The Register Citizen (Torrington, CT)
Advocates: Who’s holding nursing homes accountable?
While many agree the no-visitor policy put in place in nursing homes in March has stemmed the spread of the new coronavirus, the rule means family members have lost the ability to monitor firsthand their loved one’s care.
Even ombudsmen, state advocates for patients and families, are barred from physically entering the facilities they serve.
The policy has some lawmakers and resident’s family members raising
concerns about the level of accountability and level of care in skilled nursing care facilities while there’s less in-person oversight.
“Most nursing homes provide exceptional care, and staff are risking their lives right now to do their jobs,” said Anna Doroghazi, associate state director of advocacy and outreach for AARP Connecticut. “That said, it’s concerning that people have fewer opportunities to communicate with people they trust and that there are fewer options for investigating complaints.”
State Sen. Marilyn Moore, D-Bridgeport, said what’s happening now could help her champion a bill she’s introduced in the past, but has never made it into law, that would put in place measures like adding cameras to nursing home rooms for more oversight.
“Now more than ever, I think we’ve got a chance of getting it,” Moore said.
Yet others argue the industry is under immense scrutiny since the pandemic began, as they continue reporting the highest infection and fatality rates in the state.
The state health department has a much more “aggressive” in-person approach to monitoring all nursing homes for infection control, “which wasn’t in place two months ago,” said state Rep. Jonathan Steinberg, D-Westport, co-chair of the Public Health Committee.
“Some of the union members are making sure that we know what the story is on the ground in these nursing homes,” he continued. “...Like in any industry there are good actors and bad actors…so you can’t treat them monolithically. You have to look at the circumstances for each one.
“So, I would challenge anybody to say that nursing homes are not very much under the spotlight at this point in the game,” he said.
More oversight already?
DPH officials are now entering nursing homes every 10 days, only for instances concerning infection control and “immediate jeopardy” related to COVID-19, said Mairead Painter, Connecticut’s longterm care ombudsman.
“In some ways, that’s more than they would have gone in, in the past,” said Painter, who oversees the Connecticut ombudsman program. “But (now), it’s for different reasons.”
The inspections began after members of a union representing nursing home workers raised concerns about infection control practices and what they said was a lack of personal protective equipment like masks and gloves. The National Guard joined health officials on the inspections several weeks ago.
Av Harris, a spokesman for the health department, said the inspections teams have already surveyed all 213 of the state’s nursing homes — some more than once.
While inspectors have been visiting nursing homes, Painter and eight regional ombudsmen in Connecticut have not been allowed into the facilities they are meant to watch over.
The federal government created the ombudsman program in 1972 after it became clear that abuse, neglect and substandard care existed in nursing homes across the country.
The long-term care industry had become unregulated and substandard care was widespread with no recourse to address violations of residents’ rights, safety, concerns and health, according to the National Long-Term Care Ombudsman Resource Center.
Ombudsmen advocate for residents of nursing homes, assisted living facilities and other adult care institutions and resolve the problems individual residents are facing. But they do not conduct licensing and regulatory inspections, nor do they perform adult protective services investigations.
Painter said she and her colleagues have increased their virtual and voice communications with residents and their families since March, using iPads to video chat with patients.
Painter also fields calls with families and patients through email, phone and social media daily from 7:30 a.m. to 8 p.m. She hosts a Facebook live event three times per week, which spurs a deluge of comments, questions and concerns from viewers, she said.
Social workers at nursing homes are also ensuring residents have contact information for Connecticut ombudsmen.
“I’ve been writing to residents and members as well each step of the way (since) it first started, when the restrictions went out,” Painter said.
“We have heard some buildings did not give my letter, which they’re not allowed to impede my access to the residents. So I have an independent representative from the attorney general’s office and I’ve had them make contact with the association to say, if my communication does not get through to the residents and family members, that that’s an interference with my office and there’s a fine for that,” Painter said.
Doroghazi, of AARP, Moore and family members of nursing home residents, are still skeptical of the current level of oversight in nursing homes while they remain closed to the public. But Painter said although it would be “great” if an individual could monitor nursing homes daily, it’s not possible.
Cameras inside
On May 15, Democratic lawmakers went on a tour, stopping outside 15 nursing homes across the state.
“We did it because we can’t get inside,” said Moore, chair of the Senate’s human services committee.
“We have heard from people, different things that were going on and we saw some people who were giving (different) statements about what was happening inside the nursing homes, and all we have is somebody’s word for what’s happening,” she said.
In 2017 and 2018, Moore advocated for a bill that would include installing cameras in the rooms of nursing home residents, to create more transparency, she said. Workers and loved ones of people living in nursing homes had requested the legislation, Moore added. But the bill never made it out of committee because some lawmakers said it would invade residents’ privacy, especially in instances where patients shared rooms.
On April 22, during a call with state commissioners and lawmakers, Moore suggested adding a compliance officer to monitor each public nursing home daily and create and organize programs like the cameras, if that bill passes in the future. The compliance officer would be independent and not a state employee, Moore said.
“I don’t want someone internal monitoring their own behaviors,” she said.
Painter said she is encouraging members of the public to contact her with complaints and concerns.
“Even though DPH can’t go in and investigate now, we still want it documented,” Painted said.
Connecticut ombudsmen can be reached at 1-866-3881888.