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Now the feds are entering the investigation into the LA nursing home deaths.

WASHINGTON — Federal investigators said Thursday that they have joined a Louisiana probe of nursing home deaths during Hurricane Katrina, as the government begins considering stronger requirements to protect patients in health-care facilities during natural disasters.

Industry officials, however, say the deaths were tragic exceptions in chaotic circumstances under which most facilities carried out their duties, some heroically.

The inspector general’s office in the U.S. Department of Health and Human Services said it was assisting the investigation of 34 deaths at St. Rita’s Nursing Home in St. Bernard Parish. State authorities have charged the owners of the home with 34 counts of negligent homicide for allegedly ignoring requests to evacuate.

“This office is tremendously concerned about the possible abuse and neglect of hospital patients and nursing home residents,” Inspector General Daniel Levinson wrote to Sen. Charles Grassley (R-Iowa) in a letter released Thursday. Grassley has also asked for a Justice Department investigation.

Every nursing home has to have disaster plans in place. Detailed plans. It’s part of the Life Safety Code each facility must pass in order to continue receiving federal funds.

Separately, officials of the department — which, through Medicare and Medicaid, is the nation’s largest payer for hospital and nursing home care–said they would consider a broad range of actions to prevent such deaths in the future.

“I think only Rip Van Winkle would be able to ignore the wake-up call that Hurricane Katrina offers with regard to emergency preparedness,” said Thomas Hamilton, director of the Health and Human Services office that sets standards for health-care facilities.

Responsibility for oversight of health-care facilities is shared by state and federal agencies as well as by independent professional organizations that issue accreditation. Washington generally plays a secondary role to state regulators.

In the St. Rita’s probe, federal investigators will be examining whether the nursing home fulfilled its duty of care under Medicaid regulations. Possible penalties include barring the nursing home owners from billing Medicaid and Medicare, which is tantamount to exile from the health-care marketplace.

Federal regulations require nursing homes to have an evacuation plan tailored to local conditions, to train their staffs and to periodically practice the plan. Nursing homes say they often have to bear the cost of evacuations, which can run to tens of thousands of dollars. But the government says many have insurance to cover it and Medicare also helps pay ambulance transportation for residents.