning with the critical patients and then moving others. In practice, the message meant that even Memorial patients who were less sick would be prioritized ahead of LifeCare’s generally very ill patients. The distinction was organizational as well as clinical: LifeCare was responsible for its patients, yet the available evacuation sequence was being set within the larger hospital where its unit was located.

The crisis also exposed how hard it was for LifeCare staff to make their attempts legible to outside decision-makers. Later, when a grand jury considered the case, jurors were described as assuming that LifeCare staff had failed to care for or evacuate their patients. The evidence that could have complicated that impression—including communications among staff inside and outside the hospital about arranging evacuation, and the confusing messages from Memorial—was not presented to the jurors, according to a draft letter from the attorney general. LifeCare employees and administrators had given statements voluntarily, but the draft letter said they had not been called to testify about their efforts or the directions they had received from Memorial staff.

At the final grand-jury meeting, assistant administrator Robichaux and nurse executive Therese Mendez did testify. Mendez said that Anna Pou came upstairs, assumed responsibility for the patients, and said they would receive a lethal dose of drugs. Neither Mendez nor Robichaux saw what followed: they had left to clear LifeCare staff from the floor. Their testimony therefore recorded both what they reported hearing and the limits of what they had personally witnessed. That distinction became important in a case where LifeCare’s role in evacuation, patient care, and the later medication controversy was being assessed through incomplete accounts.

Care, Loss, and Staff Consequences

The record of LifeCare’s work also includes the care patients received from relatives and staff under conditions where ordinary resources were unavailable. Angela McManus, exhausted and anxious about a sibling living near the levees, cared for her mother, Wilda, by feeding her through a tube, changing her colostomy bag, and helping arrange a wipe-down and wound-dressing change when there was no running water. Angela talked, sang, and prayed with her. Before the storm, LifeCare staff had joined Wilda’s prayer sessions, which they called church. The episode shows how caregiving on the unit could extend beyond formal procedures, even as staff and families struggled to meet basic needs.

The aftermath was not limited to the patients’ deaths or the investigations. Cheri Landry told a colleague that losing her job had been worse for her than losing everything she owned, and wondered whether she and Lori Budo would ever be able to work as nurses again. Tenet continued to pay the nurses’ legal fees, but Landry and Budo lacked the university positions Anna Pou could return to if they could not practice clinically. Landry had lost her home and was caring for her ill mother; Budo was the principal breadwinner for a family with two children in college. Mortgages, rent, and car loans continued while their professional futures were uncertain.

Institutional Contrast and Significance

The account sets LifeCare’s experience within a wider contrast among New Orleans hospitals. Charity Hospital, the public hospital, faced flooding, loss of power and basic services, no helipad, and no corporate overseers. It took until the afternoon of September 2 to transfer all its patients, a day later than the transfer at Memorial, despite having about twice as many patients across its two campuses and fewer staff per patient. Fewer than ten patients died there. Its staff had drilled for a Category Three hurricane and levee failure, obtained portable generators, oxygen-powered ventilators, and a ham radio with federal preparedness funds, and trained security officers for disasters. Workers also held frequent all-staff meetings, staged a flashlight talent show, painted, and laughed as ways to sustain morale. They siphoned car fuel to run ten portable generators that powered intensive-care ventilators and cardiac monitors, including those keeping a very premature baby alive.

That comparison sharpened the questions raised by LifeCare’s position at Memorial. Charity’s preparations and improvised use of generators contrasted with Memorial’s use of hand-operated Ambu-bags after its power failed; two similar generators there were later used for lights and fans in common areas and at the helipad, rather than for medical equipment. The comparison does not erase the different circumstances of the hospitals, but it shows how preparation, equipment, staffing, and control of evacuation resources could shape what care remained possible.

LifeCare’s story thus joins a practical organizational problem to a contested moral and legal one. Its separate facilities had to be coordinated across weak communications; its patients’ medical dependencies made evacuation urgent and difficult; and at Memorial, its responsibility for those patients did not give it control of the hospital’s evacuation order. The later scrutiny of its staff was shaped in turn by what evidence reached investigators and what did not. In a later account of disaster response, the reporter observed a nonprofit hospital parent company using a highly organized local command center to provide proactive assistance to its own hospitals and others in the region, in contrast to the support Tenet and LifeCare headquarters had provided during Katrina. The comparison places LifeCare within a larger institutional question: how much a hospital’s ability to protect patients depends on coordination and preparation beyond the bedside.