In states where Medicaid was expanded under the Affordable Care Act (ACA), women are more likely to receive breast cancer diagnoses at an early stage, compared with women in other states, new research shows. Among women younger than 50, the average rate of diagnosis at advanced stages lowered from 23% to 21% between 2012-13 (before most states expanded Medicaid) and 2015-16 (after expansion), according to a Yale Cancer Center study published today in JAMA Surgery. In states where Medicaid wasn’t expanded, the average rate of advanced-stage diagnoses stayed constant at 26% during those years. “It’s a small percentage change [in expansion states] but it was statistically significant,” said Dr. Tristen Park, senior author of the study and a breast cancer surgeon at the Yale Cancer Center and Smilow Cancer Hospital, especially since the drop was evident over just a few years. “It’s quite exciting.
Families with loved ones in nursing homes–unable to visit while getting frustratingly sparse information about them–have found a champion in Mairead Painter. Painter, the state’s long term care ombudsman, who works for the state Department of Aging and Disability Services, launched live chat sessions on Facebook that quickly evolved into a real-time information pipeline for families. “I was trying to think about how we can reach people. Normally, residents and family members are sometimes the last people to get information,” said Painter, whose office is independent of the state Department of Public Health. “I wasn’t sure anybody would join [the chats].
The state has fined six nursing homes for violations that jeopardized residents’ safety, including an incident in which resident with Alzheimer’s was found dead outside a facility in Wallingford. The facilities were fined by the state Department of Public Health (DPH) for violations that occurred between September 2019 and February 2020. Skyview Rehab and Nursing of Wallingford was fined $10,000 after a resident with Alzheimer’s disease left the facility in January and was found dead about 50 feet from the facility, DPH said. Staff noticed the resident was missing at 7:30 a.m. on Jan. 26, and the resident was found at 8:46 a.m., DPH reported.
As cases of COVID-19 surged throughout Connecticut and the nation, “a perfect storm” of circumstances rendered nursing homes unable to handle the crisis, hastening the virus’ spread and deaths, experts say. “It’s just kind of this perfect storm. It’s just the nature of the beast. This is the worst situation for a virus like this,” said Dr. David Hill, professor of medical science and director of global public health at Quinnipiac University Frank H. Netter MD School of Medicine. Indeed, nursing homes care for an extremely frail population, many with underlying health conditions.
The COVID-19 pandemic will likely result in a “huge paradigm shift” toward in-home dialysis treatments in the future, experts predict. Home “is the safest place for them to be,” said Dr. Holly Kramer, president of the National Kidney Foundation and a practicing nephrologist. In times like this, immunocompromised individuals are at increased risk of becoming ill. Roughly 85% of dialysis patients get their treatments in centers—often three days a week, and typically for several hours at a time—where other dialysis patients also are being treated, she said. Before the COVID-19 outbreak, nephrologists nationwide were urging a growing number of patients to consider at-home care, she said, and the pandemic “will push things much, much faster” in that direction.
Despite strengthened care protocols and improved infection-control practices in Connecticut and throughout the country, nursing homes have been unable to stem the rise in COVID-19 cases. The two Connecticut nursing homes with reported cases of COVID-19 – Evergreen Health Center in Stafford Springs and Sharon Health Care Center – are operated by Farmington-based Athena Health Care Systems, which also owns facilities in Massachusetts and Rhode Island. Two residents at Evergreen Health Center have died from the infection; and the number of residents with the COVID-19 rose to eight this week. At Sharon Health Care Center, one resident contracted the virus and is quarantined along with the resident’s roommate, as of mid-week. About once a year, nursing facilities are inspected and rated on staffing levels and the quality of care provided to residents, including how well they prevent infections.
Social distancing is one way to curb the spread of the coronavirus, but for health care workers who provide care in people’s homes, especially for the elderly, that type of care brings heightened risks, experts say. Home health workers assist clients with daily tasks like bathing, dressing, toileting, walking and transferring out of bed; all things that require them to be extremely close to those they serve. In many cases, they also shop for groceries and pick up prescriptions and other necessities. It’s a challenging time, but home health workers are committed to delivering quality care, said Pedro Zayas, spokesman for the SEIU Healthcare 1199 NE, which represents more than 5,000 independent personal care attendants. “Our providers are people who went into this field because they like caring for others,” he said, adding that caregivers are diligent about self-monitoring for fever and other symptoms.
Cases of the highly contagious coronavirus continue to spike in Connecticut and nationally, with elderly people being particularly susceptible.
As coronavirus cases increase, posing heightened risks to the elderly, nursing homes will face growing scrutiny from state health inspectors. In Connecticut and nationally, complying with federal infection-control requirements is a challenge for some nursing homes. Between 2017 and 2019, 145 of Connecticut’s 217 nursing homes – or about 67 percent – were cited for infection-control violations, according to a Conn. Health I-Team analysis of data from the Centers for Medicare & Medicaid Services (CMS). (View list of nursing homes cited below).
Four nursing homes have been fined by the state Department of Public Health (DPH) for various violations that jeopardized residents’ safety or caused injuries. Western Rehabilitation Care Center in Danbury was fined $10,000 following several incidents. On Nov. 15, 2019, a licensed practical nurse (LPN) mistakenly discharged a resident with another resident’s medications. The error was realized on Nov.
Six nursing homes have been fined by the state Department of Public Health (DPH) for violations that endangered or injured residents. Apple Rehab West Haven was fined $6,960 after a resident reported being sexually assaulted by a visitor. On Oct. 2, 2018, a licensed practical nurse (LPN) saw the resident and a male visitor naked in the resident’s room, and the resident told the LPN they’d just had sex, according to DPH. The LPN asked the resident several times if she was alright and the resident replied that the male was her boyfriend.