In 2018, the state took the unusual step of issuing a consent order requiring a New Haven nursing home to hire an independent nurse consultant and implement minimum staffing ratios after inspections at the facility uncovered numerous lapses in care and safety violations. The order, agreed to in April by the Advanced Center for Nursing and Rehabilitation and the state Department of Public Health (DPH), tasked the independent nurse consultant with assessing the staff’s ability to do their jobs and evaluating how care is delivered. The minimum staffing ratios ordered are 30 patients to one licensed nurse on all shifts, on most units; 10 patients to one nurse’s aide on the first shift; 12 patients to one nurse’s aide on the second shift; and 20 patients to one nurse’s aide on the third shift. Officials at the facility didn’t return calls seeking comment. It isn’t often that DPH mandates staffing or requires nursing homes to hire consultants, but the order reflects a broader emerging problem affecting the care provided at many nursing homes: insufficient staffing levels and caregivers who lack training.
Most Connecticut nursing homes will see their Medicare reimbursements reduced in the coming year for having high resident readmission rates to hospitals. Of Connecticut’s 224 nursing homes, 75 percent (168) are being penalized by Medicare based on how often their residents were re-hospitalized within 30 days of discharge. Twenty-five percent (56) in Connecticut are receiving bonuses for having few readmissions, according to a Kaiser Health News (KHN) analysis of data from the Centers for Medicare and Medicaid Services (CMS). This is the first time nursing homes are being penalized or rewarded based on how many of their residents are readmitted to hospitals for conditions that could have been prevented. Medicare has administered a similar program for hospitals since the 2013 fiscal year.
Consumers will have the shortest open enrollment period yet to shop for 2019 health insurance plans – 45 days — but they can “window shop” and compare plans beginning today. Open enrollment for health plans effective Jan. 1, 2019, will run from Nov. 1 to Dec. 15, giving consumers the least amount of time to enroll in or renew plans since the Affordable Care Act (ACA) became law.
Most Connecticut hospitals will lose a portion of their Medicare reimbursement payments over the next year as penalties for having high rates of patients being readmitted, new data from the Centers for Medicare & Medicaid Services (CMS) show. Statewide, 27 of the 29 hospitals evaluated—or 93 percent—will be penalized in the 2019 fiscal year that began Oct. 1, according to a Kaiser Health News analysis of CMS data. The Medicare program has penalized hospitals since the 2013 fiscal year for having high rates of patients who are readmitted within a month of being discharged. Nationally, hospitals will lose $566 million in penalties, which were instituted as part of the Affordable Care Act to encourage better health care delivery.
Various violations that jeopardized patient safety, including two that preceded patient deaths and several involving the improper use of restraints, have taken place at Connecticut hospitals, according to the most recent hospital inspection reports released by the state Department of Public Health (DPH). The reports, which can be found in C-HIT’s Data Mine section, cover inspections that took place at hospitals between 2016 and this year. Some of the violations resulted in injuries to patients, while others showed lapses in protocols and procedures. Bridgeport Hospital was cited for 26 violations, including an incident in which a patient with a diagnosis of an ovarian mass suffered a burn during surgery. Hartford Hospital was cited for 60 violations, including two violations that preceded patient deaths.
Cancers linked to the human papillomavirus (HPV) rose dramatically in a 15-year period, even as the rates of young people being vaccinated climbed, the Centers for Disease Control and Prevention (CDC) reported. The 43,371 new cases of HPV-associated cancers reported nationwide in 2015 marked a 44 percent jump from the 30,115 cases reported in 1999, according to a CDC analysis. HPV vaccination rates have improved over the years, but not fast enough to stem the rise in cancers, the CDC said. Oropharyngeal (throat) cancer was the most common HPV-associated cancer in 2015; accounting for 15,479 cases among males and 3,438 among females, the CDC data show. HPV infects about 14 million people each year and between 1999 and 2015 rates of oropharyngeal (throat) and vulvar cancer increased, vaginal and cervical cancer rates declined, and penile cancer rates were stable, according to the CDC.
Five Connecticut nursing homes have been fined for violations that jeopardized residents’ safety. The state Department of Public Health (DPH) fined Amberwoods of Farmington $9,060 following an incident in which a resident threatened to slit another resident’s throat with a butter knife. On Feb. 6, a resident with dementia and depression entered another resident’s room with a knife and made a threatening gesture to cut the resident’s neck with a butter knife and drink the blood, according to the DPH citation. A nurse aide in the room tried to take the knife but the resident put the knife under a cushion.
The state Department of Public Health (DPH) has fined four nursing homes following staff errors and lapses in care earlier this year. Gardner Heights Health Care Center in Shelton was fined $3,480 after a resident who was known to have difficulty swallowing choked on a lasagna noodle. The resident choked in a dining room on April 24. Staff performed the Heimlich maneuver several times with no success, according to DPH. When the resident subsequently was suctioned, a three-inch-long lasagna noodle was removed; the resident soon became more responsive, had improved color and began talking again.
Four Connecticut nursing homes have been fined by the state Department of Public Health (DPH) for various violations that hurt or endangered residents. Orchard Grove Specialty Care Center in Uncasville was fined $3,480 after a resident with multiple sclerosis developed severe blisters following a moist-heat treatment. On April 7, the resident had a fluid-filled blister that measured 8 by 6 centimeters on the right shoulder, as well as a red rash on the left shoulder. Two days later, the resident had “multiple areas of large fluid-filled blisters” on both shoulders that were oozing, according to the citation. An investigation found the blisters were caused by a treatment administered by an occupational therapist during which moist heat was applied with hydrocollator packs.
It’s a summer afternoon and parents with their young children have gathered to hear what a nutritionist with Women, Infants and Children (WIC) has to offer. They watch with intrigue as Mary Paige demonstrates how to make yogurt dots from frozen Greek yogurt and French fries from roasted parsnips and carrots. After a 10-minute demo in the WIC office at Yale New Haven Hospital’s Primary Care Center, Stephany Uriostegui of West Haven is sold. She can’t wait to try the recipes at home for her 10-month-old son and 5- and 7-year-old daughters. “I always buy the [yogurt dots] from Walmart,” she said.