Greenwich Time

Nursing homes would see major staffing, transparen­cy changes under proposal

- By Dave Altimari and Jenna Carlesso

Lawmakers have introduced an ambitious and wide-ranging bill to address what they describe as deficienci­es across the state’s more than 200 nursing homes, which are struggling to staff their facilities and keep up with inflation.

The measure would boost the mandatory minimum staffing hours — time that a nurse or certified nursing assistant spends directly with a resident — from 3 to 4.1 per person each day, a level that nursing home representa­tives said will be difficult to meet.

From February 2020 to December 2022, the nursing home industry lost 210,000 jobs nationally, and staffing fell to levels not seen since 1994, officials with the American Health Care Associatio­n and National Center for Assisted Living have said.

Facilities added an average of 3,700 jobs per month over the last nine months. At the current pace, staffing would not return to pre-pandemic levels until 2027, AHCA noted.

The bill also would require nursing home operators to provide greater transparen­cy in their annual spending. Beginning this year, the operators would have to submit narrative summaries of expenditur­es along with the cost reports they already must file.

By January 2024, the state’s social services commission­er would have to post links to yearly cost reports and the plain-language explanatio­ns prominentl­y on the department’s website and include comparison­s between nursing homes’ spending and summaries of the average reported expenditur­es by facility. The operators must also provide a glossary and explanatio­n of the terms they use.

Nursing homes that fail to do so may be fined as much as $10,000 for each violation.

In addition, if a private equity firm owns any portion of the nursing home, operators would be required to disclose the name of the firm’s investment advisor and a copy of the most recent quarterly statement to investors, including any fees and expenses and the performanc­e of the firm.

“Private equity firms and owners who prioritize profits over people have had a devastatin­g impact on the lives of residents and the overall quality of care in these facilities,” said Mairead Painter, Connecticu­t’s long-term care ombudswoma­n, at a press conference Friday. “Poor staffing levels, impacted by inadequate wages and a lack of maintenanc­e to these facilities, has resulted in subpar living conditions and substandar­d care for those who need it most.”

Under the bill, nursing homes that fail to comply with staffing level mandates must pay the civil penalties imposed within seven days of the violation and must use funds from management fees or money assigned for administra­tive or general costs.

The measure also requires chronic and convalesce­nt nursing homes and rest homes to provide air conditioni­ng in all resident rooms. A revolving loan fund would be created to cover the expense.

“It is unacceptab­le to see residents who are ill and unable to get out of bed to get a drink go without air conditioni­ng in the summer,” Painter said. “Then when we go in to respond to the calls for help and investigat­e these types of issues, we often find management staff in air-conditione­d offices while the residents suffer.

“This is not the longterm care system that residents deserve or that we as taxpayers have paid for.”

John Balisciano, a resident at Apple Rehab Hewitt in Shelton, said there are not enough staff members on hand at his nursing home to fully care for residents.

“It becomes difficult for us to receive the care and attention we need to live with dignity and independen­ce,” he said Friday. “I have heard from my peers about the difficulti­es they face when it comes to completing their activities of daily living, such as getting up out of bed, getting showered or getting assistance to the bathroom.

“One particular instance that stands out to me was when a resident waited for two hours to be assisted onto the toilet. This is not an uncommon complaint. Can you imagine the embarrassm­ent and discomfort individual­s must have felt during that time? This is just one example of the challenges residents face when there are staffing limitation­s.”

In Connecticu­t, understaff­ing has led to widespread problems in some facilities. Athena, one of the largest long-term care providers in the state, has come under the scrutiny of officials in three New England states after receiving consistent complaints about conditions in its nursing homes.

An Athena facility in Newtown recently received a designatio­n of immediate jeopardy, meaning violations in the home caused or were likely to cause serious injury or death to a resident.

Inspectors with the state Department of Public Health concluded the facility failed to provide adequate staffing levels to ensure residents received timely care, resulting in neglect to 20 residents they observed. Athena corrected the issues and the order was lifted after two days.

“As our state officials begin to debate meaningful action to ensure Connecticu­t’s older adults and families have access to quality aging services and nursing home care, LeadingAge Connecticu­t stands ready to work in partnershi­p in this effort,” Mag Morelli, president of LeadingAge Connecticu­t, said in statement Friday. “On behalf of our nonprofit, missiondri­ven members, it is imperative that during this time of severe workforce shortages, we prioritize workforce developmen­t and adequate Medicaid and Medicare reimbursem­ent.

“This is how we ensure that, as providers, we have the resources available to serve the growing number of older adults who are in need of aging services, support and long-term care.”

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