Nursing homes face double-edged sword

High complaint levels show process for improvement works, industry expert says

officer of the Connecticut Association of Health Care Facilities, a trade association of 150 skilled nursing home member facilities, said he wasn’t surprised by the Centers for Medicare and Medicaid Services data.

“Connecticut’s nursing home culture is one that encourages airing nursing home resident grievances as a key part of ongoing quality improvement,” Barrett said. “It follows that CMS data shows evidence that nursing homes have a healthy grievance process with higher than average complaints.”

Staffers at Connecticut nursing homes receive annual resident rights training, he said. All nursing homes have grievance reporting policies and almost all nursing homes have resident councils where nursing home residents themselves bring concerns about their care to nursing home administrators, according to Barrett.

“All Connecticut nursing home post in a conspicuous place in the facility information on how to lodge formal complaints to state regulators and the long term care ombudsman,” he said.

The Centers for Medicare and Medicaid Services rates all nursing homes with a star system that gives five to the best facilities and one to the worst.

Connecticut has the 13th-highest percentage of nursing homes with fivestar ratings with 28.70 percent. Just 13.5 percent of the state’s nursing homes had one-star rankings, which puts Connecticut 32nd out of 50 states.

“The very same nursing home culture, regulatory oversight, and resident rights protections also explains why Connecticut nursing homes consistently score higher on quality measures, staffing and annual survey results, which is also very clear in the CMS data,” Barrett said.

If nursing homes aren’t in compliance with federal guidelines, the Centers for Medicare and Medicaid Services can issue fines. Connecticut nursing homes paid fines totaling $487,403 in the last 12 months, which puts the state 25th nationally.

The latest nursing home data is being played out against backdrop where even as members of the baby boom generation continue aging, the number of nursing homes around the country and in Connecticut is shrinking.

The number of nursing homes decreased by 4.5 percent nationally between 1995 and 2016. During the same period in Connecticut, nursing home levels declined by 15.7 percent, according to data from the National Center for Health Statistics.

During the same period, the number of nursing home residents nationally fell by 8.9 percent compared to a 22.4 percent decline in Connecticut nursing home residents between 1995 and 2016.