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).
With tougher standards, 48% of the state’s nursing homes—104 facilities—received a four- or five-star rating for staffing, data from the Centers for Medicare & Medicaid Services (CMS) show. Thirty-nine nursing homes (19%) earned a one- or two-star rating for staffing levels. Nursing Home Compare’s five-star system (5 being “much above average,” 4 “above average,” 3 “average,” 2 “below average” and 1 “much below average’) examines quality of care delivered, staffing and overall performance, among other factors. It gives consumers the ability to compare quality among facilities. CMS updated the rankings in April, following the release of new payroll data that gives insights into nursing home staffing trends.
Three years ago, Meredith Phillips’ mother, Georgia Svolos, fell and broke her kneecap, setting off a downward spiral that landed her in nursing homes on and off for a year. In one facility, she fell and broke her knee again, necessitating more surgery. All of the facilities were noisy and chaotic, and one smelled of feces. So, when Phillips learned recently about moves by the Trump administration to ease regulations and fines on nursing homes, she was alarmed. “I’m horrified and frightened,” says Phillips, who lives in Westbrook.
At the Fresh River Healthcare nursing home in East Windsor, the chance that a short-stay patient will end up back in the hospital within 30 days of arriving at the facility is less than eight percent. Meanwhile, 12 miles away at the Greensprings Healthcare and Rehabilitation nursing home in East Hartford, more than a third of patients who came from hospitals will be readmitted in 30 days. The wide swing in nursing home patients’ re-hospitalization rates has a lot to do with the condition patients are in when they are discharged from inpatient stays, as well as the planning that goes into the transition to other care. The federal government has been penalizing hospitals since 2012 for high rates of patients returning within 30 days of discharge. But now, nursing homes (or skilled nursing facilities) also are being held accountable for hospital readmissions.
State health officials have fined the operator of a Rocky Hill nursing home $5,000 and ordered it to hire an independent nursing consultant after finding dozens of violations, most of which involved the care of residents. Under the order, Apple Rehabilitation of Rocky Hill must hire an independent consultant who is a registered nurse. The consultant must be at the facility 32 hours per week and be on-site at various times during all three shifts. The consultant, who must be pre-approved by the state Department of Public Health (DPH), will work for at least six months to ensure “the safety, welfare and well-being of the residents” and to make sure the facility is obeying laws, the consent order said. The consultant is responsible for assessing, monitoring and evaluating direct resident care “with particular emphasis and focus on the delivery of nursing services,” according to the consent order.
A Wallingford nursing home has been fined $7,500 by the state Department of Public Health for numerous violations and has been ordered to hire a nurse consultant to monitor its care of residents. The nurse consultant will work for at least three months to ensure that sufficient nursing personnel are working at the Village Green of Wallingford Rehabilitation and Health Center, that residents are clean and comfortable, that doctors are notified of changes in residents’ conditions and that residents are free from abuse and neglect, records show. The nursing home, formerly known as Brook Hollow Health Care, signed a consent order April 13, agreeing to the fine in the wake of multiple violations that were found at Village Green during unannounced state inspections on Oct. 27 and Oct. 30, 2014.
Allowing the spouse of a person in a nursing home to keep enough money to live on independently is, in many ways, a moral issue. But in a tight budget year in Connecticut, it’s a fiscal issue. A proposal that would increase the minimum assets that a spouse living in the community can keep — from $23,844 to $50,000 – in order for his or her partner to be eligible for Medicaid nursing home care is being backed by elder advocates, who say the increase would help seniors, especially women, remain able to live independently. But the move is being opposed by the Department of Social Services on the grounds it will shift millions in costs to the state-funded Medicaid program. The proposal would affect couples with combined assets of between $23,844 and $100,000.