Long-term care industry: Confusion causing vaccine mandate violations
With more than $19 million in fines levied so far against Connecticut nursing homes, managed communities and and assisted living facilities for failing to comply with an order mandating COVID-19 vaccines, several organizations said the issues may come down to misunderstanding of the rules and communication problems.
State health officials said 101 of the 643 long-term care facilities face hefty daily fines because they have yet to report to the state whether their staffs are vaccinated.
The $19 million in fines as of Sunday stem from the start of November, when the state Department of Public Health began to issue cita
tions. Gov. Ned Lamont made the order for all staff, volunteers and contractors with direct access to residents in the facilities to be fully vaccinated, initially by Sept. 7, then by Sept. 27.
The facilities are not disregarding the rules, said Christopher Carter, president of the Connecticut Assisted Living Association.
“It is CALA’s strong belief that the overwhelming majority of instances where there is suspected under-reporting or non-reporting among senior living providers are due to confusion or miscommunication and not wanton disregard of the mandate,” said Carter, who also cited technical problems.
Carter went on to say that “most, if not all, senior living providers were either in full compliance...in advance of the deadline or at the time of the deadline.”
For 83 of those facilities and companies, which include nursing homes, managed residential communities and assisted living service agencies, the fine is $5,000 a day. For residential care homes, the fine is $500 a day, officials said.
Matt Barrett, president and chief executive officer of the Connecticut Association of Health Care Facilities and the Connecticut Center for Assisted Living, and Mag Morelli, president of LeadingAge Connecticut, said in a joint statement that early reporting errors may be reflective of a misunderstanding about the rules.
“Our associations are recommending state regulators take a balanced approach to evaluating a provider’s compliance with the executive order and to weigh more heavily the actual compliance with the policy goals of vaccination, rather than on delays or mistakes in reporting,” Barrett and Morelli said in th written statement.
When asked about these potential issues, the health departmnt said it was not aware of any technical problems in reporting.
“Facilities identified as ‘NonReporters’ will have the opportunity to contest the civil penalties and explain why they failed to report this information,” DPH spokesperson Christopher Boyle said. “We are entering a dangerous time of year from a COVID-19 standpoint and DPH needs the cooperation of the long-term care industry to help protect our most vulnerable citizens.”
Barrett and Morelli said early feedback they have received shows that some of the facilities are already appealing the fines.
DPH first issued fines against long-term care facilities in October, citing those that had reported but missed the deadline. Initially a group of 59 facilities, it was narrowed down to 26 when the state offered a seven-day grace period for the fines. At the time, DPH said it acknowledged the “challenges” in implementing the order.
However, no grace period was offered to the facilities that had not reported, according to DPH. The fines, which DPH started assessing on Nov. 1, were first issued last week, the department said.
DPH declined to release a list of facilities that have not reported to the state under the executive order, citing an active investigation as a reason for an exemption under state Freedom of Information rules.
These facilities were an early focus by the state’s vaccine rollout last December, given that COVID-19 had spread quickly through these facilities with a devastating toll. And while other states have opted for broader vaccine mandates, Lamont tailored his orders to limited groups — including workers for long-term care facilities.
Despite fines over reporting, Carter, Barrett and Morelli all said they believe that workers in these facilities have broadly been vaccinated.
“The numbers demonstrate overwhelming compliance with the vaccine policy objectives and that the few nursing homes fined are an outlier in what is clearly an enormously successful vaccine initiative,” Barrett and Morelli said in their statement, referencing a recent report showing that 95 percent of nursing home workers in Connecticut had been vaccinated.